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Physiotherapy for the mind

Physiotherapy helps to restore movement and function when someone is affected by injury, illness or disability. It can also help to reduce your risk of injury or illness in the future.

The above definition is from the NHS https://www.nhs.uk/conditions/physiotherapy/. I believe that we can and should shift focus in health care to treating the human mind in the same as we do other parts of the body that are affected by injury, illness or disability, devoting care, attention and resource to rehabilitation. In practice this will enable people to develop the necessary skills to make the progress that they want to make and empower them with the confidence and self belief to sustain those changes. 

A positive step forwards was announced by NHS England this week who plan to recruit 1,000 social prescribing 'link workers' into general practice by 2021, as discussed here in GP online.

https://www.gponline.com/nhs-recruit-1000-social-prescribers-2021-ease-gp-workload/article/1523979

Arguably, the main motivation is to reduce costs and reduce pressure on GP services, who regularly see patients who need more time and support than they are able to offer, to address the challenges that they face which may or may not be directly connected to existing medical conditions that need to be treated. However, regardless of the factors behind the decision, it is a hugely positive and progressive step which will lead to positive outcomes for patients which will result in improved health and wellbeing and overall quality of life.

As explained in the article;

'community services such as exercise or art classes, history groups and even ballroom dancing can boost health and wellbeing more than dishing out pills or other treatments'.

Positive progress is often more straightforward and more achievable than it first appears, the difficulty can be getting started. Finding the motivation, confidence and self belief to try something new or even just to reconnect with someone or something again can be extremely difficult at times for any person, not to mention someone who may have one or multiple support needs and who may be isolated and lonely, and furthermore not least for someone living in an area affected by deprivation.

Even the practicalities of how to get started can be challenging. For example, for a man in his seventies or eighties living alone who finds it very difficult to be in social situations, who does not have the knowledge and understanding of how to use computers nor the ability to access one, and who may also be living in poverty, finding and attending an opportunity such as a walking football group (@WalkingFootball) can be virtually impossible without support. Opportunities such as meeting others, having some fun and enjoying exercise that are available through attendance at such groups often feel like a step too far.

This role represents an opportunity for people to bridge that step by accessing the support that they need at that crucial stage where a route forwards can appear daunting and confusing. Patients will have the opportunity of being referred to a Link Worker by their GP in the same way as they are currently able to be referred for an appointment with a Physiotherapist or other specialist. The results, can be and often are literally life saving for very obvious reasons.

This system is currently already running successfully in Scotland in a number of different local authority areas including parts of Edinburgh and Glasgow, as part of a Scottish Government pilot which is due to be completed and reviewed next year. https://news.gov.scot/news/gp-link-worker-programme.

I have regularly had the opportunity to observe this service in action and the positive results are already very clear to see. Regardless of circumstances for individuals (particularly in terms of level of support required), many people are benefitting from an opportunity to connect with a skilled professional who can form a relationship with them. They will listen, assess their specific needs and support them to form a plan, and follow through with positive action over a relatively short period of time that will lead to them feeling more connected to themselves and their communities.

They will also achieve positive outcomes in key areas such as exercise, nutrition, managing difficult situations, fun and enjoyment and relationships. Their individual project may be gardening, reading, counselling or coaching or any of the examples mentioned above or something entirely different. The target may be to gain confidence and meet new people. The outcome invariably is improved health and wellbeing and overall quality of life.

This social prescribing role is a crucial step forwards along the path towards seeing health and wellbeing as being about the whole person, bringing together the concepts of mental and physical health. Someone may well be contending with multiple mental and physical health issues, which often do need specific treatment, however when health care is focused around education and support for the individual simply to improve their health and wellbeing, the results will be more powerful and long lasting. The mind and body are inextricably linked in ways that we are beginning to understand and discover more about, and this role represents a crucial step forward in how we see health care. This is why I see the Community Link worker role as physiotherapy for the mind. The mind is the machine that powers everything that we do, think and feel, and it requires adequate attention.

Supporting people to understand and take effective control of their health and wellbeing is the key, and the foundation is the relationship that Community Link workers have time to build and sustain with patients. The creation of 1000 new NHS roles will be another positive step forwards along this path.