Title: The Benefits of Physical Activity and Wellness Education for Clients Diagnosed with A Mental Illness. Project Lead: Michele Van Bibber, Winona State University Health & Physical Education Student Kimberly Borcherding, Senior Case Worker, Thresholds, Woodstock, Illinois

Ms. Melodee Justen Proposals Co-Chair MHRL for McHenry County P.O. Box 204 McHenry, Illinois 60051 Dear Ms. Justen: The Thresholds Organization is respectfully requesting a grant in the amount of for a project that helps the clients participate in physical activity. Thresholds is a organization that serves many people diagnosed with a mental illness to overcome their struggle in order to lead every day lives by themselves. The problem exists in that there is currently no funding for the physical aspect of the clients prescription plan and most of the treatment these clients are receiving is emotional and medicated treatments. This program that is piloting for the first time with help these clients to (1) gain knowledge on physical activity and wellness practices in order to better their physical self and (2) help them to become more physically active in order to naturally medicate their mental health issues they are facing. All of the clients enrolled at Thresholds would be using the requested funds in order to receive fitness memberships at a local facility in order to encourage and allow them the opportunity to participate in the program. Should we find at the end of our pilot year that this program is in fact successful, I would hope that we could repeat the funding money in order to keep these individuals healthy throughout multiple aspects of their lives; socially, mentally, physically. Thank you for your consideration of our request. I will follow up with you in the next week to answer any questions you might have, as well as to learn whether there is a possibility of meeting with you to discuss the merits of our proposal. Should you have any questions in the interim, please feel free to contact Kimberly Borcherding, the project lead at Thresholds, at (815) 715 – 1810 or myself at (507) 429 – 5739. Sincerely,

Michele

EXECUTIVE SUMMARY

Even though the psychological benefits from regular exercise are well known, researchers have only recently begun to examine the impact of physical activity on the mental and physical health of individuals with serious mental illness. The use of physical activity to promote both mental and physical health among individuals with serious mental illness is a new idea. In the general population, a strong relationship has been found between physical activity and mental health as well as between physical activity and physical health. According to the American Psychiatric Association, “People who have serious mental illness, including major depression, schizophrenia, and bipolar disorder, often have poor physical health and experience significant psychiatric, social, and cognitive disability. Physical activity has the potential to improve the quality of life of people with serious mental illness through two routes – by improving physical health and by alleviating psychiatric and social disability” (Richardson, 2005). According to the U.S. Department of Health and Human Services, an estimated 26.2 percents of Americans ages 18 and older suffer from a diagnosable mental illness in a given year; this is about one in four adults. This can translate to nearly 57.7 million people in a given year. In McHenry County, Illinois, Thresholds Mental Illness Agency has been working with diagnosed mental illness patients for over 50 years. The clients funded through the State of Illinois through Thresholds are lacking in federal funding. The state of Illinois has been in a serious crisis in relation to funding these specific programs to mental health clients. Cuts from the Illinois Department of Human Services estimate that $71 million for mental health divisions and substance abuse programs have had their funding cut in order to help the State of Illinois out of it’s debt. A spokesperson from the Public and Mental Health Board stated that, “This is a public health crisis. Proposed cuts to behavioral health greatly affect public health and to cut back on treatment is detrimental.” According to Thresholds Agency, their mission for each of their clients is to, “Assist and inspire people with severe mental illnesses to reclaim their lives by providing supports, skills, and the respectful encouragement that they need to achieve hopeful and successful futures” (Thresholds, 2009). This first begins with helping those clients to regain control of their lives, both mentally and physically. A treatment strategy specifically used for people with a diagnosed mental illness is holistic medicine. According to the American Holistic Medicine Association, “The goal of holistic medicine is to help to transform health care to patients through the integration of all aspects of well-being: physical, mental, emotional, spiritual, environmental and social” (AHMA 2010). The focus is to promote health, prevent illness, and help raise awareness of disease in our lives rather than merely managing symptoms. Holistic medicine relieves symptoms, modified contributing factors, and enhances the patient system to optimize future well-being. This practice is used by Thresholds Agency on their clients to help increase their overall well-being and help with their life transformations. With the lack of funding given to the McHenry County facility, Thresholds, many programs and opportunities for the clients have been drastically cut. One of the most important areas of holistic medicine is the physical activity and well-being of the clients. Many of the clients who attend Thresholds are unable to afford memberships to fitness facilities and also have no knowledge on how to be physically active to stay healthy. This lack of the physical portion of health transformation is due to budget and funding cuts to the facility. According to the U.S. Department of Health and Human Services,

“Physical activity has been proven to help promote psychological wellness, which is key in the treatment of people who have a mental illness” (U.S. Dept. HHS 2002). Also, regular physical activity has been shown to reduce the morbidity and mortality from many chronic diseases. According to the American Psychiatric Association, “People with serious mental illness are at higher risk of premature mortality than the general population. On average, people with severe mental illness die ten to 15 years earlier” (AMA 2010). Overall, regular physical activity can improve mental health among people with serious mental illness. Improvements in quality of life and emotional well being due to physical activity have been reported in the absence of objective diagnostic improvement. With the implementation of physical activity program and memberships, clients from Thresholds will be able to participate in the physical health of the holistic medicine prescription plan. The clients will not only shorten their treatment time, but may actually reduce the amount of prescription medications they are using which is very cost savvy and beneficial to their overall health. Mental illness is an epidemic streaming throughout our nation. With the help of holistic medicine practices, hopefully the number of new cases or existing can be reduced dramatically. Physical activity has an important role to play in the lives of individuals with serious mental illness. By integrating physical activity programs into psychiatric services, the physical health outcomes of mental health clients can be substantially improved, as well as improvements seen in the psychological and social outcomes. Physical activity interventions are a critical component of an approach in recovery mental health services.

PROGRAM GOALS & OBJECTIVES

Program Goal: To improve the overall physical health and wellness and to provide access to physical health and wellness centers to the Thresholds Members of McHenry County, IL.

Objective #1: By March 2010, 90% of the mental health clients at the Thresholds Clinic will participate in physical activity and wellness programs to help to increase their physical well-being and treatment practices.

Objective#2:ByMarch2010,100%ofthementalhealthclientsattheThresholdsClinicwillobtainmembershipstoacommunityhealthfacilityandhaveaccesstoalltheirprogramsandequipment.

• Objective#3:ByDecember2010,75%ofthementalhealthclientsatthe

ThresholdsClinicwillhaveanincreaseintheirphysicalwell‐beingandoverallhealthknowledge.

PROJECT IMPLEMENTATION PLAN

According to the U.S. Department of Health and Human Services, “Regular physical activity, fitness, and exercise are critically important for the health and well being of people of all ages. Research has demonstrated that virtually all individuals can benefit from regular physical activity, whether they participate in vigorous exercise or some type of moderate health-enhancing physical activity” (2002). This program is being created and funded in order to help individuals who are diagnosed with a mental illness to improve their physical activity level and overall wellness. By accomplishing the goals and objectives of the program, our clients will help to improve their physical wellness as well as their mental illness from which they are suffering from currently.

Activities Personnel

Timeline (logical

sequence)

Desired Outcome

For objective #1, mental health clients will participate in an overall physical health

evaluation and wellness evaluation.

1. Clients will go through physical fitness testing.

2. Undergo training in health and nutrition practices.

Local Physical Fitness Trainer

Health Promotion

Professionals

One Month Clients will have a comprehensive evaluation

on their overall health practices and will be able

to work on various aspects of physical activity and

nutrition to help improve themselves.

For objective #2, mental health clients will gain access to a fitness facility and their

programs associated. 1. Secure funding sources to obtain these

memberships for clients. 2. Contact organizations to help find the funds

to support the programs and facility usage.

Funding Organizations

Grant

Fulfilling Company

Six Months Clients will gain access to a local physical fitness

facility and all the resources available within.

Clients will begin to participate in the facilities

activities in order to increase their fitness level

and mental health awareness.

For objective #3, mental health clients will participate in a physical fitness assessment

and wellness assessment. 1. Clients will participate in physical

fitness testing. 2. Clients will undergo a health and

nutrition assessment following a use of the program.

3. Clients will have an evaluation with caseworker on their mental illness

symptoms and overall health.

Local Physical Fitness Trainer

Health Promotion

Professionals

Mental Health Case Workers

Six Months Clients will be shown progress of participating in physical activity and

shown the benefits in their overall health of

participating in the programs.

EVALUATION The overall outcome of the project will be assessed using impact and process evaluation techniques. Process Evaluation Process evaluation will be an ongoing task, and the following questions will be asked to improve the quality of the program:

1. Doestheareaallowforhelpfromthelocalcommunity?2. Dowehaveaccesstothenecessaryequipmentandpersonnelforthetesting

dates?3. Didtheclientstakeadvantageofthefacilityusage?

ImpactEvaluation Impact evaluationwill be collected from quantitative data using a pre andposttestevaluationmethodandthefollowingquestionswillbeinvestigated:

1. Did the clients benefit physically and mentally from the addition of theprogram?

2. Howdidtheirbehaviorchangebeforetheprogramandafter?3. Whatdidtheylearnfromparticipatingintheexperience?

PROGRAMBUDGET

Categories Justification Grant Othersources TotalFitnessMemberships

Clientsneedfitnessmembershipsatlifetimefitness.Athree‐monthmembershipwillcost$180/perclient.Therearetenclientsparticipatingintheevent.

$1,800.00 ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐

$1,800.00

ProjectManager

Thispersonwillbeinchargeofobtainingthememberships,followingthroughwiththeclientsworkouts,andmakingsureallthingsareorganizedandaccomplished.

$1,200.00 ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐

$1,200.00

FuelCosts ClientswillneedtransportationtoandfromthefitnesscenterthroughaThresholdsissuedvehicle.

‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐

$280.00 $280.00

TransportationSupervisor

ClientswillbetransportedbyaThresholdsissuedvehiclebyahiredprofessionalfourdaysperweek.Driverwillreceive$20perday.

$960.00 ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ $960.00

Revenue Grant:$3,960.00FitnessClub:VolunteeredProfessionals

Expenses Grant:$3,960.00Thresholds:$280.00

If this proposal is funded, it is understood that you will be required to report back on progress made toward the specific goals and objectives outlined in the proposal. Applicant Signature: ________________________________ Date: _________________ Chair, Applicant Board: ___________________________________

SUMMARY

Thresholds Organization in a nonprofit organization located in McHenry County

Illinois and all throughout the Chicagoland Area in Illinois. Thresholds mission is to

“help to assist and inspire people with severe mental illnesses to reclaim their lives by

providing supports, skills, and the respectful encouragement that they need to achieve

hopeful and successful futures.”

The purpose of this grant is to obtain fitness memberships for ten mental health

clients at the Woodstock, IL, Thresholds in order for them to incorporate physical fitness

and wellness education into their prescription plan in order to better their lives and

become self-reliant individuals.

The program goal is to help the clients at Thresholds become more physically

active in order to help improve their physical health as well as their mental health. The

objectives of this program is to help the patients obtain memberships at a local fitness

club and to participate in fitness evaluations in order to show improvement through this

program. Also, to allow for the patients to participate in wellness education training helps

them become of aware of their physical health and well-being. The clients will also

participate in a post-fitness testing plan to determine whether the program was effective.

Through the implementation of this program, we hope to have the clients involved

in the program to increase their level of physical fitness and health, while increasing their

mental health and reduce their prescription plans. This will save the government, as well

as the patients and organization, a large amount of money on medical costs and will help

to extend their life.

In order to fully complete an effective program for all of the clients involved, we

are asking for a grant total of $3,960.00. Thresholds was willing to donate an amount of

$280.00 that will be used in order to transport the members, but the remaining amount is

being requested within the grant to complete the project.

Project Timeline

Month

Activity Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec 1. Organize and

host the first collaborative meeting with the members of Thresholds.

X

2. Hire a driver for the facility runs.

X

3. Clients will undergo fitness pre-testing evaluations at the health club.

X

4. Clients will attend educational sessions on wellness practices.

X X X X X X

5. Fitness Usage. X X X X X X 6. Client post-

testing at health club.

X

7. Process evaluation: participants & volunteers

X

8. Impact evaluation: participants and volunteers

X

9. Preparation of final report.

X

SUPPLEMENTAL INFORMATION

1. References

2. Letter of Support from Thresholds

References: American Heart Association. (2009, October 29). American Heart Association. Retrieved October 29, 2009, from Physical Activity in Your Daily Life: http://www.americanheart.org/ presenter.jhtml?identifier=2155 American Holistic Medical Association. (2010). The Principles of holistic medicine. Retrieved from http://www.holisticmedicine.org/displaycommon.cfm?an=1&subarticlenbr=1 Department of Health and Human Services, Initials. (2002, June 20). Physical activity fundamental to preventing disease. U.S. Department of Health & Human Services, Retrieved from http://aspe.hhs.gov/health/reports/physicalactivity/ Lorenzo, S. B. (2006). Physical Activity and Children and Adolescent Knowledge Path. Retrieved October 21, 2009, from The Maternal and Child Health Library at Georgetown Univeristy: http://www.mchlibrary.info/KnowledgePaths/kp_phys_activity.html Mental Health Resource League for McHenry County. Retrieved March 20, 2010 from http://www.mhrl.org/sitebuilder/page1.aspx. Minnesota Department of Health. (2010, February 19). Retrieved April 5, 2010, from http://www.health.state.mn.us/orginfo.html/ National Association for Health and Fitness. (2009, July 27). Retrieved October 19, 2009, from http://www.physicalfitness.org/ Physical Activity. (2008, November 4). Retrieved October 19, 2009, from Centers for Disease Control and Prevention: http://www.cdc.gov/physicalactivity/index.html Shape Up America Home Page. (2009, October 21). Retrieved October 21, 2009, from Shape Up America: http://www.shapeup.org/index.php TD Securities. (2009, October 23). Doctor Know Trivia. Retrieved October 23, 2009, from About Kids Health: http://www.aboutkidshealth.ca/JustForKids/drknow.aspx Teaching Center. (2009, June 26). Retrieved October 21, 2009, from U.S. Environmental Protection Agency: http://www.epa.gov/teachers/order-publications.htm The Hospital for Sick Children. (2009, October 20). Just for Kids. Retrieved October 20, 2009, from About Kids Health: http://www.aboutkidshealth.ca/JustForKids/default.aspx The Nemours Foundation. (2009). TeensHealth: Your Body. Retrieved October 20, 2009, from KidsHealth: http://kidshealth.org/teen/your_body/ Thresholds, . (2009). Explore thresholds. Retrieved from http://www.thresholds.org/explore-thresholds Utenai Designs. (n.d.). Health and Fitness Quizzes. Retrieved October 19, 2009, from Sheppard Software: http://www.sheppardsoftware.com/health2.htm Will Rogers Institutes. (2009). Booklets and Pamphlets. Retrieved October 23, 2009, from Will Rogers Institute:Educaitonal Resources: http://www.wrinstitute.org/ed_resources.aspx

BoardofDirectorsRyan D. Cahill President Michael Szkatulski VicePresident Jeffrey M. Josephs Treasurer Rand E. Arons Secretary William J. Fairbanks AssistantSecretary Margot Andersen* Andy Anderson, Jr. Jana C. Barbe Raymond Barbosa John Bergholz Samuel E. Bottum Roger O. Brown* Pamela Buffett** Linda Denson Marianne Doan Harold E. D’Orazio Joel C. Falk Judy Friedman M. Fred Friedman Anne Gehring Dean H. Goossen Ronald B. Grais* Mrs. Max A. Hart* Gregory Hedges Mary Jo Herseth* Mrs. Melville Hill, Jr.* Vicki Horwich Richard J. Loewenthal, Jr. Roxanne Martino* Mrs. Henry Mautner Keith E. McClintock Joseph Moos Anne Marie Morley Lt. Jeff Murphy Steven Perlin Tammy Randa Christine M. Rhode Jeffrey A. Riemer Linda G. Sahagian Chris Segal Christopher J. Whybrow LifeDirectorsMrs. Louis Behr Theodore Bosler* William Crane* Howard Galper James W. Mabie* Martin N. Sandler ChiefExecutiveOfficer Anthony M. Zipple, Sc.D., M.B.A. *Past Presidents **Honorary Director As of March 2010

Dear Michele, Thank you so very much for all of the work you’ve done for the agency throughout the past

months. Your constant involvement and inquiries regarding the advancement of this

project show me that you truly care for the clients here at Thresholds. Your hard work and

dedication to the implementation of this program bring me great hope for the future of the

clients here. I am speaking for them when I say that they truly will benefit from this

program being started.

In regards to the funding source at the MHRL, I will be sure to contact you in regards to

their fundraising options for the coming year. As they normally donate to Thresholds, we

can expect a generous donation in order to implement the program you’ve created.

Thank you again for all your hard work and taking charge of such a creative and important

project for our clients. A visit to the organization is a must so you can see what an impact

you’ve made on the lives of all the clients you’ll be touching.

Good luck with the remaining coursework of your schooling and if you need anything,

please feel free to contact me or anyone here at Thresholds.

Sincerely,

Kimberly Borcherding

Senior Case Worker Thresholds Woodstock, IL 60098 (815) 715 – 1810 kborcherding@thresholds.org

April 4, 2010

4101 N. Ravenswood Ave. Chicago, IL 60613 Phone: 773.572.5500 Fax: 773.572.5290 www.thresholds.org