ABSTRACT
Background: Individuals with SCI face the same difficulties related to COVID-19 as others with disabilities, but also experience challenges related to the nature of SCI. Objective: Understand how concerns about medical rationing, access to personal care attendants (PCAs) and medical supplies, and resilience are related to overall and mental health in the context of the COVID-19 pandemic. Design: Cross-sectional findings from a longitudinal study. Methods: Data were collected online between May and August 2020 (N = 187). Primary outcomes were mental health, depression (PHQ-8) symptoms, anxiety symptoms (GAD-7), and quality of life (QoL Basic Data Set). Primary predictors were resilience and concerns about medical rationing, financial stability, access to PCAs and medical supplies, and social isolation. Ordinal logistic regression and generalized linear models were used to analyze the data. Results Observed: Perceived mental health was negatively associated with concern about medical rationing, social isolation, and age and positively associated with resilience. Anxiety was positively associated with concern about medical rationing and personal finances and negatively associated with resilience. Depressive symptoms were greater in those with incomplete compared to complete injury, positively associated with concern about medical rationing, social isolation, and personal finances and negatively associated with resilience. QoL was negatively associated with concern about medical rationing, social isolation, and personal finances and positively associated with resilience. Conclusions: Interventions increasing resilience and addressing concerns regarding medical rationing, social isolation, and financial insecurity may have positive mental health benefits for individuals with SCI during the COVID-19 pandemic.