How physiotherapy is playing a key role in mental health
Physiotherapists play a key role in treating patients with a physical injury. But they are increasingly working with people with mental health problems, as Philippa Ford explains…
PHYSIOTHERAPISTS have an increasingly important role to play in supporting patients with mental illness and dementia, which can help to improve their quality of life.
There have recently been a number of national drivers which have changed service delivery and approach to incorporate a recovery model and develop new enhanced roles.
This has given physiotherapists an opportunity to contribute to the multidisciplinary team.
As a result of these changes, the UK physiotherapy mental health special interest group has produced strategy documents in each of the nations in a bid to influence the provision of physiotherapy for mental health users and carers.
Some six months after the English document was released the profession has now completed its document reflecting NHS provision in Wales.
Baroness Finlay, who is president of the Chartered Society of Physiotherapy (CSP), says in the foreword to the framework for mental health services in Wales: “Over the next decade the world will see a rise in psychological disorders across a wide range of diagnoses from depression and anxiety to dementia.”
Physiotherapists have particular skills and knowledge about physical health and wellbeing which make them valuable in the field of mental health.
Physiotherapy is one of only a few professions which have specific physical and mental health training to bridge the gap between physical and mental health needs.
Physiotherapists who have specialist knowledge and experience in the mental health field use physical activity and manual techniques to support personal and social independence, to manage anxiety and to develop healthier lifestyles to counteract the higher levels of co-morbidity for cardiac, respiratory, diabetes and weight management.
The contribution to the preventative agenda is also very important, as it not only prevents physical problems but also a deterioration of mental health as a result of physical modalities.
Physiotherapy also plays a key role in the management of people with serious neurological impairments who have challenging behaviour.
Often the physical problems will need rehabilitation and physiotherapists with specialist mental health skills and knowledge will be called on to help develop treatment programmes.
Physiotherapy expertise is particularly important for the increasing elderly population with mental illness or dementia, the majority of whom will be cared for by a family member in their own home.
Many older people with dementia find they are unable to access mainstream community services.
They are best served by clinicians who already know them and understand their illness as part of a specialist mental health team.
While the framework for Wales outlines physiotherapy’s role in mental health services it also raises a number of concerns.
These include the equity of access to physiotherapy services for people who have moderate to severe mental illness compared to other patient groups and the current ability of mental health services to appropriately manage patients who have physical health problems that may be directly or indirectly related to mental health conditions.
And the profession believes the NHS needs to grow the physiotherapy service in mental health in order to deliver quality, comprehensive patient-centred services with dual trained clinicians who have physical and mental health knowledge.
The framework makes a series of recommendations we want to see addressed by the health boards and it spells out what the profession in Wales needs to do to support the change needed.
These include a review to ascertain how many mental health teams access physiotherapy across all settings; the involvement of physiotherapy in workforce and service delivery planning and improving relationships with higher education to strengthen the knowledge base and widen the experience of undergraduates to physiotherapy in mental health.
But we also have to maximise opportunities through the Assembly Mental Health (Wales) Measure 2010.
The CSP is particularly grateful to Gofal Cymru, Mind Cymru and Hafal who have contributed to the framework. The profession hopes that service users and carers will also find it useful and that it will be a framework that has an impact and makes a positive change to the services they access across Wales.
Philippa Ford is the Chartered Society of Physiotherapy’s policy officer for Wales