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As nations around the world grapple with the effects of the COVID-19 pandemic on public health and the global economy, the need for mental health services has skyrocketed. Prolonged isolation and fear of infection has fueled anxiety and depression, worsened by waves of infections, widespread restrictions, and sharp rises in unemployment and financial insecurity. Individuals with spinal cord injury who face greater risk for complications must often rely on caregivers to meet their daily needs, adding to the challenges of daily life. The stresses of the ongoing pandemic have exacerbated pre-existing mental health issues and increased the need for surveillance and intervention among this high-risk group and their caregivers.
This issue features a timely Clinical Practice Guideline from Paralyzed Veterans of America, the culmination of years of interdisciplinary work by the Consortium for Spinal Cord Medicine, which comprises professionals from organizations dedicated to improving the lives of individuals living with injuries and dysfunction of the spinal cord. This guideline, one in a series produced by the Consortium, is titled, Management of Mental Health Disorders, Substance Abuse Disorders, and Suicide in Adults with Spinal Cord Injury.Citation1
As Dr Thomas Bryce, Consortium Chair, notes in his preface, these disorders are known to be much more prevalent in the spinal cord injury population, with rates two to three times that of the population without spinal cord injury. The widespread stigma associated with mental health disorders in many cultures complicates diagnosis and treatment of this high-risk population. The Consortium’s primary objectives for this guideline are to educate clinicians about the scope of these disorders, which are often overshadowed by the pressing needs for continuing care for physical impairments, and to provide expert guidance for screening, diagnosis, and treatment. As the basis for uniform quality practice standards, this guideline will help us achieve the ultimate goal of improving outcomes for people with spinal cord injury by reducing the morbidity and mortality associated with mental health disorders and raising quality of life.
JSCM is pleased to participate in disseminating this important guideline, especially during this critical time of need for knowledgeable professionals to provide care for patients and their care partners. In addition to the worsening of the disorders described in the guidelines, providers are dealing with the impact of COVID infections on individuals, including grief and loss, post-COVID-ICU syndrome, increased disability, and the longer-term cognitive effects that some experience.
We urge our readers to familiarize themselves with this Clinical Practice Guideline and promote it as a valuable resource to their peers and institutions. Incorporating these consensus recommendations into acute and rehabilitative care is the first step toward ensuring that effective fundamental approaches translate to life-changing and life-saving interventions.