After spinal cord injury, mental health support matters long after discharge
Emotional collapse after a disabling injury is not a failure of willpower. A long-term study from two UK spinal injury centers found a suicide rate about five times the general-population comparison, with over 90% of suicides occurring in the first ten years after injury. People whose injury resulted from a suicide attempt had particularly high risk. These findings call for continuing support, not a prediction about any individual.
What it takes
A support call can be free; clinical consultations may have ordinary fees. Taking the first step may require help.
What you may gain
The cohort included 2,304 people newly admitted with traumatic spinal cord injury during 1991–2010 who survived the first year and had neurological impairment at discharge, followed through the end of 2014. Sixty-three, 2.7%, had been injured in a suicide attempt. There were 533 deaths, of which 4.2% were suicides; 91% of suicides occurred within ten years of injury. Age-standardized suicide mortality was 62.5 per 100,000 annually, 95% CI 36.4–88.6, approximately five times the 2014 England and Wales population rate of 12.2. Compared with other injury causes, an initial suicide attempt was associated with mortality OR 4.32 and suicide OR 9.46, both P<0.001.
Context & considerations
The study concerns spinal cord injury; extending its exact rate or ten-year pattern to blindness, amputation, burns, or all disability is an extrapolation. It shows that support should not end at discharge. China's 12356 helpline is described in chapter 29, entry 11. For immediate suicidal thoughts and limiting access to dangerous supplies such as large stocks of sedatives or pesticides, see chapter 1, entry 25. For persistent disabling grief or distress, see chapter 29, entry 8; help need not wait for a fixed number of months.
Research & references
Savic G, DeVivo MJ, Frankel HL, Jamous MA, Soni BM, Charlifue S (2018). Suicide and traumatic spinal cord injury—a cohort study. Spinal Cord, 56(1), 2–6. https://doi.org/10.1038/sc.2017.98