1. Rachel Spearing

2. Session objectives: At the end of the session, participants will have: Considered the clinical areas in which physiotherapists work with people with mental health problems Considered a brief overview of an undergraduate physiotherapy programme and seen where mental health teaching is incorporated. Had an opportunity to analyse a case study of a client with comorbid physical and mental health problems Understand how the case can be used to facilitate consideration of issues and management for a client with comorbid physical and mental health problems.

3. Physiotherapy A little task: Consider the clinical specialities in which physiotherapists may work Of these, consider where they may meet service users with mental health disorders Consider the interventions that you know of that physiotherapists might use Consider the impact that these interventions may have on mental well being

4. Comorbidity of physical and mental ill health: some examples Cardiovascular disease and depression (Ward et al, 2003) Stroke and depression (Whyte & Mulsant, 2002) Diabetes and depression (Eaton, 2002) Diabetes and serious mental illness (Krein et al, 2006) Rheumatoid arthritis and depression (and other conditions) (Hyrich et al, 2006) COPD and depression and anxiety (Yohannes et al, 2000) Stroke and dementia (Liebetrau et al, 2003) Pain and depression (Rethelyi et al, 2004)

5. Physiotherapy interventions that may impact on mental well being: Physical activity (Grant, 2000) Massage (Soden, 2004; Edge, 2003 and others) Relaxation (Ernst et al, 1998) Acupuncture (Ernst et al, 1998) ‘Body awareness therapy’ – movement, breathing exercises and massage (Gyllensten et al, 2003)

6. Physiotherapy at MMU A range of programmes Integrated approach Case based, problem solving approach An overview of the BSc: BSc programme structure.doc BSc programme structure.doc

7. Self study: Case study – Phil Bury COPD Case - Phil Bury.doc COPD Case - Phil Bury.doc Tutorial 1: Analyse case Skills session: role play planned treatments Lecture: mental health Tutorial 2: comparison of management of Phil Bury with and without clinical depression Study: problem list and initial plans Study: Clinical depression; comorbidity of physical and mental ill health