Mental Health in DPT Education: A Systematic Review of Explored Factors, Their Prevalence, and Interventions

BACKGROUND AND PURPOSE: Mental health concerns among entry-level Doctor of Physical Therapy (DPT) students are increasingly recognized, yet no prior systematic review has synthesized evidence specific to this population. Therefore, the objective of this systematic review was to evaluate and synthesize current literature on mental health research and associated outcomes among entry-level DPT students in North America. METHODS: Six databases (PubMed, Embase, CINAHL, ERIC, APA PsycINFO, SPORTDiscus) were searched for articles published between 2000 and 2025. Search strategies included terms related to DPT students and mental health (e.g., stress, anxiety, depression, burnout, grit). Inclusion criteria were peer-reviewed original research studies conducted in North America that reported on mental health factors among DPT students. Exclusions included studies without specific DPT data, grey literature, and COVID-specific variables. Two reviewers independently extracted data and assessed methodological quality using Joanna Briggs Institute checklists. A narrative synthesis was used because of study heterogeneity. RESULTS: Forty studies met inclusion criteria. Variables assessed included stress, anxiety, depression, burnout, resilience, grit, and general well-being. Validated instruments such as the 10-item Perceived Stress Scale, State-Trait Anxiety Inventory, 21-item Depression Anxiety Stress Scales, and the Maslach Burnout Inventory were commonly used. Stress and anxiety were the most frequently reported variables, often increasing across the curriculum. Depression and burnout were less commonly assessed but showed moderate prevalence. Resilience and psychological flexibility were protective, whereas sleep quality and academic load were consistent risk factors. Only a limited number of studies evaluated interventions; mindfulness, resilience training, and reflective practices showed promise. DISCUSSION AND CONCLUSION: Mental health challenges are prevalent and multifaceted in physical therapist education. Despite growing awareness, structured interventions remain limited. This review highlights critical gaps and underscores the need to integrate evidence-based mental health support into DPT curricula to promote student well-being and long-term professional sustainability. PROSPERO REGISTRATION: CRD42024609056.