We must stop neglecting the emotional needs of stroke survivors

 The blindingly obvious solution to that is 100% recovery protocols. And you can't see that? This is why we need stroke survivors in charge.

We must stop neglecting the emotional needs of stroke survivors

John Watson is Associate Director for Scotland, the Stroke Association

WITHOUT first-hand experience it’s hard to appreciate how it feels to have a stroke. If someone can walk and talk after their stroke, then they might be judged to have made a good recovery. But the hidden impacts can be huge. A stroke causes damage in the brain, the control centre for who we are and what we can do. As a result, our emotions, personality and behaviour can all be affected, with devastating consequences.

Overnight, a partner becomes a carer. A breadwinner is at risk of losing their job. Basic life skills, like making a sandwich or using a phone, have to be re-learnt. People's lives are turned upside down. Imagine how it feels to cope with such sudden and dramatic change.

Psychological care after a stroke is just as important as physical recovery, and can hugely influence how well someone recovers, the extent to which they regain their independence and the need they have for ongoing care and support. Yet there is an unacceptable lack of support for those struggling to come to terms with the effects of their stroke. That’s what stroke survivors keep telling us. It’s what those working in stroke services tell us too.

We work closely with NHS staff, and applaud the tireless shift they put in to support people recovering from stroke. But the system they have to operate in does not give psychological care its due space.

Yet it doesn’t have to be this way. There is a practical, cost-effective way to improve psychological care after a stroke, that has strong backing across the stroke community.

The Scottish Stroke Psychology Forum has developed a national model of psychological care in stroke services. It focuses on awareness raising and training so that all the staff engaging with a stroke patient can look out for emotional well-being, backed up by referral processes for when escalation to specialists is needed. It’s about involving stroke teams at every level to identify and support people with psychological issues after a stroke.

This model was endorsed by the National Advisory Committee for Stroke, which brings together the leading clinicians, academics and charities in the field. It was included in the new vision document for stroke published by the Scottish Government. A commitment to delivering on it must now be included in the forthcoming Stroke Improvement Plan, and implemented by every health board in Scotland.

Getting the right support to people affected by stroke is a good thing in itself. But better outcomes for stroke survivors also reduces the need for ongoing support, and delivers the savings our health and social care services so badly need.

At a time of financial crisis, and growing demand for services, we have to prioritise changes that will make the system work better, and reduce ongoing costs. So this is exactly the time when every health board in Scotland should commit to giving psychological care after stroke the attention it deserves.