More than 3 million people in Ontario live with a disability, many living with more than one. Mental health disabilities and physical disabilities are common, and it can be difficult for people who live with both.
While there is growing awareness in various sectors about the needs of people with mental health issues, and the needs of people with physical disabilities, there is much less information about these needs when disabilities co-occur.
It’s time to better understand and address the complex needs of people living with both a mental health issue and a physical disability.
The data starts to paint a picture.
Wellesley Institute recently collaborated with the Canadian Mental Health Association (CMHA) Toronto on research examining community mental health and service delivery. Data analyzed from the Ontario Common Assessment of Need (OCAN) showed that nearly 10 per cent of single, working-age people who seek community mental health services also had a physical disability.
When these disabilities co-occurred, people had significantly higher overall needs, as well as a higher level of unmet needs. In particular, their needs related to physical health, looking after their home, self-care, social connection, transportation and psychological distress were more likely to be unmet compared to people who had mental health needs but no physical disabilities.
People living with disabilities told us about their challenges.
Building on these findings, Wellesley Institute consulted with members of disability communities to better understand their experiences. Service users highlighted difficulties maintaining their physical health due to limited financial resources and inadequate transportation support. Rising food costs, for example, have made it harder for them to follow the diets recommended by their doctors. Transportation barriers, including unreliable and inaccessible public transit and insufficient transportation coverage through the Ontario Disability Support Program, were reported. This made it difficult to attend medical appointments.
Service users also discussed challenges with housekeeping and personal care and identified a need for accessible homemaking programs. They discussed how their physical disabilities made it difficult to stand for long periods to carry out household cleaning, and how mental health-related phobias prevented them from taking a shower. However, publicly funded homemaking programs generally have a long waitlist. And, specific eligibility criteria, such as age, may screen them out from accessing existing services.
Service providers play an important role.
This research by CMHA Toronto and Wellesley Institute identified potential training gaps for community mental health providers.
While they are highly knowledgeable about mental health service needs, many had limited knowledge about how to support those who also have physical disabilities. The research suggests community mental health providers could benefit from training on how to help people with physical disabilities navigate the health system.
Policy changes are needed.
People using community mental health services who also have physical disabilities have higher unmet needs that current systems are not adequately addressing. We need policy changes to tackle the financial barriers, expand access to community-based personal care support programs, and enhance support to community mental health providers.
Learn more and explore policy directions by reading the full research report.
You may also be interested in checking out Wellesley Institute’s Thriving in the City with a disability framework. The framework highlights the resources and services that people with physical and/or mental health disabilities need to live a healthy and meaningful life, including a healthy diet, social connection, physical activity, and the ability to learn new skills.