Mental health and physiotherapy

Physiotherapy is a practical degree that involves hands-on training and learning. All students will attend placements throughout their studies. Our School aims to facilitate a broad range of placements beyond a standard hospital setting, to give students experiences that will help them in their practice as qualified physiotherapists.

Graduate physiotherapist Victoria Gunn takes a look back on one of her placements which involved working with those receiving mental health support.

My thoughts before starting placement

When I first found out that my fourth placement was within in mental health, I was unsure of what to expect and actually what the role of a physiotherapist would be within this.

As an area that we hadn’t covered specifically at university, I struggled to see where physiotherapy would come into it and how this was going to help me once I was qualified.

I felt that although mental health is an important aspect to consider with all patients, I didn’t understand how much psychological factors impact on physical ability.

To be honest, I initially felt quite underwhelmed by the idea of the placement but can say that it was one of the most impactful placements on me as a practitioner.

Placement experience and learning opportunities

Throughout the placement, I encountered a number of patients with varying mental health conditions and needs. I quickly learnt that patients could present completely differently on different days and sometimes even within the same day meaning that everyday provided new challenges and learning opportunities.

The most frequent assessment that we had to carry out were falls assessments as it tended to be that patients with mental health conditions were high risk of falls, something that I was not aware of before I started but became apparent throughout placement. It was important to take a holistic approach when assessing these patients as a number of things could be contributing to them fall, including: medication, anxiety levels, sleep, blood pressure and food and fluid intake.

It became apparent to me that the role of a physiotherapist within this field is very complex and that all aspects of the patient’s wellbeing needed to be considered – MDT working was paramount.

As well as clinical experience, EPUT also organise ‘buddy scheme’ days, this is a full day where students get to have 1-1 conversations with service users and carers. This was an opportunity that I hadn’t received anywhere else and I found so helpful as I could get a good understanding of what service users and carers value in a physiotherapist and enable me to take these points forward in my practice. It was a very unique and intimate opportunity and I would encourage anyone to attend it if they are given the chance.

Although this placement was focused on patients with mental health conditions, it made me appreciate that anyone’s mental health can be affected at any point, even if they don’t directly disclose this to you.

Impact on my practice

Being able to identify when someone may be struggling with their mental health has become really important to me as a practitioner. It can be tricky to identify if someone is struggling and it is important to complete a thorough initial assessment to get a better understanding of your patient.

However, there are a few simple clues that I look out for:

1. If the patient is being particularly vague when answering your questions or seems disinterested.
2. Patient is very emotional or has quick changes in mood.
3. Loss of appetite or appearing very lethargic/drowsy.
4. Confusion/hallucinations.
5. Forgetfulness/not being able to recall simple details.

Of course, it is important to ensure that none of this is caused by a medical condition (e.g. infection) first before assuming it could be to do with their mental health. I feel that having gained awareness of how mental health can affect patients, it has made me more conscious of assessing a patient holistically and not looking at them just from a ‘physiotherapy’ perspective. Being able to do this can also highlight aspects of care that doctors and nurses may not have picked up on and in turn, provides the patient with the best care possible.

From this placement I developed a new found appreciation for how important our patient’s mental health is, no matter what area of physiotherapy you work in. It has pushed me to want to be a better and more holistic practitioner and I feel that I can give my patients a better quality of care because of it.

By considering mental health & what motivates your patients, you are able to build a good rapport and patient-therapist relationship. This is the foundation for providing good treatment and getting the best out of your patients.