Suzanne Smith-Bayley, National Manager, After Stroke and Professional Practice at March of Dimes Canada, tells us about adapting an existing mental health support program for stroke survivors.
Mental health has been receiving more attention as an important area of concern not just for the population at large but also for many individuals who have experienced a stroke. Emotional distress and mood disturbance, including depression and anxiety, are common, occurring in approximately one-third of persons who sustained a stroke. Mental health conditions are the result of a complex interaction of psychological, biological, and social factors that impact how a “client” will adjust in the aftermath of a stroke. Poststroke depression (PSD) and poststroke anxiety are highly comorbid and have been associated with greater risk for another stroke, disability, and mortality, decreased participation, and poorer quality of life (1).
In a recent National Stroke Survey (2) deployed by March of Dimes Canada in early 2023, (sponsored in part by AbbVie and Ipsen Pharmaceuticals) we gained information on the lived experience of stroke survivors and their caregivers across Canada. There were 1678 individuals who responded to the survey. In the survey, one section was dedicated to learning more about the emotional impact of having a stroke. This section below outlines what we learned:
With our healthcare systems often functioning beyond their capacity, we frequently hear from our service users and stakeholders that there is a gap in identifying and accessing community-based mental health support. Being a community-based, third sector organization, we also face resourcing challenges, struggling to meet the needs of our service users. Recognizing that there were existing models of community-based, evidence informed, mental health support programs available, March of Dimes Canada’s After Stroke program decided to adapt an existing program to offer to our service users.
One of our partners, Stroke Recovery Association of British Columbia (SRABC), had successfully collaborated with the Canadian Mental Health Association (CMHA) B.C. to offer their session based, virtual group program to stroke survivors in their region. The CMHA licensed program Living Life to the Full™ (LLTTF™) is an 8-week mental health promotion course designed to help people with mild-to moderate depression, anxiety or worry, deal with life challenges by learning better self-management skills using Cognitive Behaviour Therapy (CBT) principles.
The program aims to improve personal well-being, including reducing stress, anxiety and depression, boosting mood, improving motivation, acquiring problem-solving skills, and modifying behaviours).
Although not specifically designed for stroke survivors, the evaluation results from SRABC indicated that positive outcomes were achieved for their cohorts of stroke survivors. The flexible nature of the topics and engaging discussions allowed for a focus on those mental health challenges often linked to stroke recovery. The positive reviews by stroke survivors and their caregivers supported the decision by March of Dimes Canada’s After Stroke program to move forward with training staff and delivering the program.
We concluded the delivery of our “pilot” group at the end April 2024. Participants provided their feedback on their experience through a survey once the course was completed. When participants were asked which part of the program, they found most helpful, these were the top 3 responses:
100% of respondents indicated that the course was useful in improving my self-esteem and in improving their ability to deal with stress.
One of our LLTTF™ trained facilitators shared the following feedback: “From our survey results and the weekly group discussions this program proved to be both beneficial and useful for service users in reclaiming their identity or developing motivation to shape a new one. Hearing and sharing life experiences allowed clients to recognize that they were not alone in their recovery journey. I am looking forward to the next session!”
Collaborations with other organizations who offer specialized programs and services can be an ideal strategy to help mitigate the resource challenges in creating and launching programs to meet the needs of your service users.
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