Barriers To Mental Health Care For People With Disabilities

Mental health is just as important as physical health, but for people with disabilities, accessing mental health care can be a challenge. Many people with disabilities face barriers to care, such as lack of awareness, provider inexperience, and transportation difficulties.

Unfortunately, these obstacles can lead to people with disabilities not getting the care they need. This blog post will explore the common barriers to mental health care for people with disabilities and offer ways to overcome them.

Disability in North America

According to the Centers for Disease Control and Prevention (CDC), 61 million adults in the United States live with a disability. That’s 1 in 4 or 26% of adults. And the numbers are even higher for certain groups of people.

For example, 2 out of 5 adults aged 65 and over have a disorder. Similarly, 2 out of 5 Alaska Natives/Non-Hispanic American Indians, and 1 out of 4 women, have an incapacity. What’s more, 1 in 6, or 17% of children aged 3 to 17, have one or more developmental disabilities such as autism spectrum disorder, cerebral palsy, hearing loss, and intellectual disability.

The percentages of adults with functional disabilities are listed below:

Mobility (difficulty walking or climbing stairs): 13.7%
Cognition (problem with deciding, remembering, or learning): 10.8%
Independent living (need help with personal care or housework): 6.8%
Hearing (deaf or hard of hearing): 5.9%
Vision (blindness, low vision, or color blindness): 4.6%
Self-care (hardship in dressing, bathing, or eating): 3.7%

What makes these numbers even more staggering is we can expect them to rise in the coming years. For the adult population, the disabled are highly prone to developing chronic conditions such as diabetes (16.3%), heart disease (11.5%), obesity (38.2%), and are more likely to smoke (28.2%).

Mental Illness in the U.S

Per the National Alliance on Mental Illness (NAMI), 1 in 5 adults in the U.S faces mental illness in a given year. That’s 43.8 million or 18.5% of the population. And 1 in 25, or 4% of adults, live with serious mental illnesses such as schizophrenia, bipolar disorder, and major depression.

A severe mental condition affects about 1 in 5 young people (ages 13 to 18; 21.4%) at some point in their lives. The estimate for children between the ages of 8 and 15 is 13%.
10.2 million of the 20.2 million American adults with substance use disorders (50.5%) also had a co-occurring mental disease.
2.6% of individuals have bipolar disorder, and 1.1% of adults have schizophrenia.

Like physical disabilities, mental illness is also more common among certain groups. For instance, Asian Americans and African Americans access mental health treatments at rates roughly 1/3 and 1/2 lower than Caucasian Americans.

The consequences of the lack of mental health treatment are dire. According to NAMI, America loses $193.2 billion annually due to serious mental illness in terms of wages. More than 90% of young people who commit suicide also have a mental health issue, and roughly 18 to 22 veterans commit suicide daily.

These numbers make it clear that mental illness is a serious problem in the United States. But what’s even more alarming is that people with disabilities are more likely to experience mental illness than those without disabilities, yet they are less likely to receive treatment.

Current Access to Healthcare

Unfortunately, people with disabilities often face barriers when trying to access healthcare. In the CDC’s national survey of working-age adults with disabilities, it found that:

1 in 4 between the ages of 45 and 64 did not undergo a routine check-up in 2021
1 in 5 between the ages of 18 and 44 had an unaddressed health care demand due to expense in 2021
1 in 3 between the ages of 18 and 44 lacks a health provider

These numbers are even higher for people with mental health conditions. According to the CICS, just 41% of adults with cognitive challenges received mental health services in 2021. Meanwhile, only 62.9% of adults with serious mental illness and 50.6% of children between the ages of 8 and 15 with cognitive ailments received mental health services in the past year.

These disparities in mental health care exist for several reasons. And while some of these reasons are outside an individual’s control, we can take some steps to address them.

The Barriers to Mental Health Care

Many barriers keep people with disabilities from getting the mental health care they need. Below are some of the most common ones.

Poverty

According to the Annual Disability Statistics Compendium‘s 2020 disability report, there were 20,323,589 persons between 18 to 64 with disabilities in the U.S. in 2019. Of those, 5,261,057 were poor—a poverty rate of 25.9%.

Disabled people suffering from mental difficulties make up a huge chunk of this number. In fact, they’re more likely to live in poverty than those without disabilities. This makes poverty one of the biggest barriers to mental health care for people with disabilities.

An impoverished or detrimental living condition triggers or worsens mental health problems like anxiety, depression, and post-traumatic stress disorder (PTSD). On top of the challenges of having disabilities, lack of money can mean living in a high-crime area, having to move frequently, or being unable to afford healthy food. All of these can lead to increased stress and anxiety, which can then worsen mental health problems.

Even if people with disabilities can find mental health care, they may not be able to afford it. Poverty is further compounded by the fact that people with disabilities are more likely to live in rural areas with fewer resources and providers and have only 1/3 the median income of those without disabilities.

Lack of Adequate Insurance Coverage

Another reason people with disabilities may not get mental health care is a lack of insurance coverage. According to the United States Census Bureau, only 44.7% of persons with disabilities had private health insurance in 2018, compared to 74.9% of those without disabilities.

In contrast, 53.9% of adults with disabilities and 16% of those without disabilities had public health insurance in 2018. That’s a 37.9% gap due to several factors. First, many people with disabilities work for small businesses that do not offer health insurance to their employees. They may also work part-time or in temporary jobs that do not provide benefits.

Furthermore, not every insurance covers mental health care. Many don’t cover mental health services or limit the number of visits, making getting help very difficult and expensive. It also delays people from receiving the mental health care they need until their condition worsens, harming their quality of life.

Challenges in Communication and Transportation

While there have been great strides made in recent years to accommodate people with disabilities, many challenges still prevent them from receiving the mental health care they need. One of the biggest barriers is communication and transportation.

People with disabilities often have difficulty communicating their needs to others. It can be a barrier in many areas of life, but it can be especially difficult when getting mental health care. When people with disabilities cannot communicate their needs, they may not find providers who are willing or able to meet those conditions.

Another significant barrier to mental health care for people with disabilities is transportation. People with disabilities may not have access to transportation to and from mental health care appointments. It can be especially difficult for people who live in rural areas with limited public transportation options.

In addition, many people with disabilities rely on personal care assistants (PCAs) or other support staff to help them with daily tasks. If these staff members are unavailable, they may forego mental care altogether or have to wait until they can find someone to help them.

Lack of Knowledgeable Providers

One of the most significant barriers to mental health care for people with disabilities is the lack of knowledgeable providers. Many mental health care providers are not adequately trained to work with people with disabilities. It can lead to providers not understanding the unique needs of their clients and not being able to provide the best possible care.

This lack of knowledge can also make mental healthcare providers feel uncomfortable or helpless when working with people with disabilities. They may not know how to adapt their treatments to meet the needs of their clients. As a result, they may be less likely to provide mental health care to people with disabilities, or they may give substandard care.

For example, the UDS Foundation cites many doctors who believe disabilities cause mental illness rather than viewing them as independent challenges. Hence, people with disabilities are often undertreated or not treated at all. They receive less mental healthcare than people without disabilities, and their conditions often go untreated until they reach a crisis point.

Ignoring The Intersection Of Disabilities And Mental Illness

For far too long, the medical community has been guilty of ignoring the intersection of disabilities and mental illness. In fact, the National Alliance on Mental Illness suggests physicians address the physical symptoms of a disability while often overlooking the mental health issues that come along with it.

Invasive and painful treatments that people with disabilities endure can lead to traumatic stress. Depression and anxiety can also come from the isolation many people with disabilities experience. Yet, all too often, mental health care is not included in disability services.

This lack of awareness and understanding of how disabilities and mental illness intersect means that people with disabilities often don’t get the care they need. In some cases, this can lead to tragic consequences.

For instance, The Conversation’s April 2022 publication reveals autistic people are likely to attempt suicide six times more often than the general population. A major reason for this is that mental health support services don’t take into account the unique needs of autistic people. They are often overlooked, misunderstood, and underserved by the mental health care system.

Discrimination

Sadly, discrimination is a common barrier to mental health care for people with disabilities. Rethink‘s survey shows that 88% of those severely affected by mental illness report discrimination. It takes many forms, from being refused service to being treated differently or unfairly.

There are many reasons why people with disabilities might face discrimination when trying to access mental health care. One is simply a lack of awareness or understanding of mental illness and its effects, which can lead to people with mental illness being seen as somehow responsible for their condition or incapable of recovery.

Another reason is the way mental health services are structured and funded. In many countries, mental health care is still largely based on a medical model, which can reinforce the idea that mental illness is a ‘medical problem’ to be fixed rather than a part of who a person is. It can result in people with mental illness being seen as ‘patients’ or ‘cases’ rather than as human beings with complex lives and needs.

This kind of discrimination can profoundly affect people with mental illness, making them feel even more isolated, misunderstood, and alone. It can also make it less likely for them to seek mental health care, even when they desperately need it.

Ways of Overcoming Barriers

Despite the challenges, there are ways to overcome these impediments and get the health care disabled people need.

Tips for People with Disabilities

Talk to your doctor about your mental health needs and how they can be accommodated. If you need care from multiple providers, such as a mental health professional and a physical therapist, work with a case manager or care coordinator to ensure that your care is coordinated and you are getting the mental health services you need.
If you feel like you are being discriminated against, speak up. Talk to the doctor or mental health professional about your concerns and ask for a referral to another provider if necessary. You can also file a complaint with the office responsible for investigating complaints of discrimination in healthcare in your country or state.
Educate yourself about your rights as a patient with a disability. The Americans with Disabilities Act (ADA) and other laws protect you from discrimination in mental healthcare—whether it’s being denied service, treated differently, or charged higher prices.
Enlist the support of family, friends, or advocates to help you navigate the healthcare system and get the care you need. You can also contact organizations that provide assistance to people with disabilities, such as the National Council on Disability and National Alliance on Mental Illness.

Tips for Healthcare Providers

Healthcare providers can also take steps to improve care for people with disabilities.

Familiarize yourself about the needs of people with different disabilities and how to accommodate them. Make sure that your staff is also trained in disability etiquette and sensitivity.
Ensure that your facility is accessible and that you have the appropriate equipment and supplies to treat patients with disabilities suffering from psychological difficulties. Make a commitment to provide high-quality, coordinated care to all patients.
Promote a culture of inclusion and respect at your facility. Encourage employees to report any incidents of discrimination or mistreatment.

Tips for Policymakers

Policymakers also have a role to play in ensuring that people with disabilities receive the healthcare they need.

Pass laws and regulations that protect the rights of people with disabilities facing mental illness. Ensure that public and private health insurance plans provide coverage for mental health services for people with disabilities.
Increase funding for research on disabilities and effective treatments. Provide incentives to healthcare providers to increase access to care for people with disabilities with mental illness.
Support initiatives to educate healthcare providers and the general public about the psychological needs of people with disabilities. Disseminate information about available resources and services.

Tips for the Common Person

You can also take action to support people with disabilities in your community.

Educate yourself about the challenges people with disabilities face in accessing mental healthcare. Speak out against discrimination and mistreatment of people with disabilities who need mental help.
Provide support and assistance to people with disabilities in your community. Help them to navigate the mental healthcare system and get the care they need.
Volunteer with or donate to organizations that provide mental health services to people with disabilities. Spend time with people with disabilities to help them feel included and valued, or join a support group for people with disabilities where they can share their experiences and feel heard.

Final Thoughts

People with disabilities are just like everyone else; they have the same hopes, dreams, and fears. Unfortunately, they also live with the added stress of living with a disability, making them more susceptible to mental illness. Yet, despite their increased need for mental health care, they often face barriers in accessing the care they need.

But by increasing awareness and understanding of the challenges people with disabilities face, we can take action to remove the barriers they encounter in accessing mental health care. We can also provide support and assistance to help them navigate the healthcare system and get the care they need. In doing so, we can help people with disabilities live fuller, happier lives.

If you or someone you know is a person with a disability facing mental health challenges, get in touch with us at the Alvarado Parkway Institute. We provide comprehensive mental health services to people with disabilities, and our team of expert clinicians can help you or your loved one get the care and support you need. Contact us today at (619) 431-4877 to learn more about our services or to schedule an appointment.

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