New US data shows that the rate of substance use among people living with a disability was more than double that of the general population at the beginning of this year
Even before the pandemic, adults with disabilities – which make up over 18% of the population in the UK – were more likely to suffer from a mental health condition and engage in substance use.
Yet despite being more likely to need treatment for these conditions, research suggests that people with disabilities have lower treatment rates, both for mental health and substance use conditions, due to increased obstacles in accessing care. The situation has become even more pressing during the pandemic as 43% of adults with a disability report a greater difficulty accessing related care or medication.
The pandemic has made accessing treatment difficult for all of us due to long waiting lists of people seeking support. But there is a stark difference between the effects on those living with a disability and those living without, according to a new report from the Centres for Disease Control and Prevention.
In a US survey of over 5,000 people carried out between February and March of this year, almost 2 in 3 (64%) adults with a disability reported adverse mental health symptoms or substance use – more than double that of adults living without a disability (36%). They were also significantly more likely to experience symptoms of anxiety or depression (57% vs 29%), suicidal thoughts (31% vs 8%), and to have just started or increased substance use (39% vs 18%).
Looking specifically at substance abuse, methamphetamine, non-opioid prescription drug, and polysubstance (using multiple substances at the same time) use was around 2x higher in disabled people than in adults without a disability. Cocaine use, and prescription or illicit opioid use was also around 3x higher.
Why exactly the rates were so much higher in disabled people is not fully clear, although significantly more reported their use of substances to deal with stress or emotions compared with those living without a disability.
As a solution, the researchers suggest that there is an immediate need for "enhanced mental health screening" for people living with a disability as well as for ensuring access to routine and crisis services.
Access pathways to services for people with physical, sensory, or cognitive impairment also need to be reviewed, add the authors, while telehealth solutions (such as apps or websites) and systems specifically for adults with a disability need to be made as easily accessible as possible.
Although the focus of the study was on the disparity in the psychological impact of the pandemic on people with a disability compared with those without, worrying patterns also emerged across several subgroups of the entire study population.
Symptoms of anxiety or depression were around 2x more common, while suicidal thoughts were generally more common, in disabled adults over 50. Suicidal thoughts were also common among unpaid caregivers, and both essential and non-essential workers.
New or increased substance use was also around 2x higher among adults with disabilities in parental roles and among essential workers.
The study didn't examine the exact reasons for these specific patterns, but reports do point toward some possible factors.
For essential workers, an increased workload and severe burnout are likely major contributors to a deterioration in their mental health. A recent study among UK frontline workers revealed the shocking effect of pandemic stresses on suicide attempts.
For disabled parents, not only have they had to cope with the pressure of working and home schooling during periods of lockdown, but they have also had the added fear of their child potentially bringing Covid-19 into the home once they returned to school – a particular concern for older people or those that are clinically vulnerable.
It’s also important to highlight the impact of substance use on carers of adults with a disability. Another report released by The Centres of Disease Control and Prevention found that among adult carers experiencing the most severe mental health symptoms, many were carers of adults engaging in substance use.
Read the full CDC study here.
Written by Conor D'Andrade
Contributor for Talking Mental Health