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Published on: September 27, 2020
Perceived mental health needs among LGBTQ+ adults living with spinal cord injuries and disorders
Megan Neal1, Andrea L Nevedal2, Shane Lamba1
1Spinal Cord Injury and Disorders Center, VA Palo Alto Health Care System, Palo Alto, California, United States.
Context/Objective:
People living with spinal cord injuries and disorders (SCI/D) are at heightened risk for depression, anxiety, and post-traumatic stress disorder, yet frequently encounter barriers to mental health care. Lesbian, gay, bisexual, transgender, queer individuals and those with related identities (LGBTQ+) also experience elevated mental health disparities and marginalization in clinical settings. As no prior studies have assessed the mental health of LGBTQ+ people with SCI/D, this study sought to examine how members of this population describe their mental health needs, including barriers and facilitators to fulfilling them.
Design:
Qualitative, exploratory study using rapid directed content analysis.
Setting:
Community-based sample across the US.
Participants:
Thirty-two LGBTQ+ adults with SCI/D.
Interventions:
Semi-structured interviews.
Outcome Measures:
Interviews addressing mental health needs.
Results:
Participants emphasized the need for affirming clinical and social support that addressed their LGBTQ+ identities and disability experiences. They stressed the importance of providers who saw them as individuals through an intersectional lens. Competence with both LGBTQ+ and SCI/D issues was considered essential. Providers who were members of the LGBTQ+ and/or SCI/D communities were valued for their relatability and deeper understanding. Participants also requested therapeutic support groups that addressed both LGBTQ+ and SCI/D concerns. Social support from friends, partners, families (i.e. chosen, legal, and/or biological), and communities was also crucial. Peers with shared lived experiences provided companionship as well as invaluable emotional, informational, and tangible support.
Conclusion:
LGBTQ+ adults living with SCI/D identified affirming clinical care and social support as critical to their mental health. Findings highlight the importance of developing intersectional, person-centered clinical and social resources that meet this unique population's needs holistically.
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