Osteopathy & The Mental Health Setting – A Case Study
“For twelve years Esther Donaghey has used osteopathy to support accommodations for people with enduring mental illnesses. Promoting mental health recovery since training at the BSO, Esther’s experience is an excellent case study for the benefits osteopathic treatment can have on patients’ physical and mental wellbeing….” (As published in the October/November 2020 Osteopathy Today – The Wellbeing Edition)
The Health and Wellbeing academy at the University of Swansea recently conducted one of the first studies on the psychological impact of osteopathy – with positive results 1. As the profession continues to consider its role in the effective support of those with mental health challenges, what’s the reality for osteopaths working in the mental health environment?
The Interview:
“Whilst studying at the BSO, I was asked by a family member with a nursing background to help set up a Mental Health Supported Living scheme. Once qualified as an osteopath, I continued to work part-time managing the community projects, promoting mental health recovery and community integration. It became very apparent early on that the best outcomes were achieved when we provided a more holistic approach to recovery.
“Physical health co-morbidities are much higher in mental health, and people suffering from long term illnesses need additional education and support to manage their physical health problems.
Lack of physical activity and motivation to participate in social environments due to anxiety, fear, depression or paranoia, lead to a negative spiral of musculoskeletal problems, chronic pain, obesity and poor cardiovascular health.”
Reducing the overuse of painkillers
“I saw a role where osteopaths can expand their skills and be educators, social prescribers and highly skilled professionals in the treatment and management of chronic pain and the common symptoms associated with mental illness: anxiety, depression, non-specific musculoskeletal pain. One of my aims in the last five years of practice was to reduce the reliance and hence over-use of prescribed painkillers.
“Many patients also have a history of self-harm (and may continue to have that risk). My most recent patient has nerve and tendon damage to his upper extremities, due to repeated self-harming incidents over an eight-year period. He had been discharged from NHS physiotherapy care after a few after a few exercise-based sessions but continued to have difficulties with everyday manual tasks”
Empowering community-based projects
“I currently work in a new community project that provides accommodation, support and osteopathic treatments for people with mental and physical health disabilities. The organisation is a registered supported living provider with various local authorities. Once approved as a provider, we receive referrals from the Adult Social Care teams seeking supported living placements.
“Through our service, we have access to community recovery teams, social workers, occupational therapists, community psychiatric nurses, secondary care psychology services and psychiatrists.
“The community-based projects provide 24-hour, medium or low support through key-working to promote daily living skills, community integration and independence. Through our recovery programmes, clients placed in our schemes are supported through a holistic and person-centred approach, with an aim of promoting positive behavioural change and empowerment.”
Incorporating social prescribing
“Social prescribing for health and wellbeing is a very important part of my practice and promoting self-help skills for patients. These have included direct referrals or information and guidance to drug and alcohol services, homeopathy, exercise groups, peer support groups, self-harm support groups, books for health, music therapy, mindfulness / relaxation groups and other community activity centres that promote mental and physical well-being. Being able to give people direct contact with the appropriate support organisation, rather than telling someone to ‘Google’ help provides more validity and a better practitioner-patient relationship.”
Osteopathic approach to mental health
“My approach includes the assessment of a person’s fascia and muscle tone and sensitivity in relation to their presented mental health problem or just their mood on the day. Symptoms of depression and anxiety are reflected in the musculoskeletal system.
“During assessments, I would incorporate a mental health status exam if they have a known illness or red flags arise from new patients. This can also help with long term management of the presenting problem(s). Acupuncture and therapeutic massage for stress is popular amongst my patients with depression, chronic MSK problems and psychological pain. As an extension of my practice I have started using Solution Focused Therapy with referred patients from the local authorities and will be offering to my private patients in the coming months.
Osteopaths have always been frontline health professionals with more quality time with out patients. We can extend our practice in the mental health environment by networking and education social care professionals in the role we can play in managing chronic musculoskeletal pain and providing a MSK rehabilitation service for people who may have severely self-harmed causing neuromuscular damage”
Incorporating social prescribing
“Social prescribing for health and wellbeing is a very important part of my practice and promoting self-help skills for patients. These have included direct referrals or information and guidance to drug and alcohol services, homeopathy, exercise groups, peer support groups, self-harm support groups, books for health, music therapy, mindfulness / relaxation groups and other community activity centres that promote mental and physical well-being. Being able to give people direct contact with the appropriate support organisation, rather than telling someone to ‘Google’ help provides more validity and a better practitioner-patient relationship.”
References:
- cronfra.swan.ac.uk/cronfa41045
Esther Donaghey editor
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