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Bridging the gap: mapping and co-designing a physical activity pathway for the transition from inpatient to community mental health care
Benjamin P. Rigby1, Dan Steward1, Abbie Brayton2, Michael Clark3, Sarah-Jane Fenton4, Emily J. Oliver1, Philip Hodgson5,6
1: Population Health Sciences Institute, Newcastle University, United Kingdom; 2: Public contributor; 3: Care Policy and Evaluation Centre, London School of Economics and Politics; 4: Health Services Management Centre, University of Birmingham; 5: Adult Mental Health Services, Tees, Esk and Wear Valleys NHS Foundation Trust; 6: NIHR Patient Safety Research Collaboration, Newcastle University
Background: Transitions from inpatient to community mental health services are periods of acute vulnerability, marked by elevated risks, including of relapse and readmission. Although physical activity (PA) offers well-evidenced benefits for mental and physical health, provision of transitions-specific support remains fragmented and inconsistently embedded within discharge processes. This study aims to develop a codesigned PA support and referral pathway to enhance continuity of care, prevent deterioration, and reduce preventable readmissions.
Methods: This mixed-methods study comprises two work packages (WPs). WP1 conducts a national mapping survey of UK NHS Mental Health Trusts and community organisations, complemented by semi-structured interviews with practitioners, commissioners and PA providers, and lived experience workshops exploring transition journeys. Survey data will be analysed descriptively, while qualitative data will be examined using thematic framework analyses to identify barriers, enablers and gaps in current provision. WP2 employs structured, participatory codesign across three workshops, drawing on realist principles and systems thinking to refine pathway priorities, specify core components and develop a theory of change.
Results: This is an intervention development study and empirical findings are forthcoming (summer 2026). However, early mapping is expected to reveal substantial variation and fragmentation in transition-related PA provision, alongside mixed experiences among staff and service users. Developmental outputs will include priority pathway components, contextual contingencies and preliminary change mechanisms.
Conclusions: The project will deliver a prototype pathway suitable for refinement and feasibility testing. Anticipated implications include strengthened prevention-orientated practice, improved continuity of PA support following discharge, and actionable insights to inform scalable implementation.
