The Pandemic Weighs on Disabled People's Mental Health

A woman with a prosthetic leg holds a book and sits pensively.

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By Kathleen Bogart, Katie Wang, and Robert Manning III

More than 800,000 people in America have died from COVID-19, and millions more have faced illness or death of loved ones, financial hardship, and resulting stress and mental health challenges.

People with disabilities, who represent approximately 25 percent of the U.S. adult population, are especially likely to experience pandemic-related difficulties, yet their needs and experiences are often overlooked.

To address this knowledge gap, our team recently published one of the largest academic studies on the mental health of people with disabilities in America during COVID-19.

Many people with disabilities are at high risk for developing COVID-19 and subsequent complications. In addition, some of the disruptions associated with the pandemic tend to disproportionately affect disabled people.

One survey found that nearly 50 percent of people with disabilities had new challenges in accessing healthcare during the pandemic. Appointments, procedures, and surgeries were delayed or canceled due to the strain on the healthcare system from the pandemic. People with disabilities were already more likely to be socially isolated and live in poverty before the pandemic, placing them at even greater risk of isolation and poverty as the pandemic wears on.

To maintain their independence, many disabled people rely on home delivery of basic supplies such as food and medications, which were often unavailable during the early months of the pandemic when the general public increased demand for these services.

To examine the impacts of these myriad factors on the mental health of people with disabilities, we conducted an Internet-based survey between October and December 2020 with 441 adults living in the United States. Participants had a variety of disabilities: 50 percent had a physical disability, 32 percent had an emotional, behavioral disorder, and 27 percent had chronic health conditions; 44 percent indicated they had more than one disability.

Compared to pre-pandemic norms, our participants experienced significantly higher rates of depression, anxiety, social isolation, and stigma. Indeed, 61 percent of our participants had elevated symptoms of depression, and 50 percent had elevated symptoms of anxiety. Social isolation, pain, younger age, disability stigma, and worries about contracting COVID-19 were positively associated with depression and anxiety symptoms.

Insights to Promote Mental Health

While concerning, these findings provide important insights into potential strategies that can help mitigate the mental health burden faced by disabled adults in the United States.

1. Social isolation was identified as the strongest predictor of depression and anxiety in our study, and virtual disability communities and support groups can be accessible ways to build social connections. Many people with disabilities have been building online communities to help take care of each other, such as Crip Camp’s virtual camp. Disability communities have been found to foster social support and reduce stigma, thus leading to more positive mental health outcomes.
2. There is an urgent need to address disability-related stigma in healthcare settings, both by educating healthcare providers about ableism and by creating medical rationing policies that do not equate having a disability with poor quality of life. Such efforts may also alleviate some of the disabled people’s worries about contracting COVID-19, which are in part driven by fears of not being able to receive the same quality of medical care as nondisabled patients if they were to become ill.
3. Policymakers should ensure that guidelines to prevent the spread of COVID-19 are accessible to screen readers, captioned, and includes ASL interpretation. Guidelines should also include disability-specific recommendations, such as sanitizing mobility equipment and communicating with deaf and hard-of-hearing people while wearing masks.
4. Accessible and disability culturally competent mental and physical healthcare should be a critical priority in reducing the mental health burden of people with disabilities. This can be provided by clinicians through several modalities, including telehealth or home visits. The American Psychological Association suggests that psychotherapy via telehealth can be a powerful tool to address mental health concerns for adults with disabilities and chronic illnesses, who might have difficulty accessing in-person care due to transportation and other structural barriers. As the disability community is highly heterogeneous, healthcare providers should adopt an individualized approach when choosing the most appropriate treatment modality for each patient or client.

The COVID-19 pandemic has exposed long-existing structural inequities in our American society. For disabled adults living in the United States, this means an increase in stigma-related experiences, more extreme levels of isolation from formal and informal support systems, and exacerbated worries about severe illness and death due to COVID-19.

As our research study found, these factors all significantly contributed to mental health challenges for disabled adults. While these findings may paint a grim picture, they have also given us vital insights into creating a better and more equitable path forward.

As we witness another surge of the virus due to an even more transmittable variant, healthcare providers, rehabilitation professionals, disability organizations, and policymakers must work hard to ensure that practices supporting accessibility, inclusion, and health equity are implemented across systems of care.

Katie Wang, Ph.D., is an assistant professor in the Department of Social and Behavioral Sciences at the Yale School of Public Health. Robert Manning III is a research assistant in the Department of Social and Behavioral Sciences at the Yale School of Public Health.