Why SLPs Should Be Involved In Mental Health

Alternative medicine, or a holistic approach to healthcare, is gaining popularity. And it makes sense. The medical community is learning more about the benefits of tending to your mental health, the effects of stress on the body, and how your physical health can impact your mental health. And practitioners in all fields are realizing that sometimes the best approach to treatment requires the skillsets of multiple clinicians. 

This mindset applies to all fields, including mental health and even speech-language pathology. Jill Shook, MS, CCC-SLP says that it’s becoming much more common for speech-language pathologists (SLPs) to work more closely with behavioral health specialists. “We’re actively trying to become more holistic in how we treat clients,” she says, “so it makes sense for us to work together.” 

There are some logistical challenges when it comes to forming an interdisciplinary care team—although slightly less so now that virtual care is so common—but according to Shook, that extra effort is critical to helping clients get the best care possible. 

The Impact of Speech Therapy and Mental Health Collaborations

Shook has been in private practice for nearly ten years, and worked in a school setting prior to that. She’s always made it a priority to connect with any other providers her clients may be seeing, so that they can coordinate and avoid any confusion with their client or damage to their progress.

“There are limitations to what we can share. Obviously, I can’t get any confidential information from other therapists, so no specific treatment plans or anything like that. But I can coordinate with them, ” she says. “We can share general information about how we can both better help our client, or if there are any strategies either of us have used that have helped us before.” 

For Shook, that connection with her clients’ therapists ideally isn’t just a one time thing. She says she tries to maintain that connection the entire time she works with that client, so she can more effectively track their progress. “It can be as simple as an email once a month, or once every few months, just so I can check in on how it’s going, and how we can improve,” she says. 

Addressing Anxiety in People Who Stutter

Shook goes on to say that clients who stutter are a large group that can benefit from speech therapy and mental health providers working together. “This is definitely an area where we can connect with behavioral health professionals more,” she says. 

“Speech therapy for stuttering is really more like cognitive behavioral therapy for stuttering,” she explains. “It uses a lot of the same interventions and strategies. So there’s also a component of as clinicians, let’s make sure we’re not using the same techniques and calling them different names or describing them differently, because that’ll just confuse our client.” 

There’s a reason Shook makes such an effort to integrate speech therapy and mental health—she’s seen it work before. She once had a client who was working with her for his stutter, and another clinician for his anxiety. Shook and his therapist coordinated on his care, and together they helped him identify areas where he was feeling anxious because of his stutter, and how they could address it. 

“Since we knew that anxiety was a big concern, we were able to focus on treatments that might help his specific anxiety issues,” Shook says. “For instance, he had a lot of anxiety about people finding out about his stutter at an awkward moment, so we suggested he try telling them upfront—basically when he introduced himself—rather than wait for them to find out on their own. Since this removed that waiting period and got it out of the way right off that bat, it decreased his anxiety.”

Helping Older Adults Process Grief

Anxiety isn’t the only mental health concern that Shook has worked with other therapists to address. She says that grief is another large component of both speech therapy and mental health, especially for adults with degenerative diseases or who have had a stroke. “In those situations, they might be coming to the realization that they’re never going to reach the same level of function that they were at before,” she says. 

She goes on to explain that that realization “can actually register as a trauma, and it’s really like you’re grieving. So I’ll often recommend therapy to them, because there’s a loss there. They’re grieving the expectations they had for their language or their speech, so having the support on the mental health side while they work through that is really important.” 

Shift to Prevention and Public Health

Although Shook now runs her own practice and works with other private practitioners, she started her career as an SLP in schools. And as public health continues to be at the forefront of everyone’s mind, there’s a unique emphasis placed on schools and their role in early intervention and prevention. 

Most schools have free screenings in place, like vision exams and hearing screenings. These programs are important for prevention, because they allow SLPs to identify students who are at risk for later problems, assess current communication issues, and help develop individualized education programs (IEPs). While these programs aren’t new, Shook says the public reaction to them is changing. 

“Every school I’ve ever worked in has done screenings. So that’s been pretty consistent,” she says. “What I have noticed is parents are becoming more receptive to those screenings. When I first started out, they used to not even want them done at all. Now people are recognizing how useful they are.”

Understanding Larger Factors 

As society’s understanding of disability in general continues to grow, it’s becoming clear that social and environmental factors have an impact on a person’s development. Part of preventing communication disorders is understanding why they occur in the first place, and looking for ways to solve that initial problem—whether that’s removing a person from their environment, removing loud noises, or starting mental health treatments earlier.

In children and adolescents, developmental language disorders are linked to increased bullying, as well as emotional and behavioral disorders. These are concerns that should be addressed early on, which makes schools a critical resource—albeit not a perfect one.

Black students make up roughly 20 percent of students receiving special education services in the US, and that number increases drastically when a student exhibits a speech or language disorder. As a result, Black students who are living with undiagnosed and untreated speech and language disorders have higher school drop-out rates—and a significantly higher rate of incarceration—than other races. 

“Studies have shown that as many as 85 percent of people who are incarcerated have some kind of speech or language disorder, and often those disorders go undiagnosed,” Shook says. “So the field is starting to look at what it would mean if we had more early intervention, and caught these concerns earlier.” 

Looking at the Bigger Picture

When Shook worked in a school setting, she said she made it a priority to work closely with school counselors to coordinate their treatment, even though there wasn’t any official expectation for her to do so.  “I just wanted to make sure I was seeing the whole picture of my students,” she says. 

As private practitioners, it’s difficult for you to have an impact on the kind of care students are receiving in school settings, or in other offices besides yours. But you can prioritize seeing the whole picture of your clients, whatever that may look like. Sometimes, offering the best care might look like working as part of a multidisciplinary team, so you all can focus your attention on the areas you know best.