Help-seeking and people with aphasia who have mood problems after stroke: perspectives of speech-language pathologists.

Abstract

BACKGROUND\nAccess to treatments for mood disorders may pose a challenge to individuals with compromised communication ability. Speech-language pathologists (SLPs) have previously reported that their clients with aphasia decline formal psychological support; however, their role in their clients help-seeking has not been explored.\n\n\nAIMS\nTo investigate SLPs perspectives on how they currently support help-seeking for mood problems in people with aphasia and factors they perceive to be impacting service uptake.\n\n\nMETHODS & PROCEDURES\nA qualitative interview study was conducted. SLPs in Australia working with people with aphasia in a clinical role were recruited. Transcripts of the interviews were subject to qualitative analysis to identify relevant themes.\n\n\nOUTCOMES & RESULTS\nEighteen interviews were conducted. One overarching theme and three sub-themes were identified as central to SLPs experience. The overarching theme was of a double whammy impact on help-seeking: people with aphasia were subject to universal barriers associated with seeking help as well as additional barriers imposed by compromised communication. Three themes contributed to the overarching theme: (1) SLPs understanding of barriers and facilitators to patients with aphasia seeking help; (2) the role of the SLP as a skilled helper for mood management; and (3) mood and communication as competing rehabilitation priorities.\n\n\nCONCLUSIONS & IMPLICATIONS\nSLPs report both universal barriers to help-seeking and those specific to their clients with aphasia and attempts to overcome these; however, there appears to be a dearth of accessible mental health services for people with aphasia known to SLPs, including psychological/counselling professionals who are skilled in communicating with people with aphasia. Health professionals working within and across post-stroke and mental health services should recognize that people with post-stroke aphasia are susceptible to a decline in mental health, are amenable to formal (and tailored) psychological support, and can be supported to seek help.