Perceived mental health needs among LGBTQ+ adults living with spinal cord injuries and disorders

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.