1. Title: Physiotherapy Services for Clients With Mental Health Challenges in Malawi
Authors: Fanuel Bickton, Takondwa Bakuwa, Vyvienne M’kumbuzi
Affiliation: University of Malawi, College of Medicine, Physiotherapy Department
Background. Physiotherapy aims to bring about optimal physical functioning and quality of life in
persons who experience such limitations. Patients with mental health difficulties may benefit from
physiotherapy when they experience pain and other movement related disorders.
Objective. To explore the provision of physiotherapy services for patients with mental health difficulties
in Malawi.
Methods. A situation analysis was conducted involving observation of physiotherapy clinical practice in
a multitude of care facilities, on outreach visits and during community placements. During experiential
learning sessions, patients admitted at Zomba Psychiatric Hospital had their physical function evaluated
using a typical physiotherapy assessment tool and protocol. Discussions were held with physiotherapy
practitioners to explore further their experiences and from the clinical and academic settings. Finally, a
coping review of the instrument available for physiotherapy services within mental health services was
conducted to draw lessons on how the service could be developed in Malawi.
Results. None of the approximately 50 physiotherapists in Malawi work in situations or a facility that is
designated for the care of clients with mental health difficulties; although this aspect is included in the
undergraduate training of physiotherapists. Clients admitted at Zomba Psychiatric Hospital were observed
to have painful and stiff joints, difficulty with walking and some had sustained injuries after falling.
Dysfunction was attributable to the clinical features of the mental health condition, inadequate medication
or the side effects of prescribed medication.
Conclusion. Patients with mental health difficulties also exhibit limitations in physical functioning. These
are a feature of the mental health condition; a consequence of inadequate treatment or a result of the side
effects of their medication. In Malawi, there is growing capacity to provide physiotherapy services to
patients with mental health difficulties who also experience physical dysfunction.
Key words: Physiotherapy, Mental Health Services