IMPACT OF COVID-19 ON Person with disabilities

In times of unexpected uncertainty, such as the sudden appearance of a global pandemic like COVID-19, people have been facing a lot of mental health issues. As the coronavirus pandemic rapidly sweeps across the world, it is inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, care providers and people with underlying health conditions.

In public mental health terms, the main psychological impact to date is elevated rates of stress or anxiety. But as new measures and impacts are introduced – especially quarantine, Home Isolation and its effects on many people’s usual activities, routines or livelihoods – levels of loneliness, depression, harmful alcohol and drug use, and self-harm or suicidal behaviour are also expected to rise.

It has affected the emotional rhythm and the mind-body orchestra of the general public in different intensities depending upon the resilience of the person, social support available, economic state and pre-existing mental illness. Fear, anxiety, depression, insomnia and post-traumatic stress disorders are common issues seen. During the COVID-19 pandemic, concerns about mental health and substance use have grown, including concerns about suicidal ideation.

The COVID-19 pandemic has resulted in an increased prevalence of mental health problems among the Person with disabilities. A systematic review examining the Person with disabilities mental health status amid the pandemic found significantly higher levels of irritability, stress, anxiety, and depression.

In an attempt to lessen the emotional burden associated with this unprecedented hardship, studies have also shown an increase in maladaptive coping strategies such as higher tobacco, alcohol, and cannabis consumption, increase in junk food intake, physical inactivity, changes in sleep routines and excessive social media/news consumption.

In the current situation of the global health crisis due to COVID-19, from Bridging the Gap we would like to emphasize the higher risk faced especially in low and middle-income countries like India. Behaviours such as physical distancing, as well as their social and economic impacts, are worsening mental health consequences. However, these restrictive measures have undoubtedly affected the social and mental health of general people. As more and more persons are forced to stay at home in self-isolation to prevent the further flow of the pathogen at the societal level. Such as the current COVID 19 pandemic fundamentally disrupt human existence, and affect persons disproportionately. Some people with disabilities might require help for basic activities of daily living (ADL) while others may be more independent but find it difficult to navigate Covid -19 rules that a pandemic response demands.

The country and the world at large are faced with a major health crisis following the outbreak of COVID-19. The challenges posed by the pandemic are severe as it affects the physical and mental health of people, their finances and social life. Worries about an uncertain future and loss of employment are only some aspects that impact mental well-being. Rapid human-to-human transmission of Covid-19 resulted in the enforcement of regional lockdowns to stem the further spread of the disease. Isolation, social distancing, closure of educational institutes, workplaces, places of worship, and entertainment hubs confined people to stay in their homes to help halt the chain of transmission.

Enforced lockdowns, quarantines, restrictions in social and family gatherings, disruption of non-essential services delivery, and suspension of cultural and sporting activities have all been identified as new stressors and factors exacerbating mental health disorders. These restrictions combined with fear of contracting the virus, food insecurity, permanent and temporary layoff, relationship struggles, loneliness, boredom, and lifestyle changes (e.g., working from home, homeschooling) have had an enormous impact on the psychosocial and economic well-being of the Person with Disability.

Needs of people during the COVID-19 outbreak

Individuals with disabilities and their caregivers have to overcome barriers that could prevent them from accessing care and important information to decrease their risk during the COVID-19 outbreak. There are unique stressors and challenges that could worsen mental health for people with disabilities during the COVID-19 crisis.

These barriers might include:

Environmental barriers

• The information and communication of risk for the promotion of health, preventing the spread of infection and reducing the stress in the population, is often not developed and shared with people with communication disabilities.

• Many health care facilities are not accessible to people with physical disabilities.

• Urban barriers and inaccessible public transit systems make it difficult for people with disabilities to access health care facilities.

Institutional barriers

• Disabled people find it harder to access critical medical supplies which can become even more challenging as resources become scarce.

• The high cost of health care makes it difficult for many people with disabilities to afford essential medical services.

• There is a lack of specific protocols on how to take care of people with disabilities during the quarantine.

Attitudinal barriers

• There are many prejudices, stigmas and even discrimination against people with disabilities. There also exists a belief that people with disabilities cannot contribute towards the response to outbreak response and cannot make their own decisions. These barriers may cause extra stress for people with disabilities and even their caregivers.

• They may experience intensified feelings of loneliness in response to physical distancing measures.

The thoughts and feelings unique to people with disabilities include

• Thoughts of being a burden

• Fear about their caregiver falling sick

• Fear that they may be marginalized further during the rationing of supplies or care

• Sadness regarding feeling dependent on caregivers especially the elderly

• Thoughts of being worthless, as people do not look up to them or expect them to contribute during difficult times.

• Thoughts of being left out of the decision-making process

• Worries about financial security

• Worries about job security when things start to resume

Changes in behavioural: CwSN/Person with disabilities

Physical distancing due to the COVID-19 outbreak can have drastic negative effects on the mental health of the CwSN and disabled individuals. Physical isolation at home among family members can put the disabled person at serious mental health risks. It can cause anxiety and distress and further induce a traumatic situation for them. Family members may expect to witness any of the following changes to the behaviour of a person with disabilities.

• Changes to their sleeping and eating habits

• Irritating and shouting behaviour

• Emotional outbursts.

• Unexpected headaches and pain throughout their bodies

• Increased sadness, depression, or worry

Some common changes in children's behaviour can be: Children with Special Needs can experience anxiety, distress, social isolation, and an abusive environment that can have short or long-term effects on their mental health.

• Violent and destructive behaviours

• Temper tantrums

• Self-injurious behaviours such as hitting self, biting self, etc.

• Sleep disturbances

• Excess use of mobile phones or watching television

• Excess demand to go out of the house.

• Difficulties with concentration and attention

• Changes in eating habits

• Excessive crying and annoying behaviour

• Increased sadness, depression, or worry

• Changes in or avoiding activities that they enjoyed in the past.

• Changes to their sleeping and eating habits

• Irritating and shouting behaviour

• Emotional outbursts.

Reduce Anxiety & Stress Recommendations for Individual (Person with disabilities)

1. Spend time with family

• Spend quality time with family to reduce anxiety and stress.

• Get connected with faraway members by phone or video call.

2. Play Indoor games/ Reading books

• Playing chessboard games Listening to music

• Reading Solving puzzles

3. Do yoga / Meditation

• Remain physically active

• Walking indoors, Yoga, stretching exercises, deep breathing exercises, Meditation

4. Do small activities

• Do small activities at home to reduce boredom like gardening, cleaning, cooking, buying medicines, groceries etc.

5. Enjoy with Family members

• Connect with your loved ones, children, and grandchildren through phone or video calls.

6. Minimize news on Covid-19

• Cut down on listening to the news

• Don’t watch the news all the time as it may be upsetting & misleading

• Seek information only from reliable sources

Taking care of Mental and Physical Health of Children with Special Needs during COVID-19: The involvement of parents in healthy activities with their children can help to reduce stress and anxiety and bring relief to the overall situation.

Spend time with your Child Try to answer your child questions

• Try and answer the queries of children related to Covid 19.

• Spend Quality time with your kids Reading out stories make them feel loved.

• Look out for any signs of emotional disturbance.

• Don’t avoid their questions and try to answer their concerns.

• Assure them that with proper care things will be better.

• Don’t feel irritated by their queries.

• Give your children the emotional and moral support they need during this time.

• Have patience. This challenge is temporary, which will end in few days.

Connect With Special Educators/ Therapists

• Focus on your child’s strengths.

• Communicate with teachers, special educators or therapists about the struggles you as a parent are facing for better assistance.

Involve children in co-curricular activities

• It is important that you continue to allow time for creative activities too especially during this Covid - 19 Situation.

• Parents can help to reassure them that they are safe at home and encourage them to engage in some healthy activities including indoor sports and some physical and or mental exercises.

• Involve them in dance, yoga or exercises

• Make them help you in Household activities

• Make information creative and interesting with drawings, pictures etc.

• Promote the hobbies of the child such as watering plants, colouring pictures, painting, craftwork, etc.

Touch with Friends

• Encourage the children to talk to their friends on the phone, video calls etc.

• Involve them to have some fun activity together virtually.

Teach them to Good Habits for Health

• Ensure the good health of your children.

• Teach them to wash their hands frequently.

• Teach them to cover their mouth and nose with a bent elbow while coughing or sneezing.

• Watch out for signs of any symptoms of infection

• Ensure they sleep well.

Bullet Points Kept in Mind What to Do

• Stay at home. Voluntary isolation

• Maintain hygiene

• Home cooked fresh hot meal

• Compliance with prescribed medicines

• Connect with family and friends

• Seek medical help when falling sick

• Use telemedicine service to minimize hospital visit

• Frequent hand washing,

• Cover your nose and mouth while coughing or sneezing with a tissue or bent elbow

• Eat healthy food Get good sleep

What not to Do

• Do not self medicate

• Do not carry in

• Do not carry out

• Do not spread

• Avoid visitors and gatherings

• Do not take the effect of coronavirus lightly and take all precautions.

• Do not take excessive stress. Be alert but do not panic.

• Do not give any physical punishment to the child.

• Do not expose the child to television or mobile for keeping him/her busy.

• Do not organize any party. Also, avoid any type of social gathering.

• Do not allow the child to visit the neighbour’s house.

• Do not pay attention to any kind of rumours. If required inform the local administration.

Government should provide essentials services like as

• Increase financial and health security for people with disabilities and children with special needs.

• Increase social support for people with disabilities and children with special needs.

• Supply of Critical care equipment, Essential Medicines

• Increasing awareness on covid-19 mental health issues & prevention

CONCLUSION:

Make sure you and your family know your rights. You should also know your risks and take appropriate precautions if you have an underlying condition. If in doubt, consult your treating Doctor. Covid-19 is indeed a challenge for society, which may be faced through the collective efforts of the citizens of the country. It also gives you more opportunities to spend quality time with your family. With appropriate measures, the effective management of children with intellectual and developmental disabilities is possible at home. The present situation requires the instant launch of public awareness campaigns about how to maintain their mental health in the prevailing situation.

Thank You

Dr. Srinivas Reddy Atla 9703935321 RCI NO A65442

Rehabilitation Psychologist at Chethana Psychological & Family Counselling Centre

National President of ARPP-India

Mail Id: atla610@gmail.com

Web: http://cpa2017.jimdo.com

9703935321