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Mental healthcare under the microscope

Congress 2005 will explore how to give older mental health service users with mobility problems a chance to remain in the community. It's just one of a number of issues which will be dealt with by mental healthcare experts presenting papers at the CSP's flagship scientific event in October.

Clare Leonard is a superintendent physiotherapist at the department of old age psychiatry at Swindon's Victoria Hospital, where she works in a community mental health team. She'll talk about a liaison service she's involved in which ensures older people with dementia are not excluded from rehabilitation services.

She told Frontline that she and one other physiotherapist, along with a junior who works on a rotational basis, were included as part of the team to ensure that this client group have equal access to physiotherapy. 'We had patients going into acute settings who were not getting the help they needed,' she explains. 'A lot were being recommended to go into nursing homes but the liaison service has helped physios to get in to work with them and regain their mobility and return home.'

Ms Leonard says seeing patients having successful rehabilitation that allows them to remain in the community is 'very satisfying'.

Geriatric expert Raymond Tallis will be well-known to most readers of Frontline, particularly for his work in stroke rehabilitation, as a government adviser, and one of the key players in developing the national service framework for older people. A Congress regular, this year he will deliver a lecture on 'the somewhat artificial interface between mind and body in physiotherapy'.

Professor Tallis suggests there is a need to go beyond the 'common sense observation' that a patient's mental attitude can influence the outcome for physical illnesses. Another observation he says needs to be explored further is the fact that people with mental illness experience an impact on their motor function and posture. 'I won't be offering any solutions but just making suggestions as to a different paradigm in the way we think about things,' he told Frontline.

'I'll be trying to find a middle way between magic thinking that imagines physical problems can be solved by, as it were, mental effort and reductionism, that denies the central role of the mind in recovering from neurological problems.'

He adds: 'There is a need to break down the apartheid between physiotherapists working in mental health and those working with patients with neurological problems.'

Another prestigious speaker will be Simon Wright, a consultant psychiatrist for older people at Rotherham General Hospital in South Yorkshire. Dr Wright will outline the epidemiology, pathology and management of gait abnormalities that are associated with dementia. He will also talk about the risks of gait abnormalities and falls among this client group and discuss pharmacological interventions that may help.

Valerie Pomeroy, professor of rehabilitation for older people at the department of clinical developmental sciences at St George's University of London, will discuss enhancing the recovery of severely affected upper limbs after stroke using what she describes as a 'mirror neurone system'.

Wrapping up the Chartered Physiotherapists in Mental Healthcare programme will be Sharon Greensill, a physio specialist at Rotherham General Hospital, who will talk about mental health liaison triage with outpatient musculoskeletal physiotherapy.

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