The pandemic weighs on the mental health of people with disabilities
A woman with a prosthetic leg holds a book and sits thoughtfully.
By Kathleen Bogart, Katie Wang and Robert Manning III
More … than 800,000 people in America have died of COVID-19, and millions more have faced the illness or death of loved ones, financial hardship, and resulting stress and mental health issues.
People with disabilities, who represent approximately 25% of the American adult population, are particularly likely to experience pandemic-related challenges, but their needs and experiences are often overlooked.
To fill this knowledge gap, our team recently published one of the largest academic studies on the mental health of people with disabilities in America during COVID-19.
Many people with disabilities are at high risk of developing COVID-19 and related complications. Additionally, some of the disruptions associated with the pandemic tend to disproportionately affect people with disabilities.
One survey found that almost 50% of people with disabilities had new challenges accessing health care during the pandemic. Appointments, procedures and surgeries have been delayed or canceled due to strain on the healthcare system from the pandemic. People with disabilities were already more likely to be socially isolated and live in poverty before the pandemic, putting them at even greater risk of isolation and poverty as the pandemic drags on.
To maintain their independence, many people with disabilities rely on home delivery of basic supplies such as food and medicine, which were often unavailable during the early months of the pandemic when the general public increased demand for these services. .
To examine the impacts of these myriad factors on the mental health of people with disabilities, we conducted an internet-based survey between October and December 2020 of 441 adults living in the United States. Participants had various disabilities: 50% had a physical disability, 32% had an emotional and behavioral disorder, and 27% had chronic health conditions; 44% indicated that they had more than one disability.
Compared to pre-pandemic norms, our participants experienced significantly higher rates of depression, anxiety, social isolation, and stigma. Indeed, 61% of our participants had high symptoms of depression and 50% had high symptoms of anxiety. Social isolation, pain, young age, disability stigma, and fears of contracting COVID-19 were positively associated with symptoms of depression and anxiety.
Insights to promote mental health
Although concerning, these findings provide important insight into potential strategies that can help alleviate the mental health burden faced by adults with disabilities in the United States.
- Social isolation was identified as the strongest predictor of depression and anxiety in our study, and virtual disability communities and support groups may be accessible ways to build social connections. Many people with disabilities have created online communities to help care for each other, such as Crip Camp Virtual Camp. Communities of people with disabilities have been find promote social support and reduce stigma, leading to mental health outcomes.
- There is an urgent need to address disability-related stigma in health care settings, both by educating health care providers about ableism and by creating medical rationing policies who do not equate a disability with a poor quality of life. Such efforts may also alleviate some of the anxieties of people with disabilities about contracting COVID-19, which are driven in part by fears that they will not be able to receive the same quality of medical care as non-disabled patients if they fall. sick.
- Policymakers should ensure that guidelines to prevent the spread of COVID-19 are accessible to screen readers, captioned, and include ASL interpretation. The guidelines should also include disability-specific recommendations, such as sanitizing mobility equipment and communicating with deaf and hard of hearing people while wearing masks.
- Accessible and culturally appropriate mental and physical health care for people with disabilities should be a key priority to reduce the mental health burden of people with disabilities. This can be provided by clinicians through several modalities, including telehealth or home visits. The American Psychological Association suggests that psychotherapy via telehealth can be a powerful tool to address the mental health issues of adults with disabilities and chronic illnesses, who may have difficulty accessing in-person care due to transportation and other structural barriers. Because the disability community is so heterogeneous, healthcare providers must take an individualized approach when choosing the most appropriate treatment modality for each patient or client.
The COVID-19 pandemic has exposed longstanding structural inequalities in our American society. For adults with disabilities living in the United States, this means increased experiences of stigma, more extreme levels of isolation from formal and informal support systems, and heightened concerns about serious illness and death from COVID-19. 19.
As our study revealed, these factors have all contributed significantly to the mental health problems of adults with disabilities. While these findings may paint a bleak picture, they also gave us vital insights into creating a better and fairer way forward.
As we see another surge of the virus due to an even more transmissible variant, healthcare providers, rehabilitation professionals, disability organizations and policy makers must work hard to ensure that practices that promote accessibility, inclusion and equity in health are implemented in all health care systems.
Katie Wang, Ph.D., is an assistant professor in the Department of Social and Behavioral Sciences at the Yale School of Public Health. Robert Manning III is a research assistant in the Department of Social and Behavioral Sciences at the Yale School of Public Health.