Experiences of physiotherapy in mental health: an interpretative phenomenological analysis of barriers and facilitators to care

Abstract

Background

Service users with severe mental illness (SMI) are at increased risk of physical health co-morbidity such as musculoskeletal pain, neurological impairment, obesity and COPD; many of which require input from physiotherapists. Physiotherapists play a pivotal role in treatment of those with SMI but are reported to lack skills and confidence with this patient group. Furthermore, disparities in accessing healthcare are evidenced for those with SMI.

Purpose

This study explored experiences of physiotherapeutic care for those with co-morbid physical and mental health complaints to identify barriers and facilitators to care.

Methods

A qualitative study using Interpretive Phenomenological Analysis was undertaken. Semi-structured interviews were completed with service users (n=8) with longstanding physiotherapeutic and psychiatric complaints. Focus groups were completed with physiotherapists working in mental health. Verbatim transcripts of interviews were analysed using Interpretive Phenomenological Analysis to obtain in depth insight into participant experiences. Study quality was enhanced through use of methodological and investigator triangulation, negative case analysis, reflexivity and secondary coding.

Analysis

Data was analysed systematically following the structure: individual case analysis, emergence of themes, cross case analysis, validation of themes and ideas.

Results

This analysis produced five master themes: Communication [1], holistic care [2], benefit of physiotherapy [3], healthcare politics and service interaction [4], patient activation [5]. Results identified current service provision did not always meet the complexities of service user needs.

Conclusion and Implications

Improved physiotherapist awareness of mental health and how to communicate and treat this population was identified. The importance of better integration between services was also highlighted. A positive experience of physiotherapy is vital for patient activation and engagement with physiotherapy.