Mental Health Awareness Week 2024 – Movement for disabled people

Sport Wales Mums & sons, Sue and her son - left

Sue Williams is the Health Disability Activity Practitioner for Powys Teaching Health Board (PTHB). During Mental Health Awareness Week, with its 2024 theme of Movement for Mental Health, it seemed the perfect opportunity to find out more about her role and how the pathway can support disabled people on their way to better physical and mental wellbeing.

What is the Health Disability Activity Pathway?

The Health Disability Activity Pathway supports disabled people across the lifespan to become more physically active. The pathway has been created to enable health professionals to instigate referrals that support the signposting of disabled people to physical activities and sporting opportunities in the local community. This occurs using the expert knowledge of teams within Local Authorities. Moreover, the pathway can be used by anybody, not just healthcare professionals.

The referral and signposting process (which is not a medical referral), was rolled out nationally with Welsh Government funding in 2022 following a successful pilot project in Betsi Cadwaladr University Health Board (BCUHB). Notably, people can be referred to another scheme the National Exercise Referral Scheme (NERS) and also use the Health Disability Activity Pathway.

Health Disability Activity Pathway Process

Tell us more about your role as a Health Disability Activity Practitioner

I moved to this new role in PTHB in May 2022, having previously worked as a physiotherapist in BCUHB.

A major part of my role is delivering presentations about the pathway to staff groups and individuals who work with people with disabilities. I talk about the benefits of physical activity (including participation in sport). I also get the opportunity to attend conferences and events to promote the pathway and learn more about the opportunities available, particularly within local communities across PTHB, and to work on projects that help promote physical activity and its benefits.

Recently, I have also started co-delivering sessions to university physiotherapy courses with a colleague from Disability Sport Wales. I love that through this work we are also starting to embed engagement with the pathway from the very outset of health professionals' careers.

Volunteering at a Boccia event

What drew you to the role originally?

This role brings together my experience as a healthcare professional, and my passion for sport and physical activity, and their many benefits. Through many years of NHS community and inpatient work, I have gained an excellent understanding of the teams who work with patients whether this is NHS, Social Services or the Third Sector. 

I have taken part in sport and outdoor activities for most of my life, but not on a regular basis for several years while my children were growing up. When my son started playing hockey for our local hockey club, I gradually got drawn in. New starters were always welcomed (and still are) and another hockey mum and I started training. Very soon we were both playing in league matches. I never imagined I would return to competitive hockey at age 45, having last played on grass in school! I have experienced first-hand so many benefits of being active and being involved in a sports club; as a player, parent of a player, coach and committee member.

I’ve always been captivated and inspired by “the power of sport” in changing people’s lives whether through rehabilitation, bringing people together, the social impacts (individual and community) disability or masters sports for those aged 35 to 80+. Through the COVID-19 pandemic, I developed a growing interest in the benefits of blue and green outdoor spaces, in particular the positive impacts on mental health and wellbeing.

NHS Wales works closely with Disability Sport Wales and Local Authorities to provide this service. How does that work?

The pathway relies on collaborative working between Disability Sport Wales, the 22 Local Authorities, and their corresponding health boards. Each health board has a Practitioner in post who, as well as delivering training sessions, facilitates the links and relationships required to ensure the pathway is a success. Monthly partnership team meetings involving the Practitioners and relevant Disability Sport Wales team members is just one example of how this is achieved.

Wheelchair Fencing World Cup Cardiff 2024

Why is this project particularly innovative?

To the best of our knowledge this pathway, or anything remotely similar, does not exist in any of the other Home Countries, or indeed elsewhere in at least Europe. There is an overall pathway, but not as simple or purely focused on disability, in place in Scotland. The all-Wales pathway focuses on signposting disabled people and giving them the chance to explore and access opportunities they historically may not have been aware existed. It also aims to make the most of every contact to improve their knowledge around the benefits of physical activity and the options available. All of this is led by the underpinning aim of increasing physical activity (including sport participation) and decreasing healthcare resource use.

During the pilot project from 2013 to 2016 there were 560 signposts, with Disability Sport Wales reporting a 21% increase in physical activity levels in North Wales.

Who is eligible to receive support through the HDAP initiative? Is it All Age?

The pathway is for people with a wide range of impairments from age 2, but more opportunities are available from age 5. There is no upper age limit. Referrals for signposting can be made for all types of physical impairments including wheelchair users, sensory impairments, and intellectual impairments.

How are people referred into the pathway?

A form can be filled in with any healthcare professional/other or a self-referral can be made by an individual or their parent/guardian. The form is available on the HDAP website. Health Disability Activity Pathway | Disability Sport Wales + NHS Wales. The person referred or their parent/guardian will be contacted by a Sport Powys team member to arrange to discuss the referral. This is usually by phone. The conversation will aim to explore what the person is interested in and inform them of relevant opportunities. This is usually followed up with a further phone call or email.

Chartered Society of Physiotherapists' conference

Tell us more about the mental health benefits of getting involved in sport and physical activity

The benefits of physical activity for mental health and welling are well-established; both in terms of general wellbeing and their role in the management of specific conditions. Benefits range from improving mood and sleep; increasing motivation and focus, and increasing self-esteem and confidence; to reducing stress, tension and anxiety, and preventing the onset and managing the symptoms of depression. Importantly, getting involved in sport and opportunities to be physically active can also reduce loneliness by connecting people.

There is some great advice and information from Mind about the benefits of physical activity on your mental health.

It is important to remember that there are so many resources available online if someone is not quite ready to try out a new club or activity. In addition, people can be active in so many other ways such as walking and gardening. There are benefits to physical and mental wellbeing from volunteering at a club as well.

What might happen to people if they did not receive the right support?

The pathway is there to bridge a gap. Staff/volunteers working with people with disabilities might only know about 1 or 2 local opportunities. Therefore, without a conversation about physical activity the person may not be made aware of everything available and might miss out on the right club/opportunity for them.

When people find something that suits them, and that they enjoy, they are more likely to continue with it and therefore gain more benefits, more regularly, and long-term.

What are the main challenges of your role?

NHS pressures: this can have a significant impact as there is often a lack of time to fit in training with teams. The geographical size of Powys is another challenge: at an individual level, barriers to engagement in opportunities can be travel or that a certain activity happens in one part of Powys, or indeed regionally within Wales, but not in multiple locations.

Will and Rygbi Gogledd Cymru

Tell us about some of the most rewarding work you have done as a Health Disability Activity Practitioner

Without a doubt this is hearing about success stories: from people just trying a sport because of using the pathway, to being able to follow their journey. I met Will, who lives in mid Powys, last year after speaking with his physiotherapist. Will has a condition that has led to him having a curved spine, needing to use a wheelchair and only being able to walk short distances unaided. He had been playing wheelchair basketball since he was eight after being signposted to the N-able club in Newtown. 

Will then found that two people with the same condition as him were playing wheelchair rugby including Wales and GB’s Josh Williams. Despite not having the correct sport chair and there not being a club in Powys, Will was determined to start playing wheelchair rugby. With the support of his family and Mark Baines of GB Wheelchair Rugby, in the past 12 months, Will has been training with and playing for RGC (Rygbi Gogledd Cymru) Wheelchair Rugby team and continues to progress in the sport. He will admit to being very competitive, but Will loves the social aspects and enjoys being able to play these sports with his friends and family.

My role and work have also challenged my own knowledge and perceptions; for example, observing Boccia training sessions and competitions has allowed me to gain a deeper understanding to be able to promote the activity in a more informed way. Seeing physiotherapy students' perceptions change when they learn about and take part in Boccia in the sessions we run, has been very gratifying.

The hockey playing Williams family

When you’re not working how do you enjoy spending your time?

I live with my husband on a small holding where we keep sheep, so some of my spare time is spent helping with farmwork especially at lambing time. A big portion of my time is for hockey related activity; I play for Dysynni Hockey Club Ladies 2s, I am the vice-captain, and also the club secretary. I have been getting more involved in coaching, particularly with the junior goalkeepers, and I am leading on the work for our club to become Insport accredited (Insport is a Disability Sport Wales scheme, delivered with the support of Sport Wales, which recognises good work in creating inclusive opportunities).

My husband and 2 children also play hockey, so we enjoy going to the social hockey session together, watching and talking about hockey! I love watching sports-related documentaries - one of my favourites and a huge inspiration for me taking this job was “Take His Legs”; about comedian and TV presenter Adam Hills and the inclusive rugby team (Physical Disability Rugby League) he joined. “The documentary deals with issues of mental health, Post Traumatic Stress Syndrome, and the true impact of sport and teamwork in overcoming both physical and mental challenges.”

You can find out more about the Health Disability Activity Pathway on the website or contact Sue directly by email suzanne.williams15@wales.nhs.uk

Mental Health Awareness Week 2024 - Movement

Sue Newham jive dancing

The theme of this year’s Mental Health Awareness Week 

13 - 19 May 2024 is Movement - moving more for our mental health.

The Mental Health Foundation, the charity which has hosted the annual Mental Health Awareness Week since 2000, explains why Movement is the chosen theme:

“Being active is important for our mental health. But so many of us struggle to get enough exercise. We know there are many different reasons for this, so this Mental Health Awareness Week we want to help people to find moments for movement in their daily routines. Going for a walk in your neighbourhood, putting on your favourite music and dancing around the living room, chair exercises when you’re watching television – it all counts!”

Sometimes it is easy to come up with excuses as to why we can’t exercise - perhaps we’re too busy, too tired, think it’s too expensive, have bad experiences from previous attempts, feel embarrassed to join in with others and not sufficiently motivated to get active at home. We asked some of our PAVO colleagues (shown here in reverse alphabetical order) about their excuses not to exercise and how they overcame them.

Trish Varley - Finance Officer

My excuse is that I watch sooooo many exercise instruction videos on Pinterest, that I'm too tired to actually do the exercise!!

But my dog Rosie gets so fed up watching me watching exercise clips that the look on her face prompts me to do lots of walks along the Newtown river paths and the beach at Borth.

Trish Varley and Rosie

Sue Newham - County Development Officer, Making a Difference in Powys - Numeracy Grant Scheme (photo above)

My excuse would be that I am too busy to fit exercise in.

I have been going to jive classes in Caersws with Luv2jive for about a year now. I went initially because I was aware how little exercise I was getting, but it has taught me so much.

It has helped me to accept that being rubbish at something is an unavoidable part of getting better at it. It has helped me to get over feeling self conscious about what others might be thinking about me. The people are all really friendly, and we always have a laugh. People are there to dance, but they also support each other in many little ways. The final thing I have learnt is that I have to force myself off the sofa, no matter what the weather, or how busy the day, because jive is good for me, and I don't want to get out of the habit.

Sharon Healey

Sharon Healey - Head of Health, Wellbeing & Partnerships

My normal excuse is because I don't have the right coat or footwear. I love to walk but the weather over the winter months makes it very difficult to find the energy and motivation to get out for a walk.

I recently invested in a very good waterproof coat as the weather has been awful. To make me get out and walk I sign up to a month's walking challenges or set a challenge for myself on a walking app. This month I'm trying to do 12,000 steps a day whatever the weather. A normal day is 10,000 steps so I'm having to walk further each day to reach 12,000. Walking each day helps me unwind and switch off following a day in work. I'm fortunate I live in a beautiful part of Mid Wales with the Wye Valley walk on my doorstep. I have so many walking routes available.

Penny Tanner - Macmillan Community Connector

The best excuse is 'No Time!', 'So much to do!', 'Family!'

Schedule it in, write it in a diary or daily list or make a weekly timetable.

I joined a weight lifting group in January 2023. I felt the benefits for my mental and physical health immediately. Previously being a runner, lifting weights strengthened my joints and having over a year off running, I am now starting to run again. I wanted to train in the gym more often, to gain the benefits, but this meant more travelling to the local gym for me. 

Time then became an issue and the thought of travelling to the local gym wasn't so appealing, but thinking of the benefits to my bone health and the social aspect, I began making a plan, so on a Sunday I would look at the week ahead and schedule the gym in around other commitments, such as family and work and liaise with my gym buddy. Having a gym buddy is accountability and shares the travelling cost. 

 A major benefit for me was that you don't have to spend lots of sessions or time lifting weights, because the benefits on your mind and physical health continue after your session has finished and in your resting.

Louise Hardwick

Louise Hardwick - County Development Officer (Social Value)

My excuse: it's raining, I can't be bothered! I'll do it tomorrow!

I have always been an early bird, now as I’m approaching that certain age I am up before the larks! Rather than just sitting at home I started going out for little walks, this has then developed to trying to go out every single day before the sun has even appeared, catching that gorgeous sunrise if the weather permits! 

I've also joined our local yoga studio in town and have been going religiously since September last year, the difference it has made is crazy - feeling better about my flexibility, mobility and just general wellbeing. 

Walking, by myself!!, it's MY time, no family allowed on the morning walks (not that they would want to come as they're all still sound asleep!!) allows me time to decompress, clear my head, breathe and just appreciate those early morning sunrises, the peace and tranquility - aside from the birds chirping furiously away - and revelling in the gorgeous surrounds that we are privileged to live in. I do try and do a lunch time walk several times a week, packing my trainers in the car when in the office so there's no excuse - planning ahead - get that clothing set out the night before so there's not another reason not to do it, your body and mind will definitely thank you!!

Janet Walker

Janet Walker - Senior Officer Internal Services

I have chronic pain and I feel low and hopeless at times. When my condition was severe I had physiotherapy treatment from Rachel Kili Physiotherapy and I now go weekly to Simply Fit (movement and exercise in the countryside). If I am honest I don't always feel like going, especially if it's wet and cold which makes my condition worse. I have a million excuses - last week it was because the dog had an operation - but I know I feel better if I attend so I try not to miss the sessions. 

Everytime I roll up, fatigued and unmotivated - but after an hour of being in the company of supportive people (we all have our good and bad days) with a leader who is a qualified physiotherapist with a different philosophy from fitness instructors I feel amazing! 

This is not boot camp - it's movement for life at a pace that suits each person in the group - it has helped us all to understand why we need to move better as we are naturally designed and evolved to do and develop core strength and balance - so we can keep doing the things we love and that make us whoever we are, all packaged up with being out in nature. It's my lifeline and I am really grateful that my line manager enables me to work flexibly so I can attend.

Helen Johnson

Helen Johnson - Digital & Telephone Befriending Officer

Excuse - my leg doesn't work anymore…

After an episode of ill health I found myself reliant on others to leave the house. I experienced limited use of one of my legs. After 6 months or so of watching daytime TV I ventured into Ponthafren to their art classes. I quickly realised how socially isolated and lonely I had become. I felt broken and useless. Ponthafren offered me acceptance and gave me a purpose again. I volunteered there for 18 months, every shift growing in confidence and self worth.

After raising my mental health came the challenge of making my body useful again. Firstly I joined up to Race at Your Pace and set a goal of running 25 miles a month. I devised that I could do a sort of run on a mini trampoline at home by the bannister so I could hold it when I wobbled. I couldn't run and definitely not outside on uneven ground but I found a way to move myself safely and achieve this great goal. As you can see from the photo I completed 2 months before going onto my next challenge which was to swim the channel in a pool for Diabetes UK.

The first time I went into a pool after my illness my leg floated away from me. I had no control of it at all. I knew I wanted to get stronger again but had no idea that with persistence and hope I would be able to swim all those lengths. It took me months to complete but I did it.

By moving myself from the sofa into the outside world I was able to improve my mental health. I supported others which encouraged me and then I was able to face the journey back to physical health.

My advice would be - if you can't make a start for yourself, make it about supporting someone else.

Gareth Marston - Development Officer Shared Prosperity Fund Grant Scheme

Invariably the reason I don't exercise more revolves around Sunday mornings and a Ladies only session at Maldwyn Sports Centre.

When for various reasons I've got up early on the Saturday I tend to sleep in a bit on Sunday to compensate. Ideally unless we're doing anything on the Sunday I should have my second trip of the week to the gym however on Sunday there is a Ladies Only session from 1100 to 1200 which means I have to be there by 1015 at the latest which I often don't get up and dressed in time for!

If the weather gets better! I will have the garden to work on this summer as an alternative and get out in the fresh air and get my steps up instead of the gym. I also walk to and from work at the PAVO Plas Dolerw office twice a week.

Claire Sterry

Claire Sterry - Senior Officer Third Sector Development

Every excuse under the sun for not exercising previously! it's raining, I'll do it tomorrow etc, etc, etc….

Now I've joined the local leisure centre as a member, so I want my money's worth so I'm doing swimming, aquafit, konga every week, as well as walking the dog.

Also joined a Garmin step challenge with my new friends I've made from going to exercise classes (an unexpected bonus) - so I go for a walk around my estate in the morning before work to get my steps in. I'll also park at the far end of the supermarket car park, and walk up and down all the aisles, whether I need anything from them or not.

The Garmin is a really good motivator as you can join challenges etc. to get you moving.

Exercise has made a massive difference to my mental health - if I'm feeling low or anxious, or just need to clear my head, it lifts me up and rebalances me. It's also helped me lose 3 stone along with using the Noom app - so physically feeling much better too. It's been a real life changer for me.

Clair Swales walking (and dancing with her daughter)

Clair Swales - Chief Executive Officer

This happened to me just yesterday! I was pushing myself to go for a walk (I set myself a target of walking everyday in April after a particularly unwell period and being rather sedentary).

My excuse: I couldn't get my earphones to connect to my phone and as such couldn't listen to a podcast. So I promptly took my coat and trainers off and sat back on the sofa, with the tv playing some awful programme and mindlessly scrolling through social media on my phone at the same time.

I had to kick myself up the bum and later that day force myself to go for a walk after I had fixed my earphones - no more excuses once they were fixed! Trouble was had I gone when I was originally going, it would have been sunny but instead I got soaked! Walking is great for my mental and physical health. Getting some fresh air in the lungs, taking in the sights and sounds of a country walk, being with my dog all help me to clear my mind of work and tasks.

Update: I managed to walk over 62 miles in April and go dancing! Having a daily walk as a focus has really helped to improve my mental health and wellbeing. In February and March I had been quite poorly but getting outside has helped significantly. Never one to say no to a challenge I am now taking on a fundraising walk this Sunday with Hay football club and walking 23 miles from Hereford to Hay.

Thank you to PAVO colleagues for their wonderful contributions! 

You can find out more about the connection between physical activity and mental health 

on this Mind website page.