Emerging data shows that physical therapy and mental health therapy are becoming more intertwined. There are an increasing number of patients who consult with a physio and have mental health issues simultaneously. However, another element that is also coming to light is that many physios around Australia feel ill-equipped to handle their patients’ mental health concerns.

Physiotherapist and researcher, Ryan McGrath is currently completing a PhD at Charles Sturt University and has recently published the third paper from his ongoing PhD study. The three papers look at the interactions between physios and their patients who experience psychological issues. His study brings up an interesting point: there needs to be a much more broad approach to health and well-being.

His research has found that from a survey conducted on 340 physios, 36.1% of all patients appeared to be experiencing psychological distress and 15.6% appeared to be experiencing severe psychological distress. A survey by Musculoskeletal Australia found that 50% of patients found that their physical condition impacts their emotional and mental wellbeing.

Bernadette (wishes to withhold her last name) works at a private practice in Canberra. She graduated from the University of Canberra with a Bachelor of Physiotherapy at the end of 2021. Since then, she has felt completely unprepared for patients who have seen her and also suffer with mental health complaints.

“I don’t think people realise but physical therapy and mental health issues often come hand-in-hand. I have had patients come into the clinic who suffer from a variety of musculoskeletal back issues and the majority of them also suffer from anxiety and/or depression. While I feel confident to treat their physical issues and of course, listen to them, I do not feel I am equipped to handle their emotional issues”.

Sam Brown, 31, Melbourne, was referred to a physio by his GP in April of this year for ongoing tension headaches. He found himself opening up to his physio when he was asked about his levels of stress.

“I had been suffering from tension headaches on and off for around 6 months and decided to go and get it checked out. In my first physio session, I was asked about my current stress levels. I felt the floodgates open and revealed to my physio just how stressed and anxious I was about work. I could tell he cared, but I also felt like I overwhelmed him. I mean, I guess physios are there to help you with body ailments but they aren’t psychologists” said Sam.

Bernadette has spoken to her direct manager of the clinic in Canberra about being trained in mental health and her boss has agreed that this is something either the Australian government should cover the costs of or the Physio Therapy training in Australia (Australian universities) should be including.

“I am not against learning more and being trained in mental health – it would improve my skills exponentially. But I feel like my uni degree poorly underprepared me for dealing with this aspect of physiotherapy and unless the practice I work in is going to cover the costs to undertake a course, I will have to front the money myself. I am not in the position to do this when the cost of my education has already been so high” explains Bernadette.

“I always suggest activities like physical exercise to my patients and we often come up with a plan together as I know physical activity is beneficial for those suffering from mental health disorders, but I know that for some people, that isn’t enough”.

Physiotherapy needs a more biopsychosocial approach. Physios around Australia would like to receive more education about the signs and symptoms of mental health disorders, including the side effects of medications that many people take for mental health management.