How They’re Connected & Why Integrated Care Matters
Our minds and bodies are inseparably linked—and on a much deeper level than the basic coordination that allows us to push in a chair or practice our favorite hobbies. As researchers continue to learn more about the connection between physical and mental health, it’s become increasingly clear that achieving whole-person wellness requires focusing on both.
Physical therapy is unique because it intersects with both physical and mental health. Of course, many PT patients receive treatment primarily for physical symptoms. At the same time, they may also be working to regain their independence, find relief from chronic pain, or adapt to a life-changing incident—all things that can have a drastic effect on mental health. And for the 20% of people in the United States who are living with a mental illness, physical therapy can also be an important part of their treatment plan.
Let’s explore more about the relationship between physical therapy and mental health and why integrated care to treat both body and mind is quickly becoming the new standard.
Understanding the Connection Between Mental and Physical Health
The link between mental and physical health is well-documented but also complex. Health researchers continue to make new discoveries about how physical and mental health interact in patients of all ages and health statuses.
Many types of physical health issues can impact a person’s mental health. Whether it’s an athlete forced to sit out the sports season or somebody coming to terms with a disease diagnosis, a decline in physical capability often coincides with mental health struggles. Physical trauma can also lead to post-traumatic stress disorder (PTSD) and adjustment disorders, as people relive their injuries and struggle to adapt to any resulting disabilities or limitations. People who live with chronic pain can even experience structural and functional changes in the brain, leading to difficulty processing emotions or making decisions.
Additionally, people who have poor mental health are at greater risk for a huge variety of health concerns, from strokes and sleep apnea to heart disease and digestive problems. According to the National Alliance on Mental Illness (NAMI), people with depression are 40% more likely to develop cardiovascular or metabolic diseases. Other mental illnesses like eating disorders and addiction disorders can also lead to significant short- and long-term health issues.
The Role of Physical Therapy in Mental Health Treatment
Ask any mental health provider about tips to improve your mood, and regular exercise will be one of the first things they mention. Staying active can help individuals with a variety of mental health diagnoses manage their symptoms and improve their all-around wellness. Even in people without clinically diagnosed mental illnesses, regular physical activity is still essential for good mental hygiene.
Physical activity helps your brain release vital chemicals like endorphins and serotonin, which elevate your mood and improve your ability to think and reason. One study showed that people who exercise regularly have 40% fewer poor mental health days than those who did not exercise regularly, even when accounting for other factors like age, health, and socioeconomic status.
Plenty of people still need medication to manage their mental illness, and there’s no shame in that! However, research suggests that for some, exercise could be even more effective than medication in treating common mental health conditions like depression and anxiety. It’s also been proven to significantly improve sleep quality, another critical element of both physical and mental health.
Techniques and Approaches in Integrated Care
Physical therapy for treating mental health issues can come in many different forms. Therapeutic exercises can be tailored to each patient’s physical capabilities to provide general fitness benefits. Bilateral movements like walking on a treadmill or pedaling a bike can also promote relaxation and increased mental flexibility, which can help people see past problems that previously seemed overwhelming. (Bilateral stimulation is a central component of EMDR therapy, a popular and effective type of mental health treatment.)
Relaxation techniques are also therapeutic for people with mental illness. From massage and stretching routines to breathing exercises, physical therapists and their assistants often provide their patients with tools to reduce stress and relieve tension. Body-awareness techniques are similarly effective for many people. By focusing on simple, intentional actions to regulate breathing and posture, they’re able to improve their emotional regulation as a result.
Likewise, movement therapies like yoga and tai chi are regularly integrated into physical therapy treatment plans for people with mental health challenges. These activities are low-impact and low-intensity while encouraging mindfulness, making them an excellent complement to many other types of mental health treatment.
When physical therapists and mental health professionals work together with a whole-person approach to healthcare, the benefits to patients are immense. Collaborating across disciplines encourages providers to learn from one another’s expertise. It also encourages sharing valuable context that can inform future diagnoses or treatment plans and ultimately lead to better outcomes for patients.
Strategies for Integrating Physical Therapy and Mental Health Care
Integrated care is still a relatively new concept in modern health systems. With so much specialization across different areas of healthcare, providers can naturally become siloed from one another. Integrated care brings providers together to collaborate with patients (and each other) in an effort to improve patient’s overall health and quality of life.
In the case of physical therapy and mental health, interprofessional education, training, and networking between the two fields can lead to better outcomes for patients. When experts in both fields are prepared to make initial evaluations and referrals, patients who may benefit from additional forms of treatment can more easily access the help they need.
Collaborative care models are not only better for individual patients, but they also help break down stigmas by reducing segmentation between mental and physical health care. NAMI estimates 60% of people with mental illness didn’t receive treatment in the last year, and stigma is one of the primary reasons why. Seeing mental health care as a normal and necessary thing—rather than something to be embarrassed or ashamed of—makes people more receptive to treatment.
Moving towards collaborative care models requires significant investment on the part of healthcare facilities, providers, and policymakers. However, those investments have proven to pay off. One analysis from the National Institute of Health found that for every dollar mental health clinics spent on implementing collaborative care models, they saved about $1.70.
Addressing the Biopsychosocial Model
The biopsychosocial model is the idea that health and wellness are determined by much more than individual biology. A person’s psychological and social needs are equally important, from their thought patterns and coping methods to their relationships and daily living environment.
Physical therapists who treat patients with mental health diagnoses must consider all aspects of each person’s life to provide the best possible care. By listening to patients’ needs and collaborating with their mental health providers, physical therapists can develop treatment plans adapted to people’s preferences and life circumstances. This makes it easier for patients to stick with their prescribed exercises and activities, leading to better outcomes all around.
At the same time, good physical therapists also consider the psychological and social implications of the patients they treat, primarily for physical ailments. For example, people with disabilities or long-term illnesses may feel isolated and disconnected from their peers or like a burden to their caregivers. Physical therapy clinics must account for how these factors can affect a patient’s treatment and should be prepared to make referrals to mental health providers, social services, support groups, or other resources.
Patient Education and Empowerment
Informed and empowered patients who understand their health conditions and treatment options have better results in both mental and physical rehabilitation. Studies have shown that patients who are engaged in their own healthcare have better health outcomes, as well as reduced healthcare costs. Physical therapists and physical therapy assistants have a responsibility to communicate with their patients and help them understand the “what, when, how, and why” of their treatment plan.
By helping patients understand the connection between physical and mental health, physical therapy providers encourage people to continue their progress and stay consistent with their treatments. They can also provide patients with helpful exercises and techniques to manage their emotions and de-escalate distressing situations.
Even among patients who aren’t in physical therapy for mental health reasons, physical therapists can screen for signs of psychological distress and make referrals to mental health providers and resources. The simple fact that somebody cares enough to notice can give a person the motivation they need to seek help.
Ethical Considerations and Scope of Practice
The American Physical Therapy Association acknowledges that it’s well within the scope of physical therapy practice to screen patients for mental and behavioral health issues as part of an integrated approach to healthcare. Modern physical therapy programs also teach providers to account for the mental challenges that come along with physical ailments and disabilities.
While physical therapy providers are trained on the fundamentals of mental health and how to spot certain issues, there are limits to the level of care they can provide for ethical and liability reasons. Physical therapists and PTAs don’t have the same level of training as licensed clinical social workers or psychologists when it comes to making diagnoses, unpacking trauma and addictions, or conducting talk therapy. They may need to refer patients to providers or organizations that specialize in mental health to supplement the services their physical therapy clinic provides.
Future Directions and Research
As ongoing research continues to show that integrated care is better for both patients and healthcare organizations, physical therapy, and mental health care will likely become linked even more closely. Combining multiple healthcare experts into patient-centric care teams is a challenging task, and we’ll need even more research to establish best practices and provide blueprints for organizations looking to scale collaborative care models. We also need to address health equity gaps to ensure everyone has access to care in the first place.
Developing technologies are also likely to shape the intersection of physical therapy and mental health. Telehealth platforms can increase access to care for patients and enable communication between providers. Emerging platforms like VR can allow collaboration between distant colleagues and provide more engaging treatment activities for patients. In the near future, we’re also likely to see AI and machine-learning tools streamlining the patient-care experience.
Like many other healthcare fields, technology in physical therapy is evolving quickly, and tools that can help providers care for patients and share information more effectively will be in high demand as integrated care becomes increasingly widespread.
Advocate for Whole-Person Wellness as a Physical Therapist Assistant
If you’ve considered a career in healthcare but had trouble deciding on a specialty, becoming a physical therapist assistant is a great way to bridge the gap between physical and mental health. You’ll have the chance to help people transform their bodies and minds through the power of movement and see firsthand all the benefits it brings to people’s well-being.
With a modern curriculum and experienced instructors, the physical therapist assistant program at Provo College teaches future PTAs about the physical and mental aspects of rehabilitative care. You’ll learn how to care for patients with compassion and skill and set yourself up for a successful career in a field that’s growing rapidly.