Seventeen years ago, Kevin Lau had a few reservations about working as a physiotherapist in the mental health field.

Today, as the head of the physiotherapy department at a large psychiatric hospital in Western Australia, he wouldn’t have it any other way.

“The longer I worked in the area, I thought - wow, this is an area that a physiotherapist is in a very unique position to be able to help people with mental health issues because of our training and expertise in physical health care,” he said.

“Sometimes I call physiotherapists working in this area the physical health gatekeeper of a person with mental health issues.

“We can screen, we can assess, we can provide appropriate early interventions to deal with the physical co-morbidities of a person with mental health issues.”

Mr Lau is one of just a few physiotherapists nation-wide specialising in mental health.

Originally from Hong Kong, Mr Lau said he works to improve the physical health of patients with a range of mental health conditions, including depression, bipolar disorder, schizophrenia, adjustment disorder in society and borderline personality disorder.

“A lot of the time patients with mental health issues are unmotivated due to a number of reasons because of their mental health issues, so they are quite sedentary.

“Sometimes the person may suffer an injury and not go to work and then they suffer financially and they become stressed and that stress component needs to be addressed as well, not just the broken bones or the back injury as such - we also need to look at the person holistically.

“As a physiotherapist, we can inspire and empower an individual, say for example, through motivational interviewing, encouragement and reassurance to help an individual to achieve their goals to improve their physical activity level to promote their recovery, not just physically but also mentally.”

Mr Lau said physiotherapists can also provide safe and effective non-pharmaceutical interventions such as manual therapy and dry needling to assist with pain.

“Sometimes their medication may affect their balance and musculoskeletal system and sometimes that person has a higher risk of falls because of that,” he added.

“Especially as they get older in a psychiatric setting, people are more likely to have falls risk so that’s why we provide falls risk assessment and effective intervention to improve their mobility and to prescribe necessary walking aids as required.”

The Australian Physiotherapy Association (APA) wants physiotherapists to play more of a role in addressing mental health issues.

APA president Marcus Dripps said physiotherapists are experts at managing chronic and preventable diseases, musculoskeletal conditions, and acute and chronic pain - conditions that can also affect people living with a mental illness.

“We’re in an ideal position to detect, assess and manage physical conditions, ranging from musculoskeletal, respiratory, and orthopedic to neurological conditions,” he said.

“Physical and mental well-being are inseparable - a person with mental health issues often suffers from a variety of physical conditions, largely due to the side effects of psychotropic medications and poor lifestyles.”

Mr Dripps said physiotherapists should have a stronger role in assisting people living with a mental illness, from raising awareness to providing pain and chronic disease management, facilitating self-management, and dealing with the co-morbidities associated with mental illness.

“Through greater funding, increased awareness, better referral pathways and more training opportunities for physiotherapists to specialise in mental health, we can be part of the solution to this issue.”

Mr Lau agreed.

“In Australia, one in four or five people will experience some sort of mental health issue throughout their life, so whether you are in a psychiatric hospital setting or even in a normal community you will find people that might have some sort of mental health issues,” he said.

“I have been continuously working in this area for so long and I’m still enjoying every day of my work.”