Mental health challenges are a ubiquitous concern worldwide. It has been estimated, for example, that in the U.S. alone, 1 in 5 adults, or 51.5 million people, will experience some form of mental illness in their lifetimes.
Despite the prevalence of mental illness, however, access to quality mental healthcare is not always equitable, nor are sufficient efforts being made to identify and support all high-risk populations.
Current research indicates, for instance, that persons with physical disabilities are at a substantially higher risk for mental illness, including depression, anxiety, and post-traumatic stress disorder (PTSD) than the general population. Nevertheless, this same high-risk group remains largely underserved, with clinicians and healthcare providers often prioritizing patients’ physical care over their mental health needs.
Physical Disability and Mental Health
Whether the physical impairment is caused by a chronic, life-long condition, an injury, or a nascent illness, the reality is that living with a physical disability can be a significant challenge.
The overall impact of the disability on one’s daily functioning, one’s relationships, and even one’s self-image and self-esteem can take a profound toll on mental health. Studies have shown, for instance, that those with a physical disability were at significantly higher risk for developing depression. The connection between disability and depression, moreover, was particularly high among women.
And that is not all. Current studies also indicate a strong link between depression and other mental health conditions, particularly anxiety. Indeed, the overlap between depression and anxiety is so strong that the one often fuels the other, creating a vicious cycle from which patients may feel it impossible to escape.
Persons with physical impairments, for example, may find themselves experiencing isolation simply due to the challenges and risks associated with navigating environments that may not be designed for those who use wheelchairs or other mobility aids.
And the more the physical impairment pushes the patient to retreat into the solitude of the home, the greater the risk for loneliness and depression and the greater the potential for debilitating anxiety when he or she endeavours to venture into the community again.
Safe at Home?
In addition to contending with accessibility challenges in one’s community, it is also likely that those who are learning to live with a physical disability must face issues with access, function, and safety at home.
The simple fact is that most homes were not designed with universal access in mind. Thus, ensuring that a home is safe and functional for someone with a physical disability can take significant time and effort, and may come at a substantial cost.
From retrofitting bathrooms and kitchens to installing ramps or elevators, one’s home may look, feel, and function quite differently following an illness or injury than before the disability occurred. And that can necessitate a period of significant psychological adjustment, as homeowners learn to navigate and experience home in a new way.
Comprehensive Care
As can be seen, living with a physical disability often involves grappling with challenges far beyond the treatment and management of the condition itself. It involves accommodating a new sense of self, navigating accessibility issues in the community one calls home, and even learning to live in one’s own house in a very different way.
Living with a disability, in other words, can impact virtually all aspects of life, from combating isolation to negotiating relationships in the face of a new normal to contending with the inevitable fears and uncertainties that accompany illness and injury.
Yet, for far too long and for far too many, the mental health challenges faced by persons with disabilities were addressed, when they were recognized at all, as simply another facet of disease pathology.
And that has meant that healthcare providers have been far more likely to attempt to address the issue with largely unproven and often ineffective psychotropics, such as anti-anxiety and anti-depressant medications.
While these treatments may offer some symptom relief, at least in the short-term, they can do relatively little in addressing the underlying, and often highly complex, causes of mental illness among those with physical disabilities.
This, ultimately, is why mental health advocacy is so urgently needed for this high-risk population. The U.S. healthcare system has been lamentably negligent in its responsibility to ensure both the physical and mental wellbeing of those with disabilities, whether physical or developmental. And that has contributed to a devastating history of medical neglect and malfeasance of care.
The hope, however, lies in advocacy. This must include, for instance, the recognition of the particular mental health risks and challenges that persons with physical disabilities face. And with such recognition must come a comprehensive, holistic approach to mental health care that draws on an array of resources, from the medical to social to the psychotherapeutic, to help those with physical disabilities achieve the quality of life they deserve.
The Takeaway
For far too long, the mental health needs of those living with physical disabilities have gone largely unrecognized and unaccommodated. And that result has been that millions who might otherwise have been helped have been left to suffer depression, anxiety, and related disorders in silence. Mental health advocacy, however, can help ensure that the psychosocial needs of those with physical disabilities are acknowledged at last, enabling those in need to receive the comprehensive care they deserve.