This is probably the most common question I get when I talk to people about my profession. Everybody understands the role of a Physiotherapist – we help with pain and work a lot in sports right? Yes we do but that’s just one part of the many specialties we can work in.
I have specialised in Mental Health for 18 years now – first dipping my toe in the water by choosing this area as my elective student placement when studying at Robert Gordon University in Aberdeen. I was lucky to work with some very experienced therapists and instantly I felt at home – I had time to spend with my patients, to build a rapport and felt part of a team – not always something you get as a student.
When I qualified I took some of the things I learned into every rotation – clearly remembering the time in outpatients where I spent an hour long initial assessment just listening to a man whose injury was due to a road traffic collision with a bus. He was unsettled, agitated, and angry even but it was what he needed. When he came back he apologised and thanked me for listening – he needed to get it off his chest and he got better and left his final appointment with a smile.
It wasn’t a surprise that my first senior static post was in a large mental health hospital where I got to work with adults, older adults and specialties such as rehabilitation, forensic services and eating disorders. I continue to work in a hospital setting as a Physiotherapy Team Lead – responsible for my staff and the service we provide across 10 mental health wards. Part of this is understanding that you cannot separate mental health and physical health – when someone is admitted their physical health needs don’t magically disappear and that’s often where we come in. In any one day I could do a mobility assessment for someone who has had a number of falls, a seating assessment for someone who is having difficulty holding their own posture, assess someone with back pain, complete a hyperventilation assessment to teach diaphragmatic breathing and take 2 exercise classes ranging from circuits to cycling and dance.
Part of my role has been working in specialist wards that provide care for people with a diagnosis of Dementia. This includes supporting people to maintain their mobility and along with the team implement ways to help reduce the risk of falls. Exercise and movement are a big part of this and in our wards everything counts including walking, sports and dance. It includes positional advice in lying and sitting and we support staff and carers in discussing the best ways to help someone move.
My most recent adventure is collaborating with the boards AHP Dementia Consultant as AHP Clinical Lead for Connecting People, Connecting Support in NHSGGC. This project focuses on staff training, lived experience of the person with dementia and their care partner and looks at how we are doing as a health board against CPCS ambitions.
That is one of the things I love about my job – there is such a variety of things to do – no two days are the same and there is always something I haven’t seen before. Now don’t get me wrong mental health is unpredictable – some days nothing goes to plan but with experience brings adaptation.
Three key things we use every week – build a rapport in any way we can – if that means sitting having a cuppa, listening to music, getting to know the person or visiting regularly until the person can look or talk to you that is what we do. Equally we need to know when to back away and give some space.
In every part of our assessment we use our observation skills – body language and facial expressions tell us so much more than what the person is saying. At times our assessments can be purely observational – there is so much you can learn just from looking.
Finally being flexible – our service users can change on the spot, from day to day and week to week. There isn’t one path to recovery – we need to be able to think on our feet, respond to what is in front of us and use our imagination to help our patients meet their goals. It wouldn’t be the first time that I have danced with a patient down the corridor when they find it impossible to take just a couple of steps, when asking them to “stand up and walk”, due to anxiety.
Is it hard- yes – not necessarily physically but mentally. You need a thick skin, a bucket load of patience and an ability to recognise how you are, how you feel and an awareness of when you need a time out. If we aren’t mentally well ourselves we will struggle to support others. As a team we talk things through, rant sometimes and laugh a lot.
My hospital is like a community – our small physiotherapy team are part of the most amazing staff group where everyone plays their part in looking after individuals in most need. AHP’s, Nursing, Therapies, Medical Staff, Domestic Staff, and Activity Staff – we all have a part to play.
So there it is – a snapshot of what it’s like to be a Physiotherapist in mental health. Why would you need a Physiotherapist in mental health – why would you not?
Contributor
Angela Watson
Physiotherapy Team Lead
AHP Clinical Lead for Connecting People, Connecting Support in NHSGGC.