Health can be understood as a state of complete physical, mental, and social well-being, and not merely the absence of a disease or disability. The term “mental health”, includes emotional, psychological, and social well-being. It is all-encompassing and affects the way you think, feel, and act. Hence, mental health is essential at every stage of an individual’s life, from childhood and adolescence through adulthood. Stable mental health can be thought of as a work in progress; it is not about when you reach your destination but how you reach there.
Throughout an individual’s life, numerous factors can cause mental health problems which can affect their thinking, mood and behaviour; such as biological factors, traumatic life experiences, and a family history of related problems. Amongst these, childhood and developmental disorders are emerging issues faced by the healthcare system. As stated by Kessler et al. (2007), in their study, “the onset of many adult mental and developmental disorders occurs in childhood and adolescence”.
These childhood mental and developmental disorders include neurodevelopmental, emotional, and behavioural disorders that can have extensive and serious impacts on their social and psychological well-being. Affected children require crucial additional support from their families and educational institutions as these disorders frequently persist into adulthood (Shawet al., 2012). They are also more likely to experience a compromised developmental trajectory, with an increased need for medical and disability services.
Developmental Disabilities can be branched into two major divisions: Intellectual Disabilities (IDD) and Physical Disabilities, which sometimes, but not always, occur together. They are chronic conditions that appear at birth or in childhood, before the age of 22.
In some cases, mental illnesses and intellectual disabilities occur together, which is referred to as comorbidity, i.e., independent co-occurrence of one or more disorders; It illustrates categorical measures of mental disorder and serious psychopathology. Both developmental disabilities and mental illnesses are diagnosed by psychology professionals, although their medical expertise might vary concerning an individual’s case. Some individuals may suffer from multiple conditions, including combinations of developmental disorders and mental illnesses, the diagnosis and treatment of which are covered by The Diagnostic and Statistical Manual of Mental Disorders (DSM).
The DSM-5 has recognized that the boundaries between disorder categories are rapidly changing than ever before, and the symptoms once assigned to a single disorder may also occur at varying levels of severity in order disorders (Munir, 2016). For example, Autism Spectrum Disorder is the name given to a group of developmental disorders often characterized by impairments in the ability to communicate and interact with others. It includes a wide range of symptoms, skills, and levels of disability.
These disorders occur in about 1.5% of children; They often co-occur with conditions such as major depressive disorder, anxiety disorder, and sensory integration disorder (U.S. Department of Health and Human Services, National Institute of Mental Health, 2016).
According to a study conducted by Maria Quintero and Sarah Flick, individuals with co-occurring intellectual and developmental disabilities, have shown concerning statistics that reflect upon the fact that individuals with IDD are at a 33% higher risk of mental illness. Biological and social factors increase their susceptibility because mental illnesses are caused or aggravated by biochemical irregularities, and a brain with reduced performance is at a higher risk of biochemical imbalances.
In addition to this, people with IDD are often secluded and have few, if at all, social networks of support. They are often left alone in social settings and educational activities or are treated differently. This isolation becomes more apparent with age when they graduate without any established social circles. This social isolation and exclusion combined with already prevalent brain differences, more often than not, set the stage for susceptibility to mental illness (Quintero & Flick, 2010). Thus, children with developmental disabilities are at a substantially greater risk of developing mental health problems compared to typically developing children. However, the mental health co-morbidity often goes unrecognized in these cases, leading to reduced quality of life and increased burden of care.
With the growing understanding of mental health and related disorders, there has been a surge in consciousness towards the need for community services and support – provided by social workers – for instance – people with a dual diagnosis. However, there is still a dearth of professional services working in this realm in the Indian context. Programs like ADAPT – developed by the Mental Health and Mental Retardation Authority (MHMRA) of Harris County, based in Houston – helps adults in developing coping and self-management skills and access local resources needed to learn, work and live as contributing members of their communities.
They offer hope, opportunity, and encouragement to the most vulnerable populations whom mental professionals serve, and certainly, communities from across the world could benefit from the program and therefore should look to implement the same.
REFERENCES
- U.S. Department of Health and Human Services, National Institute of Mental Health. (2016). Autism spectrum disorder. Retrieved from: https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml
- American Association on Intellectual and Developmental Disabilities. Declaration on health parity for persons with intellectual and developmental disabilities. Joint Position Statement on Health, Mental Health, Vision, and Dental Care. Washington, DC: Retrieved from: https://www.aaidd.org/news-policy/policy/position-statements/health-mental-health-vision-and-dental-carePatel,
- V., D. Chisholm., T. Dua, R. Laxminarayan, and M. E. Medina-Mora, editors. 2015. Mental, Neurological, and Substance Use Disorders. Disease Control Priorities, third edition, volume 4. Washington, DC: World Bank. Retrieved from: https://creativecommons.org/licenses/by/3.0/igo/Quintero, M. & Flick S. 2010.
- Co-Occurring Mental Illness and Developmental Disabilities. Social Work Today. Retrieved from: https://www.socialworktoday.com/archive/092310p6.shtml
- American Psychiatric Association (APA) The diagnostic and statistical manual of mental disorders. 5. Washington, DC: American Psychiatric Publishing; 2013. https://scholar.google.com/sholar_lookup?title=The+diagnostic+and+statistical+manual+of+mental+disorders&publication_year=2013&
- Kessler RC, McGonagle KA, Zhao S. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in among persons 15 to 54 in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994.