According to the International Organization of Physical Therapy in Mental Health (IOPTMH), physiotherapy in mental health is a recognized specialty of physical therapy, with a subgroup representing physiotherapists from around the world before the World Confederation of Physical Therapy (WCPT). It is implemented in different settings, in health, psychiatry and psychosomatic medicine. It is person-centered and is provided to children, teenagers, adults and older persons with mild, moderate and severe, acute or chronic mental health problems, in primary and community care, inpatients and outpatients.

This specialty, despite having a long history in Europe, has had just a few developments in Americas. This does not suggest that physical therapy is not practiced in patients with mental illnesses, since many psychiatric hospitals have physical and occupational therapy areas since they were founded; However, there are some techniques such as Basic Body Awareness Therapy, Norwegian Psychomotor Therapy and Psychosomatic Therapy, unknown and therefore used.  Most used techniques in hospital centers or clinics are exercise and physical activity, manual therapy and adapted massage, psychomotricity, different relaxation techniques and neurorehabilitation.

Adding to the already mentioned techniques different forms of breathing (such as slow diaphragmatic breathing), global postural reeducation, oriental techniques such as Yoga, Tai-chi and some meditative practices, it is clear that physiotherapists have so much to contribute in the evaluation, treatment and improvement of the symptoms of people living with mental health problems. These approaches, offered in conjunction with the patient's pharmacological and psychotherapeutic treatment, in the context of an inter or transdisciplinary team, have been shown to help improve the quality of life, socialization, decrease biopsychosocial disability and also help reduce the use of drugs.

A quarantine can be lived as an unpleasant experience, with the worry, fear, anxiety, uncertainty and boredom that it brings, added to the loss of freedom, the separation of loved ones or friends, can lead to suicide attempts or completed suicides if mental health problems are not attended and detected.

Analyzing the current situation, there is an increase in the rates of mental problems both in health workers: depression 50.4%, anxiety 44.6%, insomnia 34.0%, and distress 71.5%, and in the general population: depression, anxiety, negative feelings, alcohol, tobacco or medication abuse, concentration problems, fatigue from teleworking and worsening symptoms in people who are suffering from mental problems due to social isolation and economic impact.

And on the other hand, other causes of distress that arise with the pandemic, such as in those who were directly affected by the disease or death of a relative by covid-19, those who lost their jobs, families who had to move because they lost their home, those who were exposed to a lot of misinformation (“infodemic”) on social networks with the risk of fake news creating worries or people who have a family member with a disability and had their physical therapy suspended in their rehabilitation care center.

"The figures are there," warns the WHO, recalling that in conflict settings around 1 in 5 people suffer from mental disorders, data that could be reached or exceeded in this crisis if measures are not put in place to alleviate, accompany and give support to those who need it. Although the covid-19 pandemic is a physical health crisis, they note, "the impact on mental health is significant and could lead to greater difficulties if not properly addressed".

"We know”, said the WHO, “that mental health needs are not receiving the attention they require," something that is exacerbated by the lack of investment and prevention in this area before the arrival of the pandemic. I therefore consider it is important to emphasize that for physical therapists it may be a time of opportunity to strengthen specialties in physical therapy, as we know many physical therapists specialized in cardiac, respiratory and mental health rehabilitation will be required to provide care and treatment to the population affected by covid-19 and who were hospitalized or in intensive care unit for a few weeks.

In this situation, how can Mental Health Physiotherapists promote the well-being of the population facing a pandemic? Physiotherapists specialized in mental health rely on both the biopsychosocial concept of health and the concept of therapeutic intervention called "body-mind", because the symptoms and the state of the body are interpreted in the context of it, as a regulator of the emotional well-being of the person. The physical therapist assesses the relationship between physical condition, verbal and body expression and sees if there is consistency among them.

Physical well-being is a prerequisite for mental well-being and vice versa. Mental problems cause alterations in the body and physical disorders reverberate in our psychology, and from there it can move to somatization, where emotional and mental symptoms are expressed in the body through physical discomfort, due to situations that sometimes people cannot recognize.

Given the different approaches, one way of acting is on the direct consequences of the disease or on the patient's somatic complaints, this can be pain, anxiety, muscle tension just to name a few examples and can be intervened with breathing techniques, relaxation, manual therapy or adapted massage, basic body awareness therapy, postural reeducation. In relation to exercise, there is sufficient evidence of the physiological and psychological benefits: mood improvement, cognitive function, cerebral circulation, self-esteem by improving body image and perception of physical condition, contributes to have more effective coping mechanisms, it favors cardiovascular health, an important point in those patients who are consuming psychotropic drugs, with the well-known metabolic adverse effects.

Since gyms and sports centers are closed, public parks are restricted and given the limitations of mobility, it is recommend that people look for other strategies such as: walking at home, jogging, exercising on a stationary bike, dancing, etc; however, for those who do not have these means, they can perform slow diaphragmatic breathing exercises (5 seconds of inhalation and 5 seconds of exhalation) and some meditation techniques such as mindfulness. These activities can help during isolation to protect physical and mental health.

It is important to expand the knowledge of the Mental Health Physiotherapy, not only in the face of the pandemic. Considering that one in four people will experience a mental health problem throughout their lives and that these problems are among the main causes of morbidity and mortality in the world, in addition to the fact that many of the patients that are treated by physiotherapists present depression or anxiety as comorbidities, it is evident that this is a strong public health problem, without taking into account the economic impact people are facing.

Mental Health Physiotherapy has been underestimated, there is evidence that it can improve the quality of life of people who have a mental illness. Improving the physical health of the patient will be reflected in his mental health, and it can also help reduce psychosocial disability and by improving bodily functions like breathing, balance and flexibility that are associated with a feeling of greater security and improved self-esteem.

To sum up, I consider it is important to underline the usefulness and value of physiotherapy in mental health and its techniques. Even if these techniques are a little unknown, let’s note that they are economical and relatively easy to be done at home with the right physiotherapist. Not only this, but from all the benefits in mental and physical health already mentioned, feeling calmer can improve a wide scope of things from relationships to the immune system, not to mention enhancing decision making and making it less likely to suffer from panic attacks due to the infodemic. Even though there is a clear and strong connection between physical well-being and mental health, there still is a lack of acknowledgment and understanding of the great value of physiotherapy when treating not only people with mental disorders and illnesses but also people in general suffering from stressful situations like this pandemic or other life situations.