When I graduated as a physiotherapist, research and mental health were both far off my radar. After lounging around for the summer post-graduation, my Mum (who was the head of Pharmacy at a local psychiatric hospital) encouraged me to go and talk to the head of physiotherapy – and I did that to mainly get my Mum off my back! After an informal discussion, and to my surprise, I was invited for an interview and then offered a job in a Neurobehavioral Brain Injury Unit. This was a highly unusual move for a physiotherapist at that time to start off working in mental health but it set me off down a very interesting path.
In the Neurobehavioral Brain Injury Unit, I found myself working with a close-knit multidisciplinary team with some interesting patients whose behaviour, cognitive and physical presentations had changed drastically as a result of a brain injury.
“The challenge, variety and need to consider the mind and body together had me hooked.”
I realised it would be difficult for me to go and work in a “traditional” physiotherapy area again. I subsequently went on to develop a physiotherapy service in a Huntington’s Disease specialist unit, a specialist older adult mental health and dementia unit, and a Forensic service for older adults.
When I started working on the Huntington’s Disease unit (2005), I tried to seek out the evidence for physiotherapy in this group. To my shock there was virtually none and this was quickly lead to a realisation that perhaps I could try and write about some of the clinical work we were doing. Supported by my research active clinical psychiatry/psychology colleagues,
“I started out by writing some guidelines for physiotherapy for carers and service users and then began writing up some case studies.”
Shortly after this, when working in older adult mental health, I realised this group were at great risk of falls and fractures. I worked with a psychiatrist, acquired a small amount of funding to hire a DEXA scanner, received some training and in my lunch breaks and after work started undertaking peripheral DEXA scans of our 100 inpatients and published this.
Through these initial “hobby” projects, I had acquired an interest in writing about the important clinical issues we were facing. I recognised through my work experience the poor physical health among people that use mental health services and realised that physiotherapists could play a key role – but I needed further training. I subsequently completed an MSc and became more research literate, but things really took off when I started my PhD in 2012 in a full-time capacity.
“During this time, I started to build networks of researchers and avidly devouring research methods and my research horizons really broadened.”
Whilst I enjoyed doing my PhD full time, I missed working with patients as a physio and so I was glad to be able to secure a job as Head of Physiotherapy at the South London and Maudsley and a post doc at the Institute of Psychiatry, Psychology and Neuroscience (King’s College London). During this time, I was working with patients in clinic again every week and was back also being ‘Brendon the physio’. Here, in this role, I have been able to further develop my clinical, leadership and research skills and undertake a wide range of stimulating research projects with colleagues across the UK and all over the world.
Today, my research focuses on understanding and improving the physical (and mental) health of people that use mental health services and in particular the role of lifestyle psychiatry. I use local and national data and am also involved in clinical trials. More recently, I have enjoyed disseminating research into the public domain through popular media or podcasts such as the “Feel better Live More” podcast by Dr Rangan Chatterjee, Europe’s most- listened to health podcast. Times have changed – during this time in the early 2000’s, mental health physiotherapy lacked recognition and I recall when I turned up on one mental health ward, a Consultant Psychiatrist warmly welcomed me but politely asked “what on earth do we need a physiotherapist for?” My clinical and research work, has always focused on the links between physical and mental health, initially people were sceptical about physiotherapy in mental health but this work and our work feels more relevant and important than ever.