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Patients and Mental Health: Let’s Keep the Conversation Going

May 08, 2019

We’d like to thank everyone who joined us for our webinar, In Harm’s Way: Strategies to Support Patients with Mental Health Issues.

We received a ton of great questions before and during the webinar, and we apologize that we weren’t able to address everything in the allocated hour. It’s evident that this is an important conversation and that many physiotherapists are looking for ways to best support patients who disclose mental health challenges, while staying within their scope of practice.

We were fortunate to have two extremely knowledgeable practitioners, Dr. Mary Preisman and Dr. Yvonne Bergmans, who shared numerous tangible take-aways and helpful resources that will benefit physiotherapists.

Key Take-Aways for PTs

  • Remember that it’s not your job to counsel patients about their mental health. Obtain permission from the patient to discuss what they’ve disclosed to you with a more appropriate health professional.

  • Duty to warn may supercede patient confidentiality when there is imminent risk to the patient’s safety, the safety of another person or when the patient has demonstrated a complete inability to care for themselves. Imminent risk may include if the patient has told you they plan to leave your office and harm themselves or someone else. When in doubt, consider asking a colleague.

  • If there’s something that stands out to you about a patient, comment on it. This may include bruises, cuts or the way someone moves their body during treatment. Consider starting with “I notice there are some cuts on your arm, would you like to tell me about that?” As a physiotherapist you may be the first person to see cuts, marks or bruises on a patient’s body. Ask the patient if it’s something they may want to talk to someone about and then inform the appropriate practitioner. Acknowledgement and empathy can often lead to a conversation that ends up being quite helpful for the patient. Note that if the patient is under 16 years of age you are required to file a report with the Children’s Aid Society, and if the patient is 17 or 18 years of age you are still permitted to file a report if you have concerns.

  • Use your physiotherapy knowledge to help patients develop a sense of control. If you’re aware of how long the pain will last, how long the course of treatment will be or what experiences they can expect during treatment, always inform the patient so that there’s an end goal. This is especially helpful for patients who are struggling with chronic pain that’s impacting their overall mental health. As Dr. Preisman said, “as humans, we can tolerate almost anything if we know when it’s going to end.”

How to Approach Discussions Around Mental Health

The webinar offered a number of helpful phrases that PTs can keep in their toolkit should patients disclose that they have been abused, are experiencing suicidal thoughts or struggling with mental health. Remember it’s very important to be empathetic, non-judgmental, and to use words that feel authentic. Here are some examples:

  • I can tell that you’re really going through a lot right now.
  • I can see that you’re suffering.
  • What can I do to help you feel more comfortable?
  • I’m concerned for your safety.
  • Is it ok if I reach out to your family doctor to let them know that you’ve raised this with me?

Webinar Resources

Suicide Crisis Line Resources
Resources for Youth
Resources for Someone Wanting to Support Someone Who Self Harms
Resources for People Experiencing Abuse and Sexual Assault
Mandatory Reporting
How to Box Breathe

If you missed the webinar you can access the archived version using this link.

More Strategies to Support Patients

Have an idea for an upcoming webinar? Share your suggestion in the comments below!

Leave a comment
  1. Tim | May 24, 2019
    Thank you!
  2. Dave | May 14, 2019

    When is the curriculum offered in Canadian Physiotherapy programs going to be audited in order to reform what students graduate with?  The topic of Mental Health is a perfect example.  Physio students are not provided with anything close to an adequate education in mental health.  Pain Education is a core feature that is supposed to be integrated into the biopsychosocial model of care.  Again, students are not provided with an adequate understanding of the psychosocial dimensions of health.  Burnout is intimately tied in with mental health as well, yet instead of accepting that it is responsible for training students in this area, leaders in the profession seem to shrug it off as part of the challenges in working in health care.  

    If this profession continues to refuse to take responsibility for making vital changes to how it trains students, and yet continues to pump out graduates that lack self confidence in clinical practice, everyone loses.

    Perhaps it's long past time for the talk to give way to actual changes that bring the profession of physiotherapy into the modern day.

  3. Payal | May 08, 2019

    no discrimination

    Have empathy

  4. P | May 08, 2019
    The role of physiotherapists in care of people living with HIV

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