Mental Health, Physical Activity and

Physical Therapy
Introduction
Mental health is defined as a state of well-being in which every individual
realizes his or her own potential, can cope with the normal stress of life,
can work productively and fruitfully, and is able to make a contributions to
his or her community. [1] More concrete mental health includes different
components of life; for example, in terms of relationships, having a good
relationship with family and having supportive friends, with the ability to
talk about feelings. For leisure time it is about having hobbies, doing
exercises on regular basis and having regular holidays. Furthermore, it is
important to follow a healthy lifestyle that includes, having healthy eating
habits, not smoking or drinking and not taking non‐prescribed drugs and at
least being able to achieve some goals in life. Mental health is not merely
the absence of a mental disorder. It exists on a continuum to include
flourishing mental health, very good mental health, mean mental health,
decreased mental health, mental health problems and mental health
disorders.[2] Exercise is an evidence-based treatment for people with mental
health issues, and physical therapists work with people who may have
mental health issues alongside other long-term health issues. [3]

Mental disorders comprise a broad range of problems. They are generally

characterized by a combination of abnormal thoughts, emotions, behavior
and relationships with others. Some examples: schizophrenia, depression,
intellectual disabilities and disorders due to drug abuse. People with
mental illness, like depression, schizophrenia and bipolar disorder, often
have poor physical health and experience significant psychiatric, social and
cognitive disability. https://youtu.be/FB49AezFJxs

Epidemiology
About half of the mental disorders begin before the age of 14. Similar types
of disorders are being reported across cultures. Neuropsychiatric disorders
are among the leading causes of worldwide disability in young people.
About 23% of all years lost because of disability is caused by mental and
substance use disorders. War and disasters have a large impact on mental
health and psychosocial well-being. Rates of mental disorder tend to
double after emergencies. Mental disorders increase the risk of getting ill
from other diseases such as HIV, cardiovascular disease, diabetes, and
vice-versa.[4]
 1 in 4 people will experience a mental health issue of some sort
during their lifetime [3]
 1 in 6 people are likely to have had mental health issues in the past
seven days[3]
 people with mental health issues are more at risk of having poor
physical health [3]
 70% of premature deaths in people with mental health issues are due
to poor physical health [3]
 mental health issues are one of the main causes of the overall disease
burden worldwide. [3]

Barriers to Mental Health Services

Misunderstanding and stigma surrounding mental ill health are

widespread. Despite the existence of effective treatment for mental
disorders, there is a belief that they are untreatable or that people with
mental disorders are difficult, not intelligent, or incapable of making
decisions. This stigma can lead to abuse, rejection and isolation and
exclude people from health care or support. Within the health system,
people are too often treated in institutions which resemble human
warehouses rather than places of healing. [4]

Human rights violations of people with mental and psychosocial disability

are routinely reported in most countries. These include physical restraint,
seclusion and denial of basic needs and privacy. Few countries have a legal
framework that adequately protects the rights of people with mental
disorders. Globally, there is huge inequity in the distribution of skilled
human resources for mental health. Shortages of psychiatrists, psychiatric
nurses, psychologists and social workers are among the main barriers to
providing treatment and care in low- and middle-income countries. [4]

In order to increase the availability of mental health services, there are 5

key barriers that need to be overcome [4]:

 the absence of mental health from the public health agenda and the
implications for funding;
 the current organization of mental health services;
 lack of integration within primary care;
 inadequate human resources for mental health;
 and lack of public mental health leadership.
 Governments, donors and groups representing mental health service users
and their families need to work together to increase mental health services,
especially in low- and middle-income countries. [4]

The Relation of Physical Activity and Exercise to Mental

Health
https://youtu.be/_6JIXnwW03Q

Mental disorders are of major public health significance. It has been

claimed that vigorous physical activity has positive effects on mental health
in both clinical and non-clinical populations. [5] Mental health problems are
the leading predictor of years lived with disability worldwide. Furthermore,
without intensified prevention and management, the burden is estimated
to increase to a greater extent. The consequences of mental health
problems are devastating for the person and society as a whole and are
compounded by physical health comorbidities with which most people with
mental health problems are confronted. Physical health comorbidities are a
major cause of the reduced life expectancy of 15–20 years in this
population. The relationship between mental health and physical activity is
supported by a growing number of articles. There is rigorous evidence now
that physiotherapy improves mental and physical health in this vulnerable
population.

Follow the link for more information about  Physical Activity and Mental
Health

Unfortunately, these efforts are becoming integrated into clinical practice

at a slow pace. Physical activity is not always considered to be a worthwhile
strategy. The benefits of physical activity are twofold, as people with
mental health problems are also at an increased risk of a range of physical
health problems, including cardiovascular diseases, endocrine disorders
and obesity. Physical activity influences cognition and cardiorespiratory
fitness and reduces dropout due to a wide range of mental health problems.
The relationship between physical activity and mental health has been
widely investigated.

The health benefits of regular exercise are:

 Improved cardiovascular fitness

 Improved sleep
 Better endurance
 A positive influence on metabolic syndrome and diabetes
 Stress relief
 Improved mood
 Increased energy and reduced tiredness.
 Exercise reduces anxiety, depression, negative mood and social
isolation and improves self‐esteem, cognitive functions and quality of life. [2]

https://youtu.be/OK_vnVbxBXE

The Role of Physiotherapy in Improving Mental Health

Not all physiotherapists realize that mental health is all the business of
physiotherapy. However, it is well illustrated in this quotation: ‘no health
without mental health'. [2] Physiotherapists are seen as experts in aspects of
physical health care and can offer:

 Non-pharmacological management of pain

 Expertise in prescribing individualised exercise programs, which can
improve mood, promote wellbeing and address co-morbidities associated
with mental health diagnoses.
 Interventions to address physical issues of people with mental health
diagnoses which hinder social participation and recovery, eg. minimising
or counteracting the side-effects some of psychotropic medications
 Expertise in motivating, where appropriate, patients and promoting
self-management in the context of mental and physical health issues.
 Management of falls and mobility issues for older people and
developmental issues for children and young people.
 Expert advice and intervention to address impaired body awareness
and reduce dissociation (disconnection from ‘thoughts, feelings, memories
or sense of identity) associated with poor mental health.
 Development and delivery of individually-tailored lifestyle and
weight management advice and programs. [6]

Good mental health is fundamental to the well-being of individuals,

families and communities. Poor mental health is identified as one of the
biggest causes of disability, poor quality of life and reduced productivity.
There is also a strong association between mental health conditions and
people reporting multiple pain sites. It has been documented that physical
activity can improve quality of life for people with serious mental illness.
Improved physical health can alleviate psychiatric and social disability. A
notable number of longitudinal and cross-sectional studies have proven the
usefulness of physical activity as a preventative strategy and as adjunct
treatment for mental illness. Several physiotherapy interventions are
potentially effective in improving physical and mental health and health-
related quality of life. The most commonly used forms of exercise are
aerobic- and strength exercises. Aerobic exercises, such as walking,
jogging, cycling, swimming, have been proven to reduce anxiety and
depression

The burden of depression, anxiety and other mental disorders call for
concerted, intersectoral response. Not only to raise public awareness but
also to provide treatment and prevention strategies that can reduce this
large and growing health problem, including the economic losses
attributable to them. The correlations between poor mental health and an
increased prevalence of musculoskeletal conditions, multiple areas of pain,
chronic and preventable diseases, emphasizes the need for an effective and
holistic multidisciplinary approach to the management of these conditions.
[7]

Physiotherapists have also a key role in the treatment of patients with

schizophrenia and their interventions may have a broad spectrum of
benefits for patients. In particular, physiotherapists are physical health
experts providing an important bridge between physical and mental health
in patients with schizophrenia. Promoting and encouraging physical
activity is central to the physiotherapist’s role in treating individuals with
schizophrenia.[8]

Definition of Physiotherapy in Mental Health

Physiotherapists who were working in mental health and psychiatry
applied in 2011 for recognition as a subgroup within the World
Confederation of Physical Therapy. The main goal of this subgroup is to
bring the different physiotherapy interventions in mental health and
psychiatry together to clarify the role of physiotherapy in this field.

For that reason, the International Organization of Physical Therapy in

Mental Health (IOPTMH) developed a definition that generally describes
the field of physiotherapy in mental health that is recognizable among most
colleagues across the world. Physiotherapy in mental health is a specialty
within physiotherapy. It is implemented in different health and mental
health settings: psychiatry and psychosomatic medicine. It is person-
centered and provided for children, adolescents, adults and older people
with common (mild, moderate) and severe, acute and chronic mental
health problems, in primary and community care, inpatients and
outpatients. Physiotherapists in mental health provide health promotion,
preventive health care, treatment and rehabilitation for individuals, groups
and in‐group therapeutic settings. They create a therapeutic relationship to
provide assessment and services specifically related to the complexity of
mental health within a supportive environment applying a model including
biological and psychosocial aspects. Physiotherapy in mental health aims to
optimize wellbeing and empower the individual by promoting functional
movement, movement awareness, physical activity and exercises, bringing
together physical and mental aspects. It is based on the available scientific

and best clinical evidence. Physiotherapists in mental health contribute to

the multidisciplinary team and interprofessional care. [2]

References
https://www.physio-pedia.com/Mental_Health,_Physical_Activity_and_Physical_Therapy

New Words Found

Epidemiology=Epidemiologie
(The branch of medicine that deals with the study of the causes, distribution, and control of disease in 
populations.)

Stigma=stigma(An association of disgrace or public disapproval with something, such as an
action or condition)

Seclusion=Izolare
Adequately= mod adecvat, suficient, corect
Inequity= Inegalitate, inechitate
Inadequate= Insuficient, neadecvat
Compounded=amplificate, agravate
Comorbidities=comorbiditati( Coexisting 
or concomitant with an unrelated pathological or disease process)

Questions
1)What are the consequences of stigma around mental ill health?
Stigma around mental ill health will always make the problem even worst, because
with stigma comes isolation of the ill
2)What are the main causes of mental disorders?
Mental disorder is mainly caused by negative factors, for example: war, violence,
racism, childhood abuse, but also lack of socialization.
3)How could physical exercises help cure mental illness?
Physical exercises are well known for their benefic proprieties, besides the fact that it
activates many benefic neurological processes, it also encourages socialization, all
mandatory for mental health well-being.
4)How can mental health awareness be spread without stigma increasing?
When talked about mental disorders, everything must be explained clearly, so that
everyone can understand that the disorders can be cured, and are not a result of low
IQ but most important is the fact that the sick is not responsible for his illness.
5) How can I tell if someone has a mental health problem?

You can’t always tell if someone has a mental illness – people might look as though
they’re fine and doing well, when actually they’re silently struggling. If someone has
bipolar disorder, they may show significant mood swings, or appear more withdrawn
if they are dealing with self-harm or negative thoughts, but everything is dependent
on the individual and there is no one way to know whether someone is unwell…
6) How can I speak to and help someone with a mental health problem like
depression or anxiety?
Perhaps the most important thing you can do is encourage them to seek
appropriate treatment. You can reassure them by letting them know that help
is out there, and that you will be there to support them. Don’t be afraid to bring it
up. It takes a lot for someone to say, ‘I need help’, but it doesn’t hurt to raise
the subject yourself. Try to be open about depression and difficult emotions,
so they know that it’s OK to talk about what they’re experiencing. Sometimes,
you don’t have to explicitly talk about mental health to find out how they are
doing – it can be as simple as texting them to let them know you’re thinking of
them, or suggesting that you go out for dinner or a walk. Try not to blame
them for feeling anxious or depressed, or tell them to ‘pull themselves
together’. They are probably already blaming themselves, and criticism is
likely to make them feel even worse. Be patient. Someone with depression
may get more irritable, and be more liable to misunderstand others, or feel
misunderstood, than usual. They may need reassurance in some situations.
Look after yourself. Your mental health is important, too, and looking after
someone else could put a strain on your wellbeing. If you are able to stay well,
you are more likely to be able to provide good support for longer. This could
include trying to stay healthy and physically active, confiding in someone –
other than the person you are worried for – taking a break from time to time
and being realistic about what you can and can’t do yourself.
7)Are drugs better for mental health conditions?
While antidepressants can be effective for some, they are not the solution for
everyone and are not generally recommended as a first-line treatment for mild to
moderate depression. Anyone taking antidepressants should be made aware of the
possible pros and cons for them, and they should have their treatment reviewed
regularly.