Charity issues urgent call for improved mental health care for stroke survivors

A woman left unable to leave the house owing to her anxiety levels after a stroke aged 40 has backed a charity’s urgent call for improved mental health care for other survivors.

It comes after 95% of stroke survivors told researchers it had an impact on their mental health.

New research by the Stroke Association found survivors “risk being let down” in hospital due to a lack of support for their mental health.

The charity surveyed around 139 survivors in Scotland ahead of World Stroke Day on October 29 and found 95% said their stroke had an impact on their mental health.

Of those, 39% said the emotional impact of having a stroke was severe, compared to 36% who said the physical effects were severe.

Paula McGuire, 41, from Glasgow, said her feelings of anxiety were accelerated to levels she had “never experienced before” following her stroke.

“I can only describe it as overwhelming and felt completely lost and alone trying to unpick what was going on, asking myself whether it was my fault,” she said.

Ms McGuire (pictured) was rendered unable to leave the house and carry on with everyday tasks such as shopping, driving and swimming.

“I kept telling myself to try harder and face my challenges. I didn’t understand what was going on and it was very frightening,” she added.

“Fortunately, the nursing staff on the ward identified my low mood and anxiety early on and helped me to understand and process the changes I was facing.”

Ms McGuire claimed doctors only wanted to treat the physical issues, without taking into account the levels of anxiety she was facing.

Most stroke survivors surveyed do not feel they got the psychological support they needed in hospital (73%) or in the community (68%).

Ms McGuire added: “I was a wreck. I’d had a stroke at 40. How could anyone cope with that?

“People should have the same amount and standard of care for their emotional health as is given to those with physical challenges after stroke. It needs to be embedded into the system.”

The charity is now calling for their recommendations from the report to be included in the Scottish Government’s forthcoming Stroke Improvement Plan.

They have called for health boards to commit to delivering those recommendations and make psychological and emotional care a priority in stroke rehabilitation and for the Scottish Government to support health boards implement the recommendations – offering appropriate resources as required.

John Watson, associate director for the Stroke Association in Scotland, said: “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.”

“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.”

Dr Jackie Hamilton is a consultant neuropsychologist who works with stroke survivors.

“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,” she said.

“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 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.

“These are all factors which are recognised as significant barriers to rehabilitation and adjustment. As such these should be considered at all stages when working and supporting individuals and their families across their rehabilitation journey.”

A Scottish Government spokesperson said: “The Scottish Government is ensuring that patients who have suffered strokes receive the best possible care as quickly as possible to enable them to live longer, healthier and independent lives.

“We recognise the psychological impact that strokes can have, and want to ensure that the detection and management of the psychological consequences of stroke are seen as a priority by health boards.

“Wider work is also currently underway to explore opportunities to improve support for those whose mental health and psychological wellbeing has been affected by physical health conditions, including people who have had a stroke.

“A new national Specification for Psychological Therapies and interventions and the new Health and Well-being Strategy, which are both currently under development, will provide an opportunity to further review and improve mental health support and access to psychological interventions for people with physical health conditions.

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