The National
Spinal Cord
Injury Association

SCI Life
Fall/Winter 1998

SCI and Inner City Violence

Dr. Pamela Ballard, offers the following advice to rehabilitation physicians and others who may need to expand their traditional training to incorporate treatment approaches that are more relevant to the inner city environment of victims of violent crime, especially those that have suffered spinal cord injury.

"Psychosocial adjustment after SCI is particularly difficult among inner city youth. Typically, they are very self conscious of their image and of being accepted. These individuals often refuse to return to school for fear of rejection from peers and concern over social stigma. Some fear being targeted for further violence because of limitations in mobility. Others may return to illicit drug activity/substance use for financial reasons or as an attempt to relieve pain or psychological distress. Altered self esteem affects the ability to cope with daily life pressures and peer relations. The combination of these and other social factors frequently impede the ability to engage in the rehabilitation process."

"Remember, supportive family and friends are key ingredients to successful patient participation and progress in the rehabilitation process, especially in transitioning to home. For many urban poor families, participation may be difficult or impossible because of the inability to obtain leave from work, lack of transportation, and childcare limitations. Families often are unable to provide the ongoing emotional support and financial assistance needed."

"Lastly, architectural barriers also are a major issue in inner city housing and can virtually lead to individuals being confined to the home."

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