Turning Point’s One Step at a Time Project is a person-centred physical activity and wellbeing intervention supporting people experiencing severe mental health challenges to progress towards recovery, independence and improved quality of life. The progamme is funded via Turning Point’s Social Value Fund, alongside grants from the BUPA Foundation Green Community Fund and a former resident’s generous donation. The challenge People experiencing severe mental illness face a significant life expectancy gap of around 15 to 20 years compared with the general population, with much of this disparity attributable to preventable physical health conditions such as cardiovascular, respiratory and metabolic disease. Medications can contribute to significant weight gain and may cause sedation or reduced motivation in some individuals. Whilst physical activity can improve mental and physical wellbeing, provision is often fragmented, underfunded or not embedded in routine care. People can also face barriers such as low motivation, anxiety, fear of judgement, and negative past experiences. The programme The programme responds through a flexible, psychologically informed model that meets people where they are. A qualified personal trainer works alongside clinical teams to deliver one-to-one and small group activities tailored to each person’s physical health, mental state and goals. Engagement might begin with conversation or gentle interaction with equipment before developing into structured exercise, outdoor activity or group sessions. The intervention is grounded in strengths-based and trauma-informed principles. Physical activity is integrated into therapeutic planning and daily routines, reinforcing its role in emotional regulation, confidence-building, routine, social connection and preparation for more independent living. The programme also creates inclusive environments that challenge stigma and promote body positivity. How the service was designed and developed Developed within Turning Point’s Douglas House, a 12-bed independent mental health hospital supporting working-age adults who may be admitted informally or detained under the Mental Health Act and expanded into Pendlebury House, a 10-bed mental health rehabilitation service for adults with enduring mental health problems, One Step at a Time positions physical activity as a core therapeutic part of mental health care. The social enterprise difference is reflected in Turning Point’s willingness to test practical, person-led solutions to gaps in traditional provision. By integrating personal trainer roles into mental health services, the programme explores workforce models that complement clinical care and make support more holistic, accessible and responsive. How One Step at a Time contributes to primary, secondary and tertiary prevention: It reduces risks linked to inactivity, poor physical health and social isolation; helps identify early signs of deteriorating wellbeing before needs escalate; and reduces the impact of existing mental health challenges by supporting recovery, independence and step-down from inpatient to community settings. For individuals, outcomes include improved confidence, motivation, physical capability, emotional regulation and social connection. These changes can support greater independence and participation in everyday life, including community activity, volunteering, education, or employment. “My dad got me into it. At first, I wasn’t sure about One Step at a Time, but I gave it a go. Now, I love it. I started seeing progress, and it made me want to keep going. My mindset’s different now. I don’t make excuses; I don’t want to give up on anything in life.” Programme participant For services and commissioners, the model enhances care quality by embedding physical activity within multidisciplinary pathways, supporting earlier intervention, reducing the risk of crisis escalation and strengthening continuity of care during transitions. The programme is currently being independently evaluated with the hopes of improving the evidence base, strengthening the case for future funding of similar projects across the country. The programme is practical, low-cost and scalable Its impact can be observed through improvements in engagement, participation, wellbeing, confidence, independence and transitions from hospital to community settings. It demonstrates how prevention can be embedded within everyday mental health care by using physical activity to support recovery, reduce inequalities and improve quality of life. What next? • More case studies of prevention in public service delivery
Turning Point’s One Step at a Time Project is a person-centred physical activity and wellbeing intervention supporting people experiencing severe mental health challenges to progress towards recovery, independence and improved quality of life. The progamme is funded via Turning Point’s Social Value Fund, alongside grants from the BUPA Foundation Green Community Fund and a former resident’s generous donation. The challenge People experiencing severe mental illness face a significant life expectancy gap of around 15 to 20 years compared with the general population, with much of this disparity attributable to preventable physical health conditions such as cardiovascular, respiratory and metabolic disease. Medications can contribute to significant weight gain and may cause sedation or reduced motivation in some individuals. Whilst physical activity can improve mental and physical wellbeing, provision is often fragmented, underfunded or not embedded in routine care. People can also face barriers such as low motivation, anxiety, fear of judgement, and negative past experiences. The programme The programme responds through a flexible, psychologically informed model that meets people where they are. A qualified personal trainer works alongside clinical teams to deliver one-to-one and small group activities tailored to each person’s physical health, mental state and goals. Engagement might begin with conversation or gentle interaction with equipment before developing into structured exercise, outdoor activity or group sessions. The intervention is grounded in strengths-based and trauma-informed principles. Physical activity is integrated into therapeutic planning and daily routines, reinforcing its role in emotional regulation, confidence-building, routine, social connection and preparation for more independent living. The programme also creates inclusive environments that challenge stigma and promote body positivity. How the service was designed and developed Developed within Turning Point’s Douglas House, a 12-bed independent mental health hospital supporting working-age adults who may be admitted informally or detained under the Mental Health Act and expanded into Pendlebury House, a 10-bed mental health rehabilitation service for adults with enduring mental health problems, One Step at a Time positions physical activity as a core therapeutic part of mental health care. The social enterprise difference is reflected in Turning Point’s willingness to test practical, person-led solutions to gaps in traditional provision. By integrating personal trainer roles into mental health services, the programme explores workforce models that complement clinical care and make support more holistic, accessible and responsive. How One Step at a Time contributes to primary, secondary and tertiary prevention: It reduces risks linked to inactivity, poor physical health and social isolation; helps identify early signs of deteriorating wellbeing before needs escalate; and reduces the impact of existing mental health challenges by supporting recovery, independence and step-down from inpatient to community settings. For individuals, outcomes include improved confidence, motivation, physical capability, emotional regulation and social connection. These changes can support greater independence and participation in everyday life, including community activity, volunteering, education, or employment. “My dad got me into it. At first, I wasn’t sure about One Step at a Time, but I gave it a go. Now, I love it. I started seeing progress, and it made me want to keep going. My mindset’s different now. I don’t make excuses; I don’t want to give up on anything in life.” Programme participant For services and commissioners, the model enhances care quality by embedding physical activity within multidisciplinary pathways, supporting earlier intervention, reducing the risk of crisis escalation and strengthening continuity of care during transitions. The programme is currently being independently evaluated with the hopes of improving the evidence base, strengthening the case for future funding of similar projects across the country. The programme is practical, low-cost and scalable Its impact can be observed through improvements in engagement, participation, wellbeing, confidence, independence and transitions from hospital to community settings. It demonstrates how prevention can be embedded within everyday mental health care by using physical activity to support recovery, reduce inequalities and improve quality of life. What next? • More case studies of prevention in public service delivery