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

Area of Science:

• Psychology
• Rehabilitation Medicine
• Health Services Research

Background:

• Psychologist resourcing in UK spinal cord injury centres (SCICs) is inconsistent, hindering standardized care for people with spinal cord injuries/disorders (PwSCI/D).
• Existing psychological care models may not adequately address the needs of PwSCI/D.

Purpose of the Study:

• To agree upon screening and standards for psychological care in SCICs.
• To assess the prevalence of psychological distress in PwSCI/D and evaluate the effectiveness of a screen-and-assessment model.

Main Methods:

• Utilized GAD-7, PHQ-9, and Appraisals of DisAbility: Primary and Secondary Scale (ADAPSSsf) for screening inpatients.
• Collected data from 646 participants at admission and a subset of 272 at discharge.
• Collaborated with the Spinal Cord Injury Psychology Advisory Group (SCIPAG) and NHS England.

Main Results:

• 43% of PwSCI/D scored above the clinical threshold for psychological distress on admission.
• 42% of participants remained above the threshold at discharge, indicating sustained psychological need.
• The screen-and-assessment model identified significant psychological needs.

Conclusions:

• Supports a universal screening and assessment model for psychological care in SCICs.
• Highlights the need for standardized psychological care and referral options for PwSCI/D.
• Advocates for wider adoption of screening and standards in psychological care for PwSCI/D.