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 important 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 process; it’s not about when you reach your destination but how you reach there.
Throughout an individual’s life, numerous factors can cause mental health problems, affecting 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 an emerging issue faced by the healthcare system. Kessler et al. (2007) stated 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 (Shaw et 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, which 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 covered by The Diagnostic and Statistical Manual of Mental Disorders (DSM).
The DSM-5 has recognised that the boundaries between disorder categories are rapidly changing than ever before. 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 characterised by impairments in communicating and interacting with others. It includes a wide range of symptoms, skills and levels of disability. These disorders occur in about 1.5% of children and often co-occur with 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 that individuals with IDD are at a 33% higher risk of mental illness. Biological and social factors increase their susceptibility. This is 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 and Flick, 2010).
Thus, children with developmental disabilities are at a substantially greater risk of developing mental health problems than typically developing children. However, the mental health comorbidity often goes unrecognised 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, such as for 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 — help adults develop 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’ mental professionals. Communities from across the world could benefit from the program and, therefore, should look to implement the same.