Management of suicidality in stroke patients with and without aphasia-a national survey among healthcare professionals in Sweden.

Abstract

Purpose: Investigating how stroke healthcare professionals manage suicidality in stroke patients with and without aphasia.

Materials and methods: A cross-sectional survey of 981 professionals in Sweden was conducted.

Results: Nearly 60% of respondents had encountered suicidality in stroke patients without aphasia, while 40% had encountered it in patients with aphasia. SLPs were more likely to meet patients with aphasia and suicidality. Routine screening was rare, while 40% reported that suicidality was assessed when needed. Psychologists, physicians, and social workers were seen as responsible for assessments, with 13% of respondents feeling it was their responsibility to assess suicidality. Less than half of those felt competent to assess patients with aphasia. Aphasia was viewed as a barrier to assessment. Uncertainty was widespread regarding intervention, particularly in patients with aphasia, and there were concerns about the competence to handle such cases when referred to psychiatry. Free-text responses highlighted a perceived lack of competence, tools, and routine procedures for handling suicidality in aphasia, alongside calls for more mental health professionals and better interprofessional collaboration regarding suicidality in stroke rehabilitation.

Conclusions: Management of suicidality in stroke patients, particularly with aphasia, is surrounded by uncertainty. Greater competence in suicidality, aphasia-friendly communication, and improved interdisciplinary efforts are needed.