MHEX Research

Enjoyment Matters: What Makes Campus Exercise Programs Work for Student Mental Health

University mental health services are stretched, and structured exercise remains an underused option for students who are struggling. A new study led by Ivan Jeftic, who completed this research during his PhD at The University of Western Australia, with the MHEX team across The University of Western Australia, The Kids Research Institute Australia, UNSW, and partner institutions, followed students through a 12-week campus exercise program and found something practical for anyone who designs or delivers these services: how much students enjoyed exercise tracked closely with their mental health, week to week.

The study was published open access in the Journal of Applied Sport Psychology.

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Why this research was needed

Around the world, university students experience mental distress and illness at higher rates than the general population, and campus services often face long wait times and a focus on acute treatment. Structured exercise is a promising complement to that care, and MHEX has shown it is both feasible and useful in this setting through the Stride program. What has been missing is an understanding of which parts of these programs matter most for students' mental health. This study set out to answer that, focusing on exercise enjoyment alongside how intense and how long each session was.

What we studied

The study drew on the Stride program, a referral-based exercise program for UWA students experiencing mental distress or illness. Students were referred by campus psychologists, student support officers, or off-campus medical professionals. No formal diagnosis was needed, and more than half were referred for anxiety or mood concerns. Importantly, the program sat alongside any other support students were receiving rather than replacing it. Sessions were run by exercise mentors, who are Master of Clinical Exercise Physiology students, and coordinated by an accredited exercise physiologist. The program's design and its early feasibility results are described in full in our earlier work: the Stride feasibility study and the background and implementation paper.

Ninety-three students took part in the research (average age 23, 69% female), completing short surveys every fortnight across the 12 weeks, for 350 observations in total. The team used an intensive repeated measures design, which simply means measuring the same people again and again over time. That approach let the researchers separate two different questions. First, do students who enjoy exercise more than others also report better health? Second, and less often tested, does a single student report better health at the specific moments they enjoy exercise more than their own usual level? Alongside enjoyment, the surveys captured depressive symptoms, self-esteem, perceived physical health, and each session's intensity and duration.

What we found

Across the 12 weeks, the direction of change in symptoms was encouraging. Depressive symptoms fell, while self-esteem and perceived physical health rose.

The clearer story was about enjoyment. Students who, on average, enjoyed exercise more reported lower depressive symptoms and higher self-esteem and physical health than their peers. The same pattern held inside each person over time: on the weeks a student enjoyed a session more than their own norm, they also reported lower depressive symptoms and better self-esteem and physical health at that point. This is the first study to show that within-person link for university students in an exercise-as-treatment setting, and it matters because it points to enjoyment as something dynamic and changeable, not a fixed trait.

Session characteristics added useful detail. Comparing across students, those who tended to exercise at a moderate to vigorous intensity (around 6 to 8 on a 10-point exertion scale) reported better outcomes. Session length ran the other way to what the team expected: students whose sessions were longer on average reported higher depressive symptoms, suggesting shorter sessions of roughly 30 to 45 minutes were more favourable. Neither intensity nor duration showed a within-person effect, so enjoyment was the factor that moved with health week to week.

How exercise is experienced may be as crucial as how much exercise is completed.

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What this means in practice

For clinicians, exercise physiologists, referrers and program designers, the message is that enjoyment is a design lever, not a nice-to-have. The everyday decisions inside a session shape it: giving students a genuine choice of activity, supporting their autonomy, and pacing the work to how they are on the day. The authors point to self-determination theory, which holds that more self-driven motivation, including enjoyment, tends to follow when a person's needs for autonomy, competence and relatedness are met. Practically, that supports building need-support skills into staff training, keeping sessions in a moderate intensity range where it is safe to do so, holding session length around 30 to 45 minutes, and checking in during each session about how the exercise feels rather than assuming a set prescription.

The idea that enjoyment drives outcomes is not new to our group. An earlier MHEX study, led by Associate Professor Bonnie Furzer found that exercise enjoyment was linked to better health outcomes and relapse prevention for young people in a drug and alcohol treatment service, captured in the paper Exercise is medicine when you enjoy it. This new study extends that thinking into university mental health services and, for the first time, shows the enjoyment link holding within individuals over time.

A few caveats keep this grounded. The design shows associations, not cause and effect, the outcomes were self-reported, and retention over 12 weeks was a challenge, as it often is for this group. The program also ran alongside other treatment, which may have contributed to change. Even so, seeing the same enjoyment signal both between students and within the same student over time gives real confidence that enjoyment is worth designing for.

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Related MHEX research

This study is part of a wider MHEX program of work on exercise and student mental health. For further reading:

• Jeftic, I., et al. (2023). The Stride program: Feasibility and pre-to-post program change of an exercise service for university students experiencing mental distress. Psychology of Sport and Exercise.
• Jeftic, I., et al. (2023). Structured exercise programs for higher education students experiencing mental health challenges: background, significance, and implementation. Frontiers in Public Health.
• Furzer, B., et al. (2021). Exercise is medicine when you enjoy it: Exercise enjoyment, relapse prevention efficacy, and health outcomes for youth within a drug and alcohol treatment service. Psychology of Sport and Exercise.

You can browse the full body of our work on the MHEX publications page.

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Read the full open access article

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Access the full published report here.