Patient and clinician perspectives of a novel intensive care psychology service

BACKGROUND: Psychological distress is common after critical illness and can result in long-term psychological morbidities. Early psychological support in the intensive care unit (ICU) may mitigate these effects, yet ICU psychology services remain uncommon in Australia, and little is known about their implementation. Building on the Psychology in Intensive Care Unit Protocol (PICUP) pilot study, further refinement requires understanding the perspectives of those who experienced the service. AIMS/OBJECTIVES: This study qualitatively explored (i) how critical care survivors experienced early psychological screening and intervention; (ii) ICU clinicians' views on the role and value of the psychology service; and (iii) facilitators and barriers to integrating it into routine ICU practice. METHODS: A qualitative descriptive design was used at a metropolitan Australian ICU where the PICUP model had been implemented. Purposive sampling identified PICUP participants who received psychological support during their admission and clinicians involved in their care. Semistructured interviews were conducted with 16 patient participants and 10 clinicians. Interviews were audio recorded, transcribed verbatim, and analysed using reflexive thematic analysis. RESULTS: Patient participants described critical illness as a traumatic and multifaceted experience and viewed psychological support as meaningful when accessed, though many reported limited recall and unmet needs for continuity beyond the ICU. Tailoring support to individual readiness was seen as essential. Clinician participants considered psychology integral to holistic ICU care, with benefits for patient engagement, recovery, and management of complex presentations. They also identified value for significant others and staff. However, clinicians perceived unclear referral pathways, low service visibility, limited psychology resources, and the inherent complexity of the ICU constrained implementation. CONCLUSIONS: Patient and clinician participants viewed the ICU psychology service as acceptable and valuable but under-resourced and insufficiently embedded. Their perspectives clarify how the service is understood in practice and what needs strengthening for effective implementation. Findings provide direction for refining the PICUP model and guiding the development of a sustainable approach to the inclusion of psychologists in Australian ICUs.