Factors that can impact on mental health and engagement

Drug and alcohol use

Research indicates that people with a spinal cord injury (SCI) are at increased risk of developing substance use disorders compared with people without SCI, including the misuse of prescribed medications. Individuals with a substance use disorder are also more likely to experience negative hospital outcomes.

Managing drug and alcohol use after SCI requires a multidisciplinary approach and should be continually assessed throughout admission. Accessing specialist support from medical, psychiatry, psychology and social work professionals is an important part of ongoing care. Referral pathways to specialist drug and alcohol services should also be considered to support discussions, develop strategies and plan for managing substance use. As with mental health assessments, providing support for transition back to the community is an essential component of ongoing care.

Cognitive difficulties

People who have experienced an SCI may be at increased risk of cognitive impairment. This can occur due to the mechanism of injury itself (e.g., a traumatic brain injury sustained in an accident) or other contributing factors such as ageing, comorbid medical conditions or medical history, polypharmacy, or psychological disorders. The presence of cognitive impairment increases the risk of challenges during rehabilitation and is therefore an important factor for healthcare teams to consider when people with SCI are admitted to hospital.

For people who are experiencing or at risk of cognitive impairment following SCI, it is important for healthcare teams to engage appropriately trained professionals, such as clinical neuropsychologists or psychologists, occupational therapists or speech pathologists. These professionals can provide evidence-based, standardised assessments and interventions to support people with changes to their cognition, helping to improve health outcomes and engagement in rehabilitation.