Psychological problems, such as depression, are common after stroke and can have negative effects on stroke survivors and their carers. Although general psychological services exist (e.g. Improving Access to Psychological Therapies (IAPT) services), there is a lack of psychological support available for stroke survivors. Some IAPT services do provide psychological support for stroke survivors, but this is rare. This may be because of the range of difficulties that stroke survivors might have, for example, problems with communication, which make it more challenging for IAPT services to provide effective support. People who have a stroke also tend to be less well-off so they may have difficulty accessing general psychological services for themselves. This means stroke survivors do not always receive the psychological care they need and, as a consequence, may have a reduced quality of life.
This research aims to see if we can use services that already exist for general psychological support (IAPT services) and adapt them to be useful for stroke survivors. We will develop an Implementation Package (pathways and training) that healthcare staff can use to ensure that stroke survivors receive suitable psychological support.
Firstly, we will carry out interviews with stroke survivors to find out about their experiences of psychological care to see what currently happens and what they would hope to see in the future. We will also carry out interviews and surveys with stroke services to find out how they currently provide psychological care, how it could be improved and the content and format for any training required. We will talk to IAPT (and other psychological services) staff about the challenges they envisage in delivering psychological care to people who have had a stroke, how it could be delivered and the content and format for any training required. We will then use this information to develop an Implementation Package of psychological care and provide training to ensure staff have the correct knowledge and skills for their role on the stroke care pathway. We will train stroke staff in different settings (in hospital, rehabilitation, in the community) so they are able to provide some basic psychological support to stroke survivors. We will train IAPT staff so they are able to provide high-level
psychological support to stroke survivors, taking into account the cognitive and/or communication difficulties people might experience after a stroke. Before the Implementation Package (training and pathway) is put into place, we will collect information about current care for six months. We will then put the Implementation Package into practice and collect information about stroke survivors’ mood and how stroke and IAPT services have used the Implementation Package to see if there is a difference in the psychological care stroke survivors receive and the effects of this