Abstract Body: Introduction: Despite the high incidence rate of post-stroke anxiety and mood changes, there is limited evidence for the integration of emotional and mental health support resources into acute care and long-term recovery. In this international survey-based study, we seek to better understand the emotional and mental health needs of survivors and caregivers.

Methods: Participants were recruited via online advertising and advocacy groups. Eligibility included: ≥18 years, fluent in English, and identified as a brain injury survivor, caregiver, or healthcare worker. This analysis focuses on the stroke subgroup. Descriptive statistics were used for quantitative data and thematic analysis for qualitative responses.

Results: 410 individuals completed the survey (stroke: n=200). Most of them (n=158, 79%) were youth stroke survivors (aged <50 years). Both ischemic (n=59, 29%) and hemorrhagic stroke (n=141, 71%) survivors experienced an average of 3 impairments: fatigue was most common (n=150, 75%).

Surveyors reported a lack of overall emotional (n=152, 76%) and mental health support (n=139, 70%), insufficient communication about anticipated recovery (n=145, 73%), and a desire for more discussion on rehabilitation options (n=108, 54%). Table 1 presents a thematic analysis of recovery.

Most experienced a high level of anxiety ( ≥6.5/10) about long-term recovery (M =6.6, SD =2.6), emerging symptoms (M =6.7, SD =2.7), uncertainty about the future (M= 6.9, SD=2.7) and financial and return to work concerns (M=6.5, SD=3.1).

Many were unfamiliar with brain injury before their diagnosis (n=152, 76%) and reported that no information about emotional or mental support was shared at discharge (n=136, 68%). Searching the internet was utilized most for seeking information (n=144, 72%).

A majority had no contacts who had lived brain injury experience (n=150, 75%) but desired someone to talk to in their transition from bedside to community; with a preference for in-person peer support. Qualitative analyses outline the ideal supporter as empathetic, resourceful, knowledgeable about recovery, and honest.

Conclusion: The survey indicates a lack of and need for early integration of emotional and mental health support services and comprehensive informational resources into longitudinal recovery plans. This data could guide future peer support programs and inform other research studies by emphasizing the importance of continuous dialogue with community partners and people with lived experience.