Substance use, adverse mental health symptoms high among adults with disabilities
Adverse mental health symptoms and substance use were more prevalent among U.S. adults with disability than those without before and after the COVID-19 pandemic, according to findings published in MMWR.
“Adults with disabilities, a group including >25% of U.S. adults, experience higher levels of mental health and substance use conditions and lower treatment rates than do adults without disabilities,” Mark É. Czeisler, MD candidate at Harvard Medical School, and colleagues wrote. “Despite disproportionate risk for infection with SARS-CoV-2, the virus that causes COVID-19, and COVID-19–associated hospitalization and mortality among some adults with disabilities, information about mental health and substance use in this population during the pandemic is limited.”
Using nonprobability-based internet surveys, the COVID-19 Outbreak Public Evaluation (COPE) Initiative determined factors associated with adverse mental health symptoms and substance use among 5,119 adults with disabilities (50.5% men; 60.6% white; 17.6% Hispanic or Latino; 12.5% non-Hispanic Black) between February and March. All participants were older than age 18 years.
After receiving survey results, researchers identified correlations between disability status and adverse mental health symptoms or substance use with adjusted prevalence ratios. These included sex, age group, race/ethnicity and income.
Czeisler and colleagues found that 1,648 of 5,119 participants reported living with disabilities (778 [47.2%] with limiting physical, mental or emotional conditions only; 171 [10.4%] with health conditions requiring special equipment only; and 669 [42.4%] with both types of conditions). Additionally, 64.1% of adults with disabilities reported adverse mental health symptoms or substance use.
The researchers found that adults with disabilities were more likely to use substances to cope with stress of emotions compared with adults without disabilities both pre-pandemic (39.7% vs. 25.3%, respectively) and in the past month from time surveyed (40.6% vs. 24.5%; both P < .001).
Study limitations included underreporting due to self-reported mental health and substance abuse from participants, and the participants with disabilities not being representative of all adults with disabilities.
“These findings suggest value in enhanced mental health screening among adults with disabilities and in ensuring accessibility of routine and crisis services, particularly given that many adults reported that the COVID-19 pandemic had reduced mental health and substance use care or medication accessibility,” Czeisler and colleagues wrote. “Strategies designed to increase access to care and medication during public health emergencies, such as telehealth, might consider telemedicine platform and system accessibility for adults with disabilities; further research to identify and address health disparities among adults with disabilities could help guide additional evidence-based strategies.”