Stroke survivors are more likely to recover from depression and anxiety if they attend NHS talking therapy, a new study finds. UCL researchers analyzed nearly 1.9 million NHS Talking Therapies participants. Of those, 7,597 were stroke survivors seeking mental health support.
More than one-third of stroke survivors experience depression or anxiety, which often slows physical and cognitive recovery post-stroke.
If untreated, mental health issues can raise mortality risk by 20–50% in stroke survivors over several years.
HIGH RECOVERY RATES WITH NHS THERAPY SESSIONS
The research showed 71% of stroke survivors improved significantly after attending therapy. Nearly half fully recovered from depression or anxiety.
These results align with NHS targets. The general recovery goal is 50%, even though chronic illness patients usually show worse outcomes. Patients received CBT, counselling, or guided self-help—either individually, in groups, or through online sessions across NHS Talking Therapies services.
HOW MENTAL HEALTH WAS MEASURED
Researchers tracked depression using the Patient Health Questionnaire (PHQ-9), which includes sleep issues, low mood and interest levels.
They used the GAD-7 scale for anxiety, which asks how often individuals feel worried, restless or unable to relax. Participants reported moderate improvements in depression and day-to-day functioning, and large improvements in anxiety symptoms.
TIMING OF THERAPY SIGNIFICANTLY AFFECTS OUTCOMES
The study revealed therapy timing matters. Survivors starting within six months of a stroke had better recovery outcomes overall.
Those beginning a year or more post-stroke were less likely to show reliable recovery, regardless of age, gender or health scores. Dr. Jae Won Suh, UCL lead author, stressed the urgency of early intervention in post-stroke therapy for the best mental health results.
“Our findings strongly support small-scale evidence that talking therapies help stroke survivors recover mentally,” Dr. Suh stated.
THERAPIES STILL LESS EFFECTIVE FOR STROKE SURVIVORS
While talking therapy was helpful, stroke survivors were slightly less likely to recover than similar patients without a stroke history.
They were also more likely to experience a decline, though this was linked more to other physical health issues than stroke alone. Once health conditions were accounted for, recovery differences disappeared, suggesting therapy should be tailored more specifically to stroke needs.
CALL FOR TRAINING MENTAL HEALTH CLINICIANS
Co-author Professor Joshua Stott called for training improvements. Therapists must better support patients with cognitive or physical complications.
“Stroke survivors may have sensory loss, cognitive impairment and chronic issues—these need specialist care within therapy frameworks,” Stott said. Enhanced clinician training, the researchers argue, will boost outcomes and improve both mental and physical well-being for thousands of patients.
FREE THERAPY SERVICE, BIG POTENTIAL IMPACT
NHS Talking Therapies for Anxiety and Depression is free, accessible, and available in-person or online across England.
The program plays a vital role in national health, particularly for groups at risk of long-term complications, like stroke survivors. The findings support expanding therapy access and accelerating referrals to help stroke survivors regain mental and emotional stability.
Backed by Alzheimer’s Society Funding
The research, published in Nature Mental Health, was funded by the Alzheimer’s Society and marks the largest analysis of its kind. With over 1.9 million cases analyzed, the evidence is clear: timely, structured therapy sessions provide real mental health benefits.
The study adds urgency to calls for broader investment in psychological services and specialist training within the NHS system.
