Psychological Screening, Standards and Spinal Cord Injury: Introducing Change in NHS England Commissioned Services

J. Clin. Med., 2023 · DOI: 10.3390/jcm12247667 · Published: December 13, 2023

Simple Explanation

This study highlights the need for standardized psychological screening and care for individuals with spinal cord injuries (SCI/D) in the UK, where psychologist resources vary significantly across centers. The research involved screening inpatients for depression, anxiety, and adjustment to disability, revealing that a substantial percentage scored above clinical thresholds, indicating unmet psychological needs. The findings advocate for a shift towards universal screening and assessment models, supplemented by referral options, to ensure that all PwSCI/D receive appropriate psychological support throughout their rehabilitation journey.

Study Duration

Not specified

Participants

646 participants with spinal cord injuries/disorders

Evidence Level

Not specified

Key Findings

1
A significant percentage (43%) of inpatients scored above the clinical threshold on at least one of the screening measures (GAD-7, PHQ-9, ADAPSSsf) upon admission, indicating prevalent psychological needs.
2
Approximately 42% of participants still scored above the clinical threshold at discharge, demonstrating sustained psychological need throughout the inpatient rehabilitation process.
3
Admission scores on the PHQ-9, GAD-7, and ADAPSSsf were predictive of discharge scores, highlighting the importance of early psychological screening and intervention.

Research Summary

This study investigated the incidence of psychological distress in individuals with spinal cord injuries (SCI/D) admitted to specialist rehabilitation centers in England. The findings revealed a high prevalence of depression, anxiety, and adjustment difficulties among inpatients, with a significant proportion exhibiting sustained psychological needs from admission to discharge. The study advocates for the adoption of universal psychological screening and standardized care pathways in SCI/D rehabilitation to ensure early identification and appropriate management of psychological needs.

Practical Implications

Service Restructuring

Supports the transition from referral-based to screen-and-assess models in SCI rehabilitation centers.

Resource Allocation

Highlights the need for increased psychologist staffing to meet the identified psychological needs of PwSCI/D.

Standardized Care

Emphasizes the importance of implementing standardized psychological care pathways and screening protocols for PwSCI/D.

Study Limitations

1
Missing data, particularly for ethnicity, may have affected the generalizability of the findings.
2
Psychological treatment was not controlled for in the analysis.
3
The subgroup with both admission and discharge data was limited in number.

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