Stroke survivors can face multiple challenges during recovery, including psychological, but the majority of those in recovery do not feel adequately supported.

This World Stroke Day, the Stroke Association is calling for more emotional and mental health support for those in recovery.

A recent survey from the national charity support people following strokes finds that 94% of respondents reported an impact on their emotional wellbeing from having a stroke.

Those who have suffered a stroke can experience anxiety and depression during their recovery, with 75% of participants in the survey did not feel they received the support they needed in hospitals.

As part of research by the Stroke Association for a new report, “Keeping Stroke Recoveries in Mind”, the survey findings have led to the charity calling for urgent action to improve psychological care provision ahead of World Stroke Day on the 29^th of October.

Dr Jackie Hamilton, Consultant Clinical Neuropsychologist on behalf of the Scottish Stroke Psychology Forum said:

"Throughout my years of experience working in stroke services I have found that often the focus is on physical recovery in the early period after stroke. What is frequently less understood is the impact of ‘hidden problems or challenges’ to achieving best physical outcomes as well as overall outcomes.

“Psychological care is not just managing anxiety and depression. It is also incorporates identifying and managing cognitive impairment and multi-factorial distress, such as the effects of experiencing a traumatic event, fear of recurring stroke, loss of role and identity, and changes to relationships and employment.”

Dr Hamilton added that these factors are well recognised as “significant barriers” to adjustment and should be considered at all stages of supporting individuals and their families in rehabilitation.  

The recommendations in the report are based on proposals put forward by the Scottish Stroke Psychology Forum which seeks to give psychological care equal prioritisation to physical effects of stroke rehabilitation. Responding to the survey, 95% of stroke survivors also reported that they want to see equal access to physical and psychological care within their rehabilitation.

The Stroke Association is calling for a commitment from health boards to deliver on the recommendations outlined in the charity’s new report to make psychological and emotional care a priority in stroke rehabilitation.

To deliver this effectively, the charity is also urging the Scottish government to support health board implementation actions by providing appropriate resources as required across Scotland’s health boards.

The Stroke Association has called for the recommendations they’ve given to be included in the forthcoming Scottish government’s Stroke Improvement Plan.

Out of those who participated in the survey, more people reported the stroke negatively impacted their psychological and emotional wellbeing than those reporting the stroke a negative impact on their physical health. While both were significant with 89% of stroke survivors reporting a physical impact, almost all (94%) reported a psychological and emotional wellbeing impact from their stroke.

John Watson, Associate Director for the Stroke Association in Scotland explained the “devasting” consequences of a stroke:

“A stroke happens in the brain, the control centre for who we are and what we can do. The impact can be devastating – wiping out speech or rendering people unable to walk. The emotional consequences of stroke can be life shattering – an overnight change to our emotions, personality and sense of self. These findings are further evidence of the desperate need for the system to address the psychological consequences of stroke.”

He added that access to psychological assessments and care is essential and will require supporting the workforce:

“Whilst guidance on psychological care and assessment and access to services has been included in the Progressive Stroke Pathway, we know that psychological care is lacking as highlighted in The Scottish Stroke Care Audit. With support from the Scottish Government, health boards have an opportunity to change that.”

“This is not just about recruiting more psychologists to treat people affected by stroke. Everyone working with stroke survivors at every level has a role to play in understanding and integrating psychological care into stroke services. An adequate level of education and training must be given to staff to meet their responsibility and give them the skills in providing that care. This is critical to help people with emotional challenges after stroke to live well.”

Of Scotland’s respondents, the vast majority (87%) want to see equal access to physical and psychological care within their rehabilitation and the Stroke Association has called for this to become reality for stroke survivors.

The charity is now specifically appealing to Scotland’s health boards and the government to deliver on the recommendations outlined in its report and provide psychological and emotional support.

 

Read more: Stroke services cope well despite pandemic pressure; Surviving stroke & supporting others during covid-19; New projects to improve neurological support

 

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