(Image includes a doctor and a patient sitting at a table. The patient is wearing an orange shirt and the doctor is wearing a white lab coat. The patient is talking, and a question mark is above his head, signifying that he is wondering if the doctor is listening. Courtesy of: Ian Conger)
“The other doctors wouldn’t even listen to me.”
This is a heartbreaking phrase to hear, not only as a clinician, but as a human being. Yet, it is one of the most common phrases I hear as a physical therapy student. People often feel their doctors spend too little time with them or disregard their opinion. Many patients with chronic disability enter rehabilitation clinics frustrated and emotional after feeling unheard for so long. Rehabilitation therapists consistently spend 30 minutes to an hour with their patients, and this often facilitates strong patient-clinician relationships. From my experience, patients feel safe talking to therapists about their physical and mental struggles, and after a few sessions, people often love sharing stories about their personal lives. One of the most memorable physical therapy situations I have experienced was related to a mother bringing in her child who was diagnosed with Cerebral Palsy. She frequently attended sessions with her child, so the therapists had built a positive relationship with her and immediately welcomed her into the clinic. The mother settled in and broke down right away, expressing how overwhelmed she was with her child’s healthcare, bills, and responsibilities. While this made my heart ache for her, the first thing I thought was, “Am I even qualified to give her any advice?”. I had no mental health training and neither had any of the other therapists in the room. We had no way of helping her in any professional way besides referring her to see someone on her own time.
In the United States, 1 in 4 people have a disability, and many people will experience some sort of disability in their lifetime, whether it's temporary or permanent. Within this population, adults with disabilities are five times more likely to experience mental distress than adults without disabilities. In 2018, 32.9% of adults with disabilities experienced frequent mental distress, and many studies have shown that these statistics are only on the rise after the COVID-19 pandemic. When it comes to caregivers, studies show that 79% of caregivers of children with intellectual disabilities are at risk for clinical depression. Parenting a child with neurodevelopmental disorders has been shown to correlate with higher levels of anxiety, depression, and stress. Some studies show even higher risks of depression and anxiety in parental caregivers who struggle financially, making lower socioeconomical families at a high risk for mental health concerns. Unfortunately, most individuals with disabilities and their caregivers do not have sufficient access to mental health resources. With the constant doctor appointments, school, and therapy sessions, most people don’t even have the time to schedule appointments with a psychologist. This is especially true for children with disabilities, who must rely even further on their parents' work schedule. Also, the health professionals that people with disabilities interact with on a regular basis often have no mental health training to offer to their patients during treatment sessions, forcing them to find it elsewhere. Lastly, people with disabilities and their parental caregivers are dealt significant medical bills, medical equipment costs, and many other accessibility costs that come with disability such as accessible transportation. So, to expect family caregivers or people with disabilities to spend even more money on mental health services almost feels unfair when they already see so many medical professionals in any given month.
All of these reasons reinforce the importance of mental health training for physical therapists. Physical therapy is a career that requires pushing people through their physical struggles, and therapists are often recruited to a person’s medical team after some sort of physical decline or impairment diagnosis. This can be a very emotional time and having a therapist that can work on helping you physically and mentally could be especially helpful. We also know that mental health and physical health go hand in hand. It has been shown that depression increases risks for physical health complications such as diabetes and heart disease. This means that psychological training for physical therapists could not only improve their patient’s overall health, but it could help improve their clinical outcomes as well. This also shows that being able to assist caregivers in their mental health struggles can improve their physical health, which will improve both their quality of life and their ability to continue to care for their child. Overall, mental health is healthcare, and by leaving this out of our treatment sessions, we have forgotten to treat the most important part of each person. In the future, hopefully we can change the catchphrase from “My doctor didn’t even listen to me” to “I have never felt more heard”.
https://www.cdc.gov/ncbddd/disabilityandhealth/features/mental-health-for-all.html
https://www.abilities.com/community/disabilities-mental-health.html
https://www.cdc.gov/mentalhealth/learn/index.htm
https://www.hindawi.com/journals/ijfm/2011/534513/
