The need for clinicians to drive evidence-based practice change to optimise patient outcomes across various settings, is supported by a growing body of evidence in physiotherapy and mental health. [1] Mental and physical health conditions commonly coexist and should not be treated in isolation by physiotherapists. [1-4] With an unprecedented mental health crisis unfolding in parts of the world, physiotherapists could be positioned to assist in closing the gap in care for many people with multimorbidity. [5]

The highest levels of evidence for improving mental health symptoms and conditions includes exercise and physical activity. [1-4,6,8] .Other key interests include benefits, barriers, fitness-for-purpose, optimal program variables and strategies to assist successful implementation of programs. [1-3] Exercise programs are safe and effective in improving depression, anxiety, cognitive functioning and fitness for many people. [2-3] Although larger effects may be seen for greater exercise intensities, [3] the main goal may be any shift in a positive direction related to regular exercise and gains in quality of life and function.

Motivating those with anxiety and stress-related disorders to follow general exercise guidelines can be more effective than highly specific, individualized recommendations for exercise. [4] Measurement and strategies for reducing sedentary behaviour are also key areas to address for people with chronic health conditions. [6]

With greater numbers of people presenting with mental health challenges in general clinical practice settings, and lower knowledge and confidence of physiotherapists related to mental health, [1] building skills is critical. Maximising physiotherapists ability to prioritise forming a trusting, positive, and safe therapeutic relationship could be valuable. [7] Additionally, physiotherapists have capacity in persistent pain management that could be utilised in addressing the complex issue of both mental illness and pain, if current treatment guidelines acknowledged the importance of both issues. [8] Due to variations in scope of practice and healthcare systems in physiotherapy globally, [1] translation of evidence-based approaches into practice is needed.  

There are opportunities for physiotherapists to optimise outcomes and bring focus to supporting people with mental health symptoms and conditions. This session will explore globally applicable strategies including trauma-informed principles to increase collaboration and empowerment, psychologically informed approaches for successful implementation of physical activity and exercise, and considerations for addressing mental health interconnected to pain.  

Ellen Lake will open with defining mental health focused physiotherapy versus mental health informed physiotherapy.  

Sophie Heywood will discuss how trauma-informed principles can be used to increase psychological safety, collaboration, and empowerment to support engagement.  

Davy Vancampfort will share the latest evidence for exercise and physical activity and strategies for behaviour change in people with anxiety and/or depression (including implementation strategies in low resource settings).  

Brendon Stubbs will present the latest data on the comorbidity and outcomes for people with chronic pain and mental disorders and propose the next generation physiotherapy led interventions to address this complex comorbidity.  

The session will conclude with audience participation on enablers to supporting mental health in different contexts and a summary of key strategies to implement, to improve the healthcare experience of both client and clinician.  

1. Heywood, S. E., Connaughton, J., Kinsella, R., Black, S., Bicchi, N., & Setchell, J.(2022). Physical therapy and mental health: a scoping review. Physical Therapy,102(11), pzac102. 
2. Stubbs, B., Vancampfort, D., Hallgren, M., Firth, J., Veronese, N., Solmi, M., … & Kahl, K.(2018). EPA guidance on physical activity as a treatment for severe mental illness: A meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental. European Psychiatry,54,124–144. 
3. Martland, R., Korman, N., Firth, J., & Stubbs, B.(2023). The efficacy of exercise interventions for all types of inpatients across mental health settings: A systematic review and meta-analysis of 47 studies. Journal of Sports Sciences,41(3),232-271. 
4. Vancampfort, D., Heissel, A., Waclawovsky, A., Stubbs, B., Firth, J., McGrath, R. L., … & Schuch, F. B. (2022). Precision-based exercise in people with anxiety and stress related disorders: Are there interindividual differences in anxiolytic effects? An ancillary meta-analysis of randomized controlled trials. Psychiatry Research,317,114803. 
5. Tatta, J.(2024). A Call to action for mental and behavioral health stakeholders: use physical therapists to close the gap in depression care. Physical Therapy,104(2),pzad147. 
6. Vancampfort, D., Van Damme, T., Albanio Machado, V., McGrath, R. L., Stubbs, B., & Schuch, F. B.(2023). Levels of sedentary behaviour in people with fibromyalgia: a systematic review and meta-analysis. Disability and Rehabilitation,1-7. 
7. Heywood, S., Bunzli, S., Dillon, M., Bicchi, N., Black, S., Hemus, P., … & Setchell, J.(2024). Trauma-informed physiotherapy and the principles of safety, trustworthiness, choice, collaboration, and empowerment: a qualitative study. Physiotherapy Theory and Practice,1-16. 
8. Ma, R., Romano, E., Ashworth, M., Smith, T. O., Vancampfort, D., Scott, W., … & Stubbs, B.(2023). The effectiveness of interventions for improving chronic pain symptoms among people with mental illness: a systematic review. The Journal of Pain.104421.