Physiotherapy in Forensic
Mental Health
Our service
• Forensic mental health services
– community team
– forensic rehabilitation unit
– court liaison service
– IPCU
• Ailsa Hospital
• Ayrshire and Arran
“A strong AHP workforce in mental health brings benefits for all”.
“It brings benefits to AHPs and their colleagues in the
multidisciplinary,multiagency team through the recognition and
deployment of highly-skilled, clinically effective AHP practitioners as
part of integrated mental health services”.
Shona Robison, MSP
Minister for Public Health and Sport
By including a dedicated Physio in the Forensic Service NHS Ayrshire
and Arran is supporting the development of new models, systems
and ways of working to facilitate early interventions and timely
access for service users and carers. (RP Rec 1)
Role of Physiotherapist
• Use physical approaches to promote, maintain and
restore physical, psychological and social well being
(RP Rec 4)
• Promote health related behaviours including smoking
cessation, weight management and physical activity.
• Maintain focus and raise awareness in all staff groups of
the importance of health related behaviours.
• To ensure the provision of evidence-based, socially
inclusive and accessible physical activity rehabilitation
programmes for service users and carers. (RP Rec 4)
Physical Activity
•
•
•
•
•
•
Evidence based
Socially inclusive
Accessible
Helps optimise mental well being
Helps optimise physical health
Reduces the risk of early death
Focus Groups
• Service users have confirmed that being
physically fit and active is important to them
• Recent research in service users experiencing
schizophrenia and living in the community
identified barriers to engaging in physical activity
• Limited experience of physical activity
• Impact of illness and medication effects
• Anxiety and the influence of support networks
Interventions
• Tailored to the individual taking into
account
•
•
•
•
•
•
Low motivation
Poor concentration
Sedentary Lifestyle
Weight Gain
Movement Disorder
Other side effects of medication
Staff Engagement
• Work with partners to promote and enhance the
provision of evidence-based, socially inclusive and
accessible therapeutic activity in a range of
settings.(Realising Potential Rec 6)
• Hobbies and interests of staff identified and matched
with those of patients
• Staff encouraged to participate with patients
• Appropriate equipment accessed
Structured activity
•
•
•
•
•
•
•
•
•
Healthy eating and dinner groups
Two walking groups per week
Daily gym sessions / Swimming access/Yoga
Badminton group weekly
Ward cycles for usage by patients
Golf supported at driving range and golf course
Exercise groups at local leisure centres
Mindfulness sessions
All patients have a timetable which is agreed with the
named nurse and updated weekly
Blood pressure
Blood pressure
Weight Loss
Staff Comments
• I have a fuller and more holistic perception of clients
needs.
• Keeps team ‘eye on the ball’ when it comes to physical
health.
• Specialist input readily available
• Consistency of care from inpatient to community helps
maintain health gains and support activity.
• Encourages staff to take stock of own physical well being
• Staff are considering activities that can have an impact
on the whole team’s health
• It’s had a positive impact on staff sickness absence
Conclusions
• High prevalence of physical health problems in those
with mental health problems and this is rising.
• Higher Mortality Rates
• Good evidence that physiotherapy led interventions are
effective in improving health and wellbeing
• Good health gains achieved
• Measuring effect of physiotherapy in a forensic
population to ascertain effectiveness of these activities in
improving physical health is ongoing.