The Value in Mental Health Screening for Individuals With Spinal Cord Injury: What Patients Tell Us

Archives of Rehabilitation Research and Clinical Translation, 2020 · DOI: https://doi.org/10.1016/j.arrct.2019.100032 · Published: January 1, 2020

Spinal Cord Injury Mental Health Rehabilitation

Simple Explanation

Individuals with spinal cord injury (SCI) are at higher risk for emotional disorders than the general population. Depression and anxiety after SCI have been associated with poor health outcomes. Psychological disorders remain underrecognized and undertreated in the SCI population. This study aimed to gather consumer perspectives on mental health screening and identify unrecognized mental health concerns in primary care settings. Identifying those with previously unrecognized mental health issues could allow for triage of individuals at higher risk of poor outcomes. The study used screening instruments for depression, anxiety, substance abuse, social isolation, somatoform disorder, pain, and functional impairment, followed by interviews to gather perceptions of the screening process. Mixed methods were used to enhance the validity of study ﬁndings.

Study Duration

Not specified

Participants

15 patients with spinal cord injury

Evidence Level

Pilot study using mixed methods

Key Findings

1
Screening identified that 11 of 15 individuals had a chronic pain condition; 1 screened positive for depression, 1 for anxiety, 3 for potential substance abuse, and 1 for social isolation.
2
Most participants rated the screening protocol as very acceptable. However, interviews revealed that participants felt the screening tools alone did not fully capture their experiences, particularly regarding resiliency.
3
Qualitative analysis identified themes related to incomplete disclosure of experiences, concealment of information, and the screening protocol's failure to assess resiliency.

Research Summary

This study evaluated the use of a mental health screening protocol for individuals with spinal cord injury in a primary care setting, combining quantitative screening tools with qualitative interviews to gain a comprehensive understanding of patient perspectives. The study found that while screening tools identified several individuals with previously unrecognized mental health issues, the qualitative data revealed that participants felt the tools did not fully capture their experiences and often failed to assess resiliency and personal strengths. The authors conclude that screening protocols for this population should include both standardized tools and opportunities for patients to discuss their psychological experiences to better support their mental health needs.

Practical Implications

Improved Screening Protocols

Develop more holistic screening protocols that incorporate both standardized tools and qualitative assessments to capture the full range of patient experiences and assess resiliency.

Enhanced Primary Care

Integrate mental health screening into multidisciplinary primary care settings to identify and address previously unrecognized mental health concerns among individuals with spinal cord injury.

Targeted Interventions

Use screening results to triage individuals at higher risk of poor outcomes and tailor management strategies accordingly, ensuring access to effective interventions and improving overall health outcomes.

Study Limitations

1
Small sample size limits generalizability of findings.
2
Screening tools used were not specifically validated for use with a SCI population.
3
Study was conducted in a multidisciplinary setting, limiting applicability to settings without such resources.

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