Are Social Relationships an Underestimated Resource for Mental Health in Persons Experiencing Physical Disability? Observational Evidence From 22 Countries

Int J Public Health, 2021 · DOI: 10.3389/ijph.2021.619823 · Published: April 16, 2021

Spinal Cord Injury Mental Health Public Health

Simple Explanation

This study looks at how social connections affect the mental health of people with spinal cord injuries across 22 countries. The study found that feeling connected to others and being happy with your relationships are linked to better mental health. Having a partner or living with others didn't consistently improve mental health, suggesting that the quality of relationships matters more than the structure.

Study Duration

January 2017 and May 2019

Participants

12,330 participants with spinal cord injury (SCI) from 22 countries

Evidence Level

Not specified

Key Findings

1
Functional aspects of social relationships were consistently related to clinically relevant higher MHI-5 scores and lower risk of mental health disorders.
2
Structural social relationships were inconsistently associated with mental health in our sample.
3
Increased feelings of belongingness, higher relationship satisfaction and fewer problems with social interactions were related to higher scores on the general mental health scale.

Research Summary

This study demonstrates pronounced and consistent associations of functional aspects of social relationships with mental health in persons with SCI across different regions of the world. In contrast, differences in mental health by partnership status and the living situation were less distinct and inconsistent across countries. Our ﬁndings highlight the importance of functional aspects of social relationships for mental health in people experiencing physical disability resulting from an SCI.

Practical Implications

Rehabilitation Programs

Interventions targeting functional aspects of social relationships should be considered in rehabilitation programs to reduce long-term mental health problems.

Education and Training

Specific education and training are needed to support coping and communication skills to strengthen partner relationships after the onset of SCI.

Cognitive Behavioral Therapy

Cognitive behavioral therapy was shown effective to enhance perceived social support and mental health after myocardial infarction.

Study Limitations

1
Sampling bias might be an issue because only eight countries applied random sampling and 14 countries relied on convenience sampling.
2
Results of country-speciﬁc analysis need to be interpreted cautiously as small samples in some countries might limit the power to detect meaningful associations.
3
Reverse causation cannot be excluded as people with mental health problems might experience more difﬁculties in maintaining good quality relationships.

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