Working with patients/clients with mental health disorders

I've recently been doing some PRN work at a local skilled nursing facility that specializes in treatment of adults with mental health illness. This has lead me to think about how I work with these patients (in the world of physical therapy), but also working with athletes that may exhibit some of these signs/symptoms.

Let's start with some surprising numbers/stats:

• Approximately 1 in 5 adults in the U.S. (18.5%) experiences mental illness in a given year.
• Approximately 1 in 5 youth aged 13–18 (21.4%) experiences a severe mental disorder at some point during their life. For children aged 8–15, the estimate is 13%.
• Half of all chronic mental illness begins by age 14; three-quarters by age 24. Despite effective treatment, there are long delays (sometimes decades) between the first appearance of symptoms and when people get help.
• Individuals living with serious mental illness face an increased risk of having chronic medical conditions. Adults in the U.S. living with serious mental illness die on average 25 years earlier than others, largely due to treatable medical conditions.
• Suicide is the 10th leading cause of death in the U.S., and the 2nd leading cause of death for people aged 10–34.
• More than 90% of people who die by suicide show symptoms of a mental health condition.

If you've been working in the health care profession or as a strength/conditioning specialist for any time greater than 3-4 months, you've almost certainly met or worked with someone that has some form of mental illness or disability (and there's a good chance you didn't even know it).

The numbers agree that the majority of individuals may not even know about their own condition, at least not until later in life. You may be one of the first people to notice traits/signs of a disorder.

What to look for:

MayoClinic has listed some signs/symptoms of mental illness. Here's what they came up with:

1. Feeling sad/down
2. Confusion or decreased ability to concentrate
3. Excessive fears/worries or extreme feelings of guilt
4. Drastic mood changes both high and low
5. Withdrawal from friends/family and activities
6. Significant tiredness, low energy, and/or problems sleeping
7. Delusions, paranoia, or hallucinations
8. Inability to cope with daily problems or stress
9. Trouble understanding and relating to situations and to people
10. Alcohol or drug abuse
11. Major changes in eating habits
12. Sex drive changes
13. Excessive anger, hostility, or violence
14. Suicidal thinking/thoughts

Understand this:

Not all mental health issues are serious and may not even need to be addressed. However, if you notice that a patient/client is showing signs of some of the more serious disorders, there are some things you can do.

Depending on the individual's age, it may be most appropriate to reach out to a parent or child(ren). If you have developed a strong relationship with the individual, it may be acceptable for you to have an honest conversation with them about things that you're seeing that have you worried. Either way, communication is extremely important, but so is the fact that you want the individual to know that you are on their side and want to see them succeed and achieve their goals.

What can we do to help?

Support! Listen! Exercise!

The first thing that we as health care professionals need to be cognisant of is the importance of our support and what it means to our patients/clients suffering from a mental disorder. If they know that we are there to help them, they will be more willing to open up to us about what they're feeling and express their concerns.

That's when we need to listen. Most people don't like being told what they should or shouldn't feel/think. Listen to their concerns and try to understand where they are coming from. If further intervention is needed (by their primary care physician, for example), they may be more willing to accept it coming from you (or a loved one) when they realize you are there to help them.

Exercise!

Multiple studies have come to the conclusion that exercise can/does help with mental health. Deslandes A., et al report that "the overwhelming evidence present in the literature today suggests that exercise ensures successful brain functioning." They also note that exercise is so beneficial to the brain, it can have a positive impact on the aging process.

This article by P. O'Connor, albeit with limited trials, suggests that strength training can aid individuals suffering from anxiety, chronic pain, cognition, depression, fatigue symptoms, self-esteem, and sleep deprivation. They seem to leave open the possibility that effective strength training may even influence the brain enough to change the degree of a given mental illness.

One last note...

If you or someone you know is suffering from a severe case of mental illness/disability and may be experiencing suicidal thoughts, here are two phone numbers that can be helpful:

Suicide Prevention: 1-800-273-8255

Mental Health: 1-866-305-0703

And a t-shirt that can help the cause!

As always, thanks for reading!