Psychological impact of disability

Type of psychology: Biological bases of human behavior; Clinical; Counseling; Developmental; Health; Rehabilitation; School

Disability is a phenomenon in society that many people may face in their lifetime. This could be attributed to a congenital condition, sudden accident, aging, or an age-related genetic disease. In the context of the Americans with Disabilities Act, a disability is defined as a mental or physical impairment that substantially limits a person from completing one or more major life activities in an able-body environment. This could include, but is not limited to, breathing, thinking, learning, processing information, seeing, hearing, walking, talking, engaging in recreational and social play, and working. Additionally, an impairment may limit an individual because of societal attitudes (stigma and prejudice) regarding the specific condition (e.g.,HIV/AIDS in the early part of the epidemic in the 1980s). Examples of disability types are characterized as persons with perceptual disabilities that include learning, visual, and hearing impairments; illness-related conditions that incorporate diabetes, cancer, and AIDS; neurological conditions such as cerebral palsy or multiple sclerosis; intellectual disabilities such as Down syndrome; psychiatric disabilities as witnessed in schizophrenia, bipolar disorder, or major depression; mobility-related disabilities such as quadriplegia; and environmental concerns as seen in asthma, allergies, and environmental toxins.

Introduction

People have been defined by their ability to engage in society on many levels. Some of this engagement consists of having the ability to love a family and procreate, participate in recreational and social play, work , be involved in a nexus with a religious affiliation, participate fully in the community in which they reside, and so much more. Being diagnosed with a disability at birth or during childhood, young adulthood, middle life, or even senior years can greatly change the expectations of accomplishing some of these life goals. Thus, living with the label of disability can be an emotional and stressful endeavor as well as a psychological adjustment.

As of 2015, the Centers for Disease Control and Prevention (CDC) estimated that there are 53 million people in the United States living with a disability (CDC, 2015). A disability is characterized as a mental or physical impairment that substantially limits a person from completing one or more major life activities. In American society, individuals with disabilities face many societal barriers that prevent them from having full access to life activities. This could cause extreme psychological stress and hardship in such an individual. Thus, strong advocates lobbying for bills to be passed into law in order to protect these individuals and grant them the rights to engage in work activities, receive an adequate level of education, and access to social services within their local community were established.

Despite proactive legislation, the severity and type of the physical or intellectual disability can impact the level of participation an individual has in society. The psychological impact of disability surrounds the personal, psychological, environmental, societal, and economic aspects of the diagnosis of the disability. The personal impact involves the feelings experienced when initially diagnosed with a disability. They may experience initial shock, disbelief, denial, anger, reduced levels of self-esteem, depression, anxiety, fear of death, and grief as they mourn the loss of body functioning and status.

The person's psychological view of the disability is considered mostly in a negative light and may include a marked unacceptable conceptualization framework of the person's body status. Many are placed into the sick role or a role of pity and charity attributed to the disability. This is a common view of the biomedical model of disability, where the disability is viewed as pathology that requires treatment. This view posits that the person who has the disability must be fixed. If unable to cure the disability, the person is then placed in the role of pity or charity because he or she is no longer viewed as having able-bodied status and requires care and assistance.

This person has lost able-bodied status and is often viewed as a non-contributor in society and, further, may require the intensive care and support of the society. The stigma and prejudice associated with the disability causes the person to feel psychological stress and develop a negative self-image. Thus, dealing with disability, depending on the person affected, is considered more an adaptation than an acceptance of the disability. True acceptance of the disability is a psychological journey that each person undertakes. This journey greatly depends on the type of disability and the quality of life after the diagnosis.

Diagnosis may cause an individual to call into question the meaning and purpose of life. It challenges one's values and life commitments, and an individual may try to find some significance to what happened. He or she may look at global meaning and situational meaning to assist with life salience.

The person may also wonder about his or her ability to deal with the effects of the disability and the impact of the disability on educational, occupational, familial, sexual, parenting, social, driving, political, religious, shopping, beauty, and exercise goals that the person had prior to the diagnosis. Can he or she still live a “normal” life despite the disability? Can he or she live in this environment despite having a disability? Can he or she work, have a family, or even engage in recreational activities despite having a disability? These questions often cause psychological stress.

Disability Awareness

Disability awareness consists of environmental, societal, and economic factors. The environmental aspects associated with disability include barriers in the environmental structure. To fully comprehend disability awareness associated with environmental barriers, it is helpful to view the construct of disability as a more global perspective. To accomplish this task, we must use the social model of disability. This model focuses on power, resources, and unequal access for persons with disabilities. This model was developed in the United States during the 1960s and 1970s.

The model originated from the deinstitutionalization and independent living movements which were organized by individuals with more severe physical and mental disabilities. They wanted to live more freely in the community and be transferred out of the sick role fostered by state and city institutions. These individuals advocated for more involvement in decisions pertaining to their living arrangements in the community, relationships, employment needs, use of assistive technology, and the removal of environmental barriers.

They believed that the disability was not the problem. Rather, the problem was the environment that created architectural and attitudinal barriers that prevented a person with a disability from accessing the liberties that society offers others. What needed to change was a society that provided equal access to all persons. Persons needed to be considered temporarily able-bodied because anyone can become disabled in the future. This thinking would enable a society to have full access for all to benefit. This access includes retail services, technology and media, legislation, polling stations, education, employment, buildings, exits, restrooms, parking spots, transportation, and medical facilities to name a few.

The societal implications of disability originate from a long history of viewing the person with a disability as an inferior individual. From the seventeenth through the nineteenth centuries, mental illness was considered demon possession and/or the lack of religious belief. The mental health movement can be traced to where individuals who had mental impairments were separated from those who did not. People with intellectual disabilities and mental illnesses were placed into asylums where they were chained, beaten, sexually abused, denied food or water, neglected, and placed into isolation for displaying their symptomology. Some of these patients died from this deplorable care, and others survived hoping for a better outcome.

Doctor Philippe Pinel from France and Dr. Benjamin Rush from the United States were the first to treat patients with mental illnesses in revolutionary new ways. These physicians took off the chains from their patients. They dispensed respect, care,dignity, kindness, and true medical alternatives, and by listening to the patients, they achieved excellent results. They emphasized the value of careful observations, record keeping, and experimentation. They also applied objective scientific methods to the study and treatment of mental illness.

Dorothea Dix also became one of America's famous champions of the rights of persons with mental illness during the nineteenth century. She was a strong advocate and visited several hundred sites in the United States where persons with mental illness were incarcerated. As she visited, she collected data and used that information to successfully launch appeals for reform to both state and federal legislators. Finally, in 1860, her efforts were successful. She was able to procure state legislatures to appropriate funds to create new mental facilities that would provide humane treatment to patients with mental illness.

Finally, there are economic facets that can be attributed to disability. These facets are the economic cost of treating the disability, the economic hardship the disability might cause due to loss of employment, underemployment, or no employment opportunity because of workplace discrimination associated with the disability. Other economic challenges attributed to disability can be cost of housing and vehicle modifications related to the disability, cost of assistive technology, rehabilitation aids and devices, human assistants, and insurance.

Disability Adjustment

As the person begins to adjust to the disability, the person needs to utilize a problem-focused coping framework. This involves developing appropriate problem-solving skills that assist the person in determining how to cope and what to do. This will help the person develop reaction steps that might be either to deal with the consequences of the disability or to ignore it. Next, the person will have to define a plan. This plan can incorporate the need for social support.

Social support is defined as the relationships that a person with a disability has in life in order to cope with the disability. These relationships have some meaning and sense of attachment for the person with a disability. There are three categories of social support:

1. social embeddedness, which is a connection a person has to others in their environment,
2. perceived social support, which is a person's cognitive appraisal of connections to others, and
3. enacted support, which is the action conducted by others as they demonstrate their support of the person with the disability.

These types of support are demonstrated by emotional or physical care, material resources, and spiritual guidance. These types of support can be given by numerous sources such as family members, friends, clergy, medical service providers, and social service agencies.

In addition to developing support, they should also utilize medical and mental health interventions. Those with a disability must take a health-oriented, self-management approach when working with the consequences of the disability. They should define their vocational calling, seek employment opportunities, or obtain volunteer options. They must also accept their new body image as a beautiful person with a disability and define their self-worth as a good person with a disability. Persons with disabilities should utilize support groups, reference materials, and work toward an achievable inner acceptance and peace. Ultimately, they are responsible for ridding themselves of the rage, anger, and frustration attributed to the diagnosis of the disability.

A Barrier-Free Society

While a person with disability may experience psychological distress, living in a barrier-free society can aid the healing process. This means that the person with the disability is not faced with architectural and attitudinal barriers and can be explained by the environmental model of disability. This model examines the individual with the disability and the environment in which the individual lives. In this model, disability is characterized as the individual's acquirement of diverse achievements, functional skills, traits, and strengths, including biological and organic features. Advocates for this model believe that limitations, experienced as the result of a disability, are environmentally or socially based. Essentially, social barriers of people with disabilities consist of both physical inaccessibility and the perceptions and attitudes held by individuals without disabilities toward individuals with disabilities. Because of this problem, legislation such as the Americans with Disabilities Act Amendments Act of 2008 (PL 110–325), the Americans with Disabilities Act of 1990 (PL 101–336), the Individuals with Disabilities Education Act of 1990 (PL 101–476), and the Rehabilitation Act Amendments of 1992 (PL 102–569) were passed in hopes of leveling the playing field for persons with disabilities. In 2010, the Department of Justice instituted new regulations for the Americans with Disabilities Act called the ADA Standards for Accessible Design, which stipulated updated requirements regarding making newly designed state and local facilities readily accessible to individuals with disabilities.

Bibliography

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