COVID-19 and the Spinal Cord Injury Community: Concerns About Medical Rationing and Social Isolation

Impact and Implications People living with spinal cord injury (SCI) are often immunocompromised, and at increased risk of respiratory infection. Therefore, individuals living with SCI may be at risk of health deterioration as a result of COVID-19 and the associated public health restrictions. People living with SCI may also experience compounding stress related to reduced access to medical supplies, and fear of being denied access to care in addition to fear of contracting the virus may contribute to reports of adversely affected mental health during the pandemic. The issues raised in this article highlight the need for rehabilitation psychologists to conduct outreach to patients who may not already have established mental health care and offer a full range of telehealth support and interventions to bridge the gap of mental health care delivery and psychosocial support to those who most need it. Purpose/Objective: To provide a descriptive account of the impact of the COVID-19 pandemic on the spinal cord injury (SCI) community focused on participants' concerns about medical discrimination and medical rationing, the impact of the pandemic on access to personal care attendants and medical supplies, and the impact of the pandemic on overall and mental health. Research Method/Design: Cross sectional, observational study among community-dwelling adults with SCI. Data were collected online between May 1, 2020 and August 31, 2020 (n = 187). The online questionnaire included questions regarding medical discrimination and rationing, the impact of the pandemic on access to care and medical supplies, and the impact of the pandemic on overall and mental health. Results: Individuals with SCI have experienced difficulty accessing medical supplies due to the pandemic, and approximately half of our participants (52%) perceived that discrimination through medical rationing was occurring. Furthermore, compared to the general U.S. population, our sample reported that the pandemic had a greater negative impact on their mental health and access to medical supplies. Conclusion/Implications: Our findings suggest that the COVID-19 pandemic has negatively impacted mental health and increased concerns of social isolation as well as access to medical supplies among those with SCI. Rehabilitation psychologists must advocate alongside the disability community to limit health disparities and to conduct outreach, specifically with regard to mental health issues. Future research should focus on the effects of pandemic-related fears and social isolation, as well as resilience in the context of public health care threats.