Mental health impacts of COVID-19 on people with disabilities: A call to action

Mental health of persons with disabilities during the COVID-19 pandemic in Bangladesh

BACKGROUND

The COVID-19 pandemic has impacted the mental health of people across the world, including those with disabilities in Bangladesh. However, very little research exists that has explored the mental health problems experienced by persons with disabilities in rural and urban areas of Bangladesh. This study aimed to investigate the prevalence and associated factors of common mental health problems in persons with disabilities in rural and urban areas of Bangladesh.

METHODS

A cross-sectional survey using the Bangla Depression Anxiety Stress Scale-21 (BDASS-21) with sociodemographic was conducted among 950 participants with varying types of disabilities in Dhaka, Narayanganj, and Gazipur. Descriptive and inferential statistical analyses were used to measure the effects.

RESULTS

The prevalence of moderate to extremely severe depression, anxiety, and stress among participants was 67.6%, 72.6%, and 49.5%, respectively. Urban participants exhibited significantly higher levels of depression (76.6% in Dhaka), anxiety (86.1% in Dhaka), and stress (32.1% in Dhaka) compared to their rural counterparts (depression: 86.16%, anxiety: 91.07%, stress: 97.77% in Gazipur). Gender differences were observed in anxiety, with females reporting higher anxiety levels than males (p<0.05). Age and geographical location were significantly associated with stress (p<0.042 and p<0.001, respectively), with those reporting higher anxiety also experiencing greater stress (p<0.001). Specific disabilities, such as visual disabilities, were linked to higher stress levels, while depression and anxiety did not show significant associations with demographic factors or disability type.

CONCLUSION

Results highlight the prevalence of common mental health problems among persons with disabilities in Bangladesh. The findings can contribute to the development of appropriate public health intervention plans taking into consideration persons with disabilities, especially during emergencies.

The Importance of Patient Experience in Obtaining Mental Health Care at HRSA-Funded Health Centers

Timely mental health care prevents more complex and costly psychological problems, particularly for underserved individuals utilizing HRSA-funded health centers. Patient experience with care services and provider interactions may facilitate timely mental health care access. This study explored which elements of patient experience at health centers minimize delayed access to necessary mental health care. We used cross-sectional data on adult patients who needed mental health services from the 2022 Health Center Patient Survey (N = 1039). Multi-variable logistic regression analyses examined the influence of patient experience using measures drawn from the Consumer Assessment of Healthcare Providers and Systems on delayed mental health care, accounting for predisposing, enabling, and need factors. 82% of patients did not cite delayed mental health care. 60% or more of patients reported always or usually receiving responsive and coordinated care, with over 80% reporting always or usually receiving positive provider interactions. Lower odds of delayed mental health care was associated with always getting timely callback during business hours (adjusted odds ratio [aOR]: 0.26; 95% confidence interval [CI]: 0.09, 0.76), and that the provider always listened carefully (aOR: 0.33; CI: 0.14, 0.78), provided easy to understand recommendations (aOR: 0.31, CI: 0.12, 0.79), knew the patient's medical history (aOR: 0.33, CI: 0.15, 0.73), was respectful to the patient (aOR: 0.49, CI: 0.27, 0.90), or was easy to understand (aOR: 0.51, CI: 0.29, 0.88). Care responsiveness and positive provider communication are integral to facilitating timely mental health care access for vulnerable populations with mental health needs.

The patients with intrathecal baclofen pump in the age of COVID-19: a single center study

PURPOSE

Intrathecal baclofen pump treatment is employed in the treatment of various diseases. Despite the benefits of intrathecal baclofen pump, patients may occasionally encounter severe complications. These complications may necessitate urgent assessment or intervention for patients with intrathecal baclofen pumps. This study aimed to evaluate the intrathecal baclofen pump-related problems, the utilization of health services, physical-psychosocial status, and the quality of life of patients with intrathecal baclofen pumps during the coronavirus disease 2019 pandemic.

MATERIALS AND METHODS

We conducted a cross-sectional, phone-based survey study between 1 June 2021 and 15 July 2021 with a sample of 23 patients with intrathecal baclofen pumps. The patients' quality of life before the implantation of the pump, after one year of implantation, and during the pandemic was evaluated with the 3-level version of EQ-5D.

RESULTS

Catheter migration developed in one of the patients, after which the pump was changed. While the dose of baclofen was altered in eight (38.1%) patients during the pandemic period, the filling period was modified in three (14.3%) patients. While 61.9% of the patients reported that their general health, mobility, spasticity and joint mobility were worse than before the pandemic, 90.5% of the patients stated that their communication and mood were worse than before the pandemic. The 3-level version of EQ-5D and EQ-Visual Analogue Scale scores of the patients were significantly decreased during pandemic (p < .05).

CONCLUSIONS

Due to the complications of the intrathecal baclofen pump, its management should continue uninterruptedly during the pandemic period.

Social Determinants of Health Affect Psychological Distress among People with Disabilities

People with disabilities experience inequitable exposure to social determinants of health (SDOH) that contribute to disparate health outcomes, including psychological distress. There is little research examining which SDOH have the strongest effect on psychological distress among people with disabilities. This leaves healthcare providers and policy makers with insufficient information to make well-informed treatment decisions or allocate resources effectively. We explored the association between SDOH and disability and which factors may moderate the association between disability and psychological distress. Using data from the US Census Bureau's Household Pulse Survey (Phase 3.5), we examined SDOH among people with and without disability (n = 26,354). Among people with disability, the odds of severe psychological distress were highest among those who had low incomes (OR = 4.41, 95% CI: 3.51-5.60), were food insecure (OR = 3.75, 95% CI: 3.43-4.10), housing insecure (OR = 3.17, 95% CI: 2.82-3.58), or were unable to work (OR = 1.98, 95% CI: 1.80-2.18). Only difficulty paying for household expenses moderated the association between disability and severe psychological distress (OR = 9.81, 95% CI: 7.11-13.64). These findings suggest that supporting employment and economic opportunities and improving access to safe and affordable housing and food may improve psychological well-being among people with disabilities.

Perceived impacts of COVID-19 on wellbeing among US working-age adults with ADL difficulty

BACKGROUND

The COVID-19 pandemic has disproportionately impacted people with disabilities. Working-age adults with ADL difficulty may face unique challenges and heightened health risks because of the pandemic. It is critical to better understand the impacts of COVID-19 on social, financial, physical, and mental wellbeing among people with disabilities to inform more inclusive pandemic response policies.

OBJECTIVE

This study compares perceived COVID-19 physical and mental health, social, and financial impacts for US working-age adults with and without ADL difficulty.

METHODS

We analyzed data from a national survey of US working-age adults (aged 18-64) conducted in February and March 2021 (N = 3697). We used logistic regression to compare perceived COVID-19-related impacts on physical and mental health, healthcare access, social relationships, and financial wellbeing among those with and without ADL difficulty.

RESULTS

Adults with ADL difficulty were more likely to report negative COVID-19 impacts for many but not all outcomes. Net of covariates, adults with ADL difficulty had significantly greater odds of reporting COVID-19 infection (OR = 2.1) and hospitalization (OR = 6.7), negative physical health impacts (OR = 2.0), and negative impacts on family relationships (OR = 1.6). However, they had significantly lower odds of losing a friend or family member to COVID-19 (OR = 0.7). There were no significant differences in perceived impacts on mental health, ability to see a doctor, relationships with friends, or financial wellbeing.

CONCLUSIONS

Working-age adults with ADL difficulty experienced disproportionate health and social harm due to the COVID-19 pandemic. To address these disparities, public health response efforts and social policies supporting pandemic recovery must include disability perspectives.