Physiotherapy students' perceptions of managing patients with mental illness: A qualitative exploration at a South African university.

Background: Mental illness (MI) is a leading cause of global ill health and disability, with nearly half of the population affected by mental health (MH) conditions at some point in their lives. Consequently, all healthcare professionals, including physiotherapy students, will inevitably encounter patients with MI in clinical practice. However, their preparedness and ability to manage these patients remain unclear. Objectives: To explore physiotherapy students' perceptions of their preparedness and ability to manage patients with co-existing (undiagnosed or known) MH conditions alongside a primary physical health presentation in clinical practice. Method: A qualitative, exploratory, descriptive design was employed. Sixteen fourth-year physiotherapy students from the University of the Western Cape (mean age 22.8 ± 1.32 years) participated in semi-structured individual interviews conducted either face-to-face or online. Data were thematically analysed using Braun and Clarke's six-phase method. Results: Four themes emerged from the data: (1) Evolving understandings of MI: knowledge, sources, and lived experiences; (2) Negotiating care within personal and clinical realities; (3) Insufficient alignment between theory and practice; and (4) Making sense of physiotherapy's contribution to MH care. Conclusion: The findings highlight the need to strengthen both theoretical and practical components of MH curricula and training within undergraduate physiotherapy programmes. Clinical implications: Improved curricular integration may enhance students' preparedness, ability, confidence and competence when managing patients with MI, while supporting more holistic and effective patient care.