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Physical activity can benefit individuals with severe mental illness (SMI) (Richardson et al., 2005). The benefits of physical activity for individuals with SMI are threefold: psychological, social and physical. Psychologically, patients can experience mood elevating effects, reduced anxiety, improved concentration, increased self-esteem and reduced psychiatric symptoms like voices (Faulkner & Biddle, 1999). Socially, co-patients in the physical activity setting can motivate, support and encourage interaction (Fogarty & Happell, 2005), facilitating the development of a positive social identity. Physically, patients can combat a significant side effect of anti-psychotic medication such as weight loss (Faulkner et al., 2003). Despite individuals with SMI understanding that there are benefits from engaging in physical activity, many have limited confidence in their ability to exercise and often perceptual biases (e.g., concerns generated from self-presentation, negative interpretaion of an interaction) can act as barriers in new and unknown settings (Soundy et al., 2007). A perceived inability to exercise, coupled with a lack of social support can lead to a further reduction in exercise participation and, potentially, permanent withdrawal from exercise (Ussher et al., 2007). Thus, there are (a) barriers that affect the initiation of exercise, as well as (b) barriers that prevent the adoption of a more physically active lifestyle. In support, a recent Cochrane review (Gorcyznski & Faulkner, 2011) has called for research to develop further understanding into how best to help patients with SMI begin and continue to exercise. Whilst some initial understanding has been provided regarding the initial engagement in physical activity, further information is needed to illustrate how experiences of physical activity vary. To this end, research is needed to consider and illustrate the psychosocial barriers and facilitators to activity in the adoption of exercise, but also in the long term maintenance of activity. This has been illustrated, although not comprehensivly evaluated, in previous research: In some research this is explicitly adressed, for example, Carless (2007) considers physical activity as phases requiring support when beginning (awareness raising) and during (engagement and practical facilitation) activity. Other research implictly addresses this; for example, Raine et al., (2002) consider the engagement of exercise in community and illustrate the experience of inititating and maintaining activity. It is clear,

Understanding the Psychosocial Processes of Physical Activity for Individuals with Severe Mental Illness: A Meta-Ethnography