“I didn’t even know you existed”: An exploratory study investigating factors impacting staff knowledge of speech-language pathology in serious mental illness patient care

This study examined knowledge of the role of the speech-language pathologist amongst patient-facing staff within an acute mental health ward in a tertiary Australian hospital. Annually, over 260,000 Australians experience serious mental illness requiring inpatient care. Serious mental illness is commonly associated with swallowing and/or communication disorders, yet speech-language pathologists are under-represented in acute serious mental health treatment teams. This study utilised a convergent parallel mixed-method design, comprising an online survey and follow-up interviews with patient-facing staff in an Australian mental health inpatient unit. Quantitative data were analysed descriptively and qualitative data were analysed using deductive content analysis and adapted reflexive thematic analysis. Twenty-nine participants completed the survey and three completed interviews. Most staff (75%) identified the speech-language pathologist role in swallowing management. Fewer than half (48%) were aware of the speech-language pathologist role in communication management, despite most (73%) reporting communication breakdowns with patients. Ambiguous referral pathways limited access to speech-language pathologists who were primarily contacted for swallowing or as a “last-resort” in communication management. Limited and ambiguous referral pathways restrict access to speech-language pathologists, perpetuating limited opportunities for interdisciplinary collaboration. Greater advocacy and education efforts are needed to enhance understanding of the role of speech-language pathology in acute care for serious mental illness.