Spinal Cord Injury Awareness Day 21 May 2021Published on: 24 May 2021
#SCIAD21 is reflecting on the impact of the pandemic and looking at stories of adversity, strength and survival.
Following on from last week’s Mental Health Awareness Week, I thought it would be helpful to focus on the issue of mental health and how this impacts upon spinal cord injury. The pandemic has brought its own challenges, which coupled with an injury clearly has significant bearings upon individual mental health, not only in relation to treatment and support available, but to coping strategies too, both in newly injured spinal patients and those continuing with their spinal injury journey.
My own practice includes clients across the spectrum. In terms of age I have adolescents right up to the recent, sad case of an 80 year old involved in a life-changing, catastrophic road traffic accident. I am privileged to act for these clients, who have come through their individual challenges showing an unprecedented strength of character, as well as physical resources. Mental health support is so important both in relation to the consequences of the trauma of the accident, as well as dealing with the subsequent issues that can flow from the injury on a lifetime basis.
A client’s mental health can be influenced by many things, whether it is an encouraging smile from medical staff (more difficult from under a mask in the current pandemic), a cheery word or an acknowledgement of concern from the legal team, as well as professional mental health awareness therapies together with the knowledge that such things as bowel and bladder management, tissue viability and vocational, education and employment issues are being dealt with. This also includes support from and to the wider family and friends coping with the ramifications of traumatic spinal cord injury. Regaining independence and mobility, and working towards those goals that arise at all stages of the journey are fundamentally important. Good mental health is a building block to coping with all steps of that journey. Communication is the key, whether it is with medical or legal professionals, case managers or treating practitioners.
At all times good emotional health is a significant contributor to overall wellbeing, physical recovery and coping mechanisms.
Often we see many aspects of psychological challenge whether it is anger, frustration, tearfulness and this too can have a significant knock-on effect on relationships, both at work and at home. Add to that the usual plethora of emotional daily life changes, whether it is hormonal changes, puberty or menopause, family changes with having children, family relationship changes. Financial or social related issues of every scenario created within the family dynamics. Sometimes there may be a breakdown in a relationship or the focus of a new challenge, possibly work or community independence and often there may be a reluctance to talk about issues due to embarrassment, isolation or mental health taboos. These are all difficult enough, particularly when compounded with an injury that is then brought into the mix. Often chronic pain is a common feature of spinal cord injury with more than half the individuals experiencing some form of neuropathic pain, which again can have a negative impact upon both physical and psychological health. However, having a spinal cord injury does not mean that general health can only be assessed in terms of physical injury and the psychological wellbeing of our clients is paramount. The last 12 months and the impact of the pandemic have been difficult in terms of getting clients’ medical appointments and, in particular, counselling with what normally would have been face-to-face support. Having strategies in place to help with the emotional wellbeing has been paramount.
In addition to the usual headings in a spinal injury schedule of loss including loss of earnings, mobility, accommodation, case management, occupational therapy, tissue viability, bowel and bladder management to name but a few, counselling, relaxation, diet, sporting opportunities, holistic therapies and outdoor pursuits have become even more important.
I have recently read the Karen Darke article in the April 2021 issue of the Forward Focus Spinal Injuries Association magazine and note that her comment, “My world was not limited by being in a wheelchair. Our ability to do anything is a state of mind not a state of body”.
The challenges of the pandemic have made spinal cord injury limitations even more challenging, however we are constantly inspired and humbled by the stories of adversity, strength and survival of many who have overcome these obstacles. Whilst the pandemic has made things even more challenging. it has emphasised the need to strengthen the opportunity to not only focus upon physical fitness and motivation which can give rich, rewarding and fulfilling experiences, but also the need to ensure that the mental health building blocks and opportunities were well and truly established in the first place and to ensure that once restrictions are lifted those opportunities can be further embraced.
Climbing Out was formed in 2010 by Kelda Wood, who was profoundly affected by the dramatic effect that the outdoors had on her own physical and mental recovery after a serious injury. Kelda provided a motivational speech when she attended our staff conference, stating her aim was to challenge and inspire young people in helping them gain belief in themselves and develop the confidence to realise their full potential. The programmes that she offers through Climbing Out are fully funded and available to young people of 16 to 30, but for the pandemic two of my spinal injured clients were due to be assessed to attend Climbing Out. The pandemic has pushed their ability to do this back a little, however the focus is still both on the physical and psychological challenges and improving mental health wellbeing continues to be a driving force.