I used to work as the Volunteer Coordinator at the Mood Disorders Association of Manitoba (MDAM). During my time there, I met and made friends with many people who had various types of mood disorders and or mental illness. Located within the same office space are the Manitoba Schizophrenia Society (MSS), the OCD Center of Manitoba, and the Anxiety Disorders Association of Manitoba (ADAM). Many of the consumers of these support structures utilized the services of more than one of the organizations there, as some people have overlapping symptoms and needs. I also met many people who were not only affected with a mood disorder, but who also had physical disabilities and/or limitations.
The thing that I noticed as I got to know certain individuals, is how a physical disability can play a significant role in the mental health of a person. There’s a lot to cope with and it can takes its toll on a person. Also, having a mood disorder makes coping with a physical disability a bit more problematic at times. Some of these issues are highlighted in an article from Austrailia:
Mental health conditions for this population are under-diagnosed (Jenkins & Gulbenkoglu, 1998). We believe this to be the most plausible account for these findings. Some reasons for this under-identification phenomenon may include:
- Accurate diagnosis of mental illness in people with disabilities is fraught with difficulties, compounded by communication difficulties, which makes information about symptomatology (for example, thought content) difficult to elicit.
- Symptoms that are normally ascribed to a mental illness being attributed to a behavioural manifestation of disability or 'challenging behaviour'.
- Poor early detection of emerging mental health condition and mild-to-moderate cases being overlooked entirely.
- Attitudinal barriers in recognising symptoms, based on the belief that people with disabilities do not possess the intellectual or personal capacity to be affected by everyday psychosocial stressors and, therefore, are protected from mental illness (Hagiliassis, 2005).
I had a difficult time trying to find Canadian content that included BOTH mental health AND physical disabilities. There seems to be a gap in the knowledge – and people are falling through it.
One of the ladies I had the privilege of working with uses a wheelchair. She also is diagnosed with Bipolar Disorder. One thing that improves her mental health is being able to leave her apartment, where she has home care, and do her volunteer work at MDAM. She is really good at what she does. Firstly, she does Peer Support, which entails her answering phone calls from a wide variety of individuals. Sometimes people want information. Sometimes they are in crisis. Some just need an understanding ear to listen. This person is qualified to speak with people who call in because she knows what it’s like to have a mood disorder. She knows the system, the medication, the hospital and the stigma that people generally have towards mental illness and mood disorders. The other thing she is doing now is facilitating some of the group sessions. This entails laying down the rules for group time, monitoring the sharing time, and offering encouraging feedback. Again, her life experience plays an important role here, which helps to provide a greater measure of safety to those seeking support. She’s been there. She knows.
However, when there was construction work being done in her building, the elevator was not in service for two weeks. She was not able to get out of her apartment to volunteer. She found it very hard, and quite depressing to be alone there for that length of time. Her quality of life was reduced during that time. But soon she was back at MDAM and back to her old self.
I also think about my other friend, the one I posted about in the “Queercripping” post. Her mental health is suffering too. I’m not sure that it’s being addressed. She feels suicidal, and depressed much of the time. Hopeless – and understandably so. I’m pretty sure she no longer has the ability to carry out a suicide. But that’s not the point. To be feeling that level of desperation is not a way to live. I do hope and pray that she is able to find a way to have joy in her life again. If you can’t find that – what is there to live for?
In “Why People Die By Suicide” by Thomas Joiner, he describes what it is that makes people especially vulnerable to suicide. The first thing is “thwarted belongingness”. When this fundamental human need is thwarted, it negatively affects health, adjustment and well being. Pain censors in the brain react the same as physical pain. The second thing is “perceived burdensomeness”. This is characterized by a deep sense of incompetence or ineffectiveness. A person feels like a burden on loved ones and others. The self image is assaulted, and there is a sense of fractured control over one’s destiny. (Joiner, 2005, p. 23, 65, 96, 97, 118). I know for my friend at HSC, she no longer belongs to the abled group. She now belongs to the group of people with a disability. That’s a pretty big loss to grieve, and a huge adjustment to make. Her sense of belongingness is very fragile. I would think that it would be quite difficult to NOT feel like a burden, when most of your life entails others having to do so much for you. I worry about her perceiving herself as a burden. Joiner claims that you can do feeling one or the other. But when you feel both, that’s when it’s dangerous.
These are just a few things to keep in mind when you consider how mental health intersects with physical disability.
Bambi
Hagiliassis,Nick; DiMarco, Mark; Gulbenkoglu, Hrepsime; Iacono, Teresa; Larkin, Helen; & Watson, Joanne. The Bridging Project: Physical disability and mental health. Retrieved from: http://www.psychology.org.au/publications/inpsych/bridging/
Jenkins, W. & Gulbenkoglu, H. (1998). Physical and sensory/psychiatric disability. Paper presented at VICSERV Conference, Melbourne, Australia.
Joiner, Thomas. (2005) Why People Die By Suicide, p. 23, 65, 96, 97, 118. Harvard University Press.
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