PERSONAL STRESSORS AND MENTAL HEALTH


PERSONAL STRESSORS AND MENTAL HEALTH

As with the general population, people with a Profound/severe disability are often subject to emotional and psychological experiences that impact on their lives in significant ways. Study of Personal stressors in the 2007-08 NHS, demonstrates that people with Profound/severe disability are at a much greater risk of stress (and by definition, other problems associated with stress) than people without a disability. These include measures of bodily pain, personal distress (Kessler 10 score) and medications taken as an indicator of the presence of chronic conditions and poor mental health.


Bodily pain by Disability status

According to studies carried out by the Accident Research Centre in Monash University, bodily pain, if experienced over a prolonged period, contributes to mental stress and limitation in the workplace and in learning.⁴ As well as injury, chronic conditions such as arthritis, rheumatism or osteoporosis are strongly associated with chronic pain.

The 2007-08 NHS asked respondents how much bodily pain they experienced in the four weeks prior to interview, referring to the severity of bodily or physical pain and the extent to which it interfered with normal work (both outside the home and housework). Of people with a Profound/severe disability, 38.0% experienced severe or very severe pain, compared to 4.0% of people without a disability (Graph 12). Although disability can exist without bodily pain, Graph 12 indicates that those experiencing Profound/severe disability were dealing with greater levels of pain compared to people without a disability.

Kessler 10 score by Disability status

In 2007-08, people with Profound/severe disability experienced greater High/Very high psychological distress levels (37.8%) when compared to people without a disability (6.3%) (Graph 13).

A further examination of K10, by age, reveals that at all ages, people with Profound/severe disability are experiencing more high and very high psychological distress levels, compared to people without a disability (Graph 14). Distress levels of people without a disability decrease markedly from the peak at age 25-34 (8.4%) to a low at age 75 years and over (2.9%). High/very high distress levels of people in the Profound/severe disability population increased from 28.0% in the 18-24 age group to 54.6% in the 45-54 age group, and remained relatively high to 75 years and over.

Personal stressors in the last 12 months

In the 2007-08 NHS, Personal stressors were defined as life events that may have been a problem for the respondent or anyone close to them in the 12 months prior to interview.

Graph 15 examines the top five stressors reported by people with Profound/severe disabilities. Of people with Profound/severe disability, 15.6% considered Serious disability a major stressor and 14.4% responded that Mental illness had been a problem in the last 12 months (compared to 6.8% of the people without a disability). Of people with Profound/severe disability, 10.7% considered being unable to get a job a serious stressor compared to 6.0% of the people without a disability.

No stressors were reported by 33.9% of people with profound/severe disability, compared to 55.9% of people without a disability.

A higher proportion of people with Profound/severe disability experienced the death of a family member or close friend as a major stressor, than people without a disability The differential was particularly marked in the 15-24 and 35-44 age groups (34.8% and 38.6%, compared to 18.4% and 18.5% of people with no disability). This finding was consistent throughout all life stages (Graph 16) and may be due to the dependence people with Profound/severe disability on people close to them, overlaid by the usual grief people feel with the passing of a family member.

There are complex social factors that contribute to a high prevalence rate of mental illness in people living with disability. People with intellectual disability have a poorer ability to manage stress through reduced cognitive and expressive functioning. This may include lack of control over one's life is an everyday experience by the Profound/severe population, who may rely on family members and paid carers for support networks, friendships, problem solving and conflict resolution as well as being fed and cleaned. The staff turnover of disability workers is high, so a continuity of care is difficult to achieve, especially where multiple physical and communication needs have to be explained and carried over to subsequent carers or staff, increasing the stress load of the recipient of care.⁵

Graph 17 shows mental illness is more likely to be an issue for people with Profound/severe disability than those without a disability, particularly between the ages of 15-44 years. For those people with Profound/severe disability in the 25-34 year age group, 35.7% had experienced mental illness as a personal stressor, compared to 9.0% of people with no disability. Similarly, 34.0% of people with Profound/severe disability in the 35-44 year age group had experienced mental illness as a personal stressor in the last 12 months, compared to 7.9% of people with no disability.