IMPACT OF PANDEMIC ON MENTAL HEALTH OF PERSONS

INTRODUCTION

COVID-19 was the world’s greatest epidemic of the twentieth century. It affected almost every part of the world (Shetty, Amaresha, Bamney, & Shah, 2022). The COVID-19 pandemic has directly impacted many people’s physical health; besides, it has posed a great threat to the mental health of millions (Tsamakis, Tsiptsios, Ouranidis, & Spanou, 2021; Usher, Durkin, & Bhullar, 2020; Shetty, Amaresha, Bamney, & Shah, 2022). Studies suggest that psychological distress and issues like depression, mood disorders, anxiety disorders, sleep disorders, post-traumatic stress disorder, behavioral disturbances, and substance use may commonly occur after natural disasters (Beaglehole, Mulder, Frampton, & Ferris, 2018; Chaves, Castellanos, Abrams, & Ramos, 2018; Granados, Christine, Ionides, & Coakley, 2018). Stressors such as longer quarantine duration, fears of getting an infection, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma increase psychological distress in the public (Panchal, Kamal, Orgera, & Alker, 2020; Shetty, Sridharan, Kumar, & Prasad, 2020). This pandemic has drastically changed the lives of people, majorly affecting their wellness due to the lockdown and economic downfall (Shetty, Sridharan, Kumar, & Prasad, 2020). Persons with disabilities are more affected than those without disabilities (Na & Yang, 2022). Psychosocial factors associated with social isolation, limited access to basic needs, loneliness, loss of income, decreased social and emotional support, and reduced physical activities have exacerbated the mental health of humans. Many developing countries faced unique problems such as limited resources to respond to the pandemic (Poudel & Subedi, 2020; Sandya, Shetty, Jaise, & Kumar, 2022). There is an increased risk of developing mental and physical health issues in vulnerable populations, especially persons with disabilities (Panchal, Kamal, Orgera, & Alker, 2020). Studies suggest that individuals affected by the pandemic may have a high epidemiological burden of depression, anxiety disorders, panic attacks, somatization disorder, sleep disorders, emotional disturbance, PTSD symptoms, suicidal behavior, and many more mental health problems (Hossain, Roy, Ullah, & Mollah, 2020; Poudel & Subedi, 2020). Many studies also indicate that vulnerable populations such as persons with disabilities and their caregivers face greater risks than the general population, making it essential to provide special interventions and care for persons with disabilities and their family members. COVID-19 AND PSYCHOSOCIAL ISSUES FOR PERSONS WITH DISABILITIES The pandemic plays a key role in increasing psychosocial issues for persons with disabilities. The economic recessions caused by the pandemic affected the financial stability of the population. Lockdowns, curfews, selfisolation, social distancing, and quarantine have impacted the overall physical, mental, spiritual, and social well-being of the population. Certain studies suggest that most people experienced extreme distress during the pandemic because of lockdowns, extreme isolation, and especially low income (Mathias, Rawat, Philip, & Bansal, 2020; Shetty, Amaresha, Bamney, & Shah, 2022). Persons with disabilities were already undergoing many psychosocial issues, such as a decreased quality of life for their family members and an increased social distance between the patient and their caregivers. These psychosocial challenges are exacerbated by social stigma (Iseselo, Kajula, & Yahya-Malima, 2016), and persons with disabilities had reduced access to the healthcare system and experienced social and lifestyle changes, decreased physical activity, and mood changes (Lebrasseur, Fortin-Bédard, Lettre, & Ducharme, 2021). During the pandemic, no nation had enough healthcare resources to combat the crisis, with fighting the pandemic becoming the priority of healthcare systems. This reduced accessibility for other patients, including those with disabilities. The increased fear of contracting the coronavirus also discouraged persons with disabilities and their family members from seeking treatment in hospitals (González-Touya, Stoyanova, & Urbanos Garrido, 2021). A lack of proper communication from authorities further amplified public fear (Garfin, Silver, & Holman, 2020). Persons with disabilities faced delays in accessing the healthcare system, resulting in delays in receiving treatment, including therapeutic interventions and medications. Lack of transportation during lockdowns further contributed to these delays. The burden on caregivers also increased during the pandemic, especially when caregivers themselves were diagnosed with COVID-19, adding strain on other family members and relatives (McKinney, McKinney, & Swartz, 2021). COVID-19 had a significant impact on persons with disabilities. In addition to psychosocial factors, the mental health of persons with disabilities and their families was also affected by the pandemic. Quarantine, lack of access to healthcare, fear, and stigma surrounding COVID-19 contributed to the mental health struggles of both persons with disabilities and their families (Jesus, Bhattacharjya, Papadimitriou, & Rodriguez, 2021; Khasawneh, 2021). MENTAL HEALTH ISSUES FOLLOWING COVID-19 Mental health conditions such as sleep disorders, mood disorders, panic attacks, and PTSD worsened life for persons with disabilities. The burden and stress among caregivers of persons with disabilities also increased due to the pandemic (Dhiman, Sahu, Reed, & Ghosh, 2020; Maggio, La Rosa, Calatozzo, & Stella, 2021). Both persons with disabilities and their caregivers were mentally affected by the pandemic. The quarantine period during COVID-19 also affected the general population, leading to post-traumatic stress symptoms, confusion about illness, and increased anger. Stressors such as long quarantines, infection fears,frustration from isolation, boredom, inadequate supplies, lack of information, financial loss, and stigma impacted the mental health of the general population (Brooks, Webster, Smith, & Woodland, 2020; Sandya, Shetty, Jaise, & Kumar, 2022). Patients with disabilities also experienced stress, isolation, fear, sleep disturbances, and mood disturbances during the pandemic, as well as difficulties accessing healthcare systems, therapeutic interventions, and medications (McKinney, McKinney, & Swartz, 2021). Financial challenges faced by families also negatively impacted the home environment for patients with disabilities. The mental health struggles of family members further affected the mental health of patients (Lebrasseur, Fortin-Bédard, Lettre, & Ducharme, 2021). STRESSORS DUE TO COVID-19 Existing literature indicates that the pandemic has presented numerous challenges for persons with disabilities. The mental health of both persons with disabilities and their caregivers was deeply affected by the pandemic. Studies suggest that mental health issues such as anxiety, panic, depression, PTSD, and other psychological problems emerged during COVID-19 (Hossain, Roy, Ullah, & Mollah, 2020). These issues were the result of an inability to cope with the stressors created by the pandemic, including limited access to healthcare, financial difficulties, and caregiver burden. The long-term consequences of these mental health issues may persist for vulnerable populations (Chaves, Castellanos, Abrams, & Ramos, 2018; Granados, Christine, Ionides, & Coakley, 2018; Usher, Durkin, & Bhullar, 2020). Many persons with disabilities live in families with elderly parents, children, or individuals with multiple disabilities and pre-existing physical or mental illnesses, especially in remote villages. These individuals face significant challenges in maintaining hygiene and accessing healthcare services, including medication, welfare benefits, and follow-up care with health professionals, making them more susceptible to stress during the pandemic (Dhiman, Sahu, Reed, & Ghosh, 2020; Maggio, La Rosa, Calatozzo, & Stella, 2021). INTERVENTIONS AND SUPPORT FOR PERSONS WITH DISABILITIES DURING COVID-19 Persons with disabilities are a vulnerable group requiring psychosocial support and care, especially during crises like pandemics. Unlike the general population, they need special attention and assistance from state authorities and organizations. Due to their disabilities, they are exposed to more stressors, and comorbid psychological conditions can arise during the pandemic. Research has shown that conditions like PTSD, anxiety disorders, mood disorders, and sleep disorders tend to increase following or during disasters (Banks, Davey, Shakespeare, & Mactaggart, 2021; Toquero, 2020). Access to healthcare systems is typically limited during pandemics. Persons with disabilities faced significant challenges obtaining the medications and interventions they needed during this time. Government and non-government organizations needed to provide support to help these individuals access healthcare. If direct access was not possible, healthcare systems should have reached out to these individuals. Primary healthcare centers (PHCs) and community healthcare centers (CHCs) could have been used to reach vulnerable populations. Mobile healthcare units could have provided support and care directly to the homes of persons with disabilities. It would be ideal for governments to include such measures in their disaster policies (Camden & Silva, 2021; Kronberg, Tierney, Wallisch, & Orton, 2021; Rojas-Rueda & Morales-Zamora, 2021; Smith, Tani, Yates, & Thornton, 2022; Uddin, Alam, Ahmed, & Rahman, 2020). Tele-counseling and video conferencing could also be used to provide support to persons with disabilities, reducing their fear of COVID19 infection and ensuring timely interventions (Sandya, Shetty, Jaise, & Kumar, 2022). CONCLUSION The pandemic has created numerous mental health challenges for persons with disabilities and their families, making them more vulnerable to these problems. The financial crisis, difficulty accessing healthcare systems, and other pandemic-related factors increased their vulnerability. This paper emphasizes the need for special interventions for persons with disabilities and their families during crises like COVID-19. REFERENCES Banks, L. M., Davey, C., Shakespeare, T., & Mactaggart, I. (2021). Disabilityinclusive responses to COVID-19: Lessons learnt from research on social protection in low- and middle-income countries. World Development, 137, 105178. https://doi.org/10.1016/ j.worlddev.2020.105178 Beaglehole, B., Mulder, R. T., Frampton, C. M., & Ferris, R. M. (2018). Psychological distress and psychiatric disorder after natural disasters: Systematic review and meta-analysis. The British Journal of Psychiatry, 213(6), 716-722. https:/ /doi.org/10.1192/bjp.2018.210 Brooks, S. K., Webster, R. K., Smith, L. E., & Woodland, L. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227), 912-920. https://doi.org/10.1016/ S0140-6736(20)30460-8 Camden, C., & Silva, M. (2021). Pediatric telehealth: Opportunities created by the COVID-19 and suggestions to sustain its use to support families of children with disabilities. Physical & Occupational Therapy in Pediatrics, 41(1), 1-17. https://doi.org/10.1080/ 01942638.2020.1825032 Chaves, C., Castellanos, T., Abrams, M., & Ramos, M. (2018). The impact of economic recessions on depression and individual and social well-being: The case of Spain (2006–2013). Social Psychiatry and Psychiatric Epidemiology, 53(9), 977-986. https:/ /doi.org/10.1007/s00127-018-1579-4 Dhiman, S., Sahu, P. K., Reed, W. R., & Ghosh, A. (2020). Impact of COVID-19 outbreak on mental health and perceived strain among caregivers tending children with special needs. Research in Developmental Disabilities, 107, 103790. https:// doi.org/10.1016/j.ridd.2020.103790 Garfin, D. R., Silver, R. C., & Holman, E. A. (2020). The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychology, 39(5), 355-357. https://doi.org/ 10.1037/hea0000875 González-Touya, M., Stoyanova, A., & Urbanos-Garrido, R. M. (2021). COVID-19 and unmet healthcare needs of older people: Did inequity arise in Europe? International Journal of Environmental Research and Public Health, 18(17), 9177. https://doi.org/ 10.3390/ijerph18179177 Granados, J. A. T., Christine, P. J., Ionides, E. L., & Coakley, E. S. (2018). Cardiovascular risk factors, depression, and alcohol consumption during joblessness and during recessions among young adults in CARDIA. American Journal of Epidemiology, 187(11), 2339-2345. https://doi.org/10.1093/aje/kwy132 Hossain, K. A., Roy, S., Ullah, M. M., & Mollah, A. S. (2020). COVID-19 and mental health challenges in Bangladesh. Advances in Medical, Dental and Health Sciences, 3(2), 36-42. https:/ /doi.org/10.1055/s-0040-1718006 Hossain, M. M., Tasnim, S., Sultana, A., & McKyer, E. L. (2020). Epidemiology of mental health problems in COVID-19: A review. F1000Research, 9, 9. h t t p s : / / d o i . o r g / 1 0 . 1 2 6 8 8 / f1000research.24457.1 Iseselo, M. K., Kajula, L., & Yahya-Malima, K. I. (2016). The psychosocial problems of families caring for relatives with mental illnesses and their coping strategies: A qualitative urban-based study in Dar es Salaam, Tanzania. BMC Psychiatry, 16(1), 1-12. https:// doi.org/10.1186/s12888-016-0757-7 Jesus, T., Bhattacharjya, S., Papadimitriou, C., & Rodriguez, M. (2021). Lockdownrelated disparities experienced by people with disabilities during the first wave of the COVID-19 pandemic: Scoping review with thematic analysis. International Journal of Environmental Research and Public Health, 18, 6178. h t t p s : / / d o i . o r g / 1 0 . 3 3 9 0 / ijerph18116178 Khasawneh, M. (2021). The effect of the spread of the new COVID-19 on the psychological and social adaptation of families of persons with disabilities in the Kingdom of Saudi Arabia. Health Psychology Report, 9(3), 264-275. h t t p s : / / d o i . o r g / 1 0 . 5 1 1 4 / hpr.2020.99014 Kronberg, J., Tierney, E., Wallisch, A., & Orton, D. (2021). Early intervention service delivery via telehealth during COVID-19: A research-practice partnership. International Journal of Telerehabilitation, 13(1), e6370. https://doi.org/10.5195/ijt.2021.6370 Lebrasseur, A., Fortin-Bédard, N., Lettre, J., & Ducharme, F. (2021). Impact of COVID-19 on people with physical disabilities: A rapid review. Disability and Health Journal, 14, 101014. h t t p s : / / d o i . o r g / 1 0 . 1 0 1 6 / j.dhjo.2020.101014 Maggio, M. G., La Rosa, G., Calatozzo, P., & Stella, D. (2021). How COVID-19 has affected caregivers’ burden of patients with dementia: An exploratory study focusing on coping strategies and quality of life during the lockdown. Journal of Clinical Medicine, 10(24), 5953. https://doi.org/10.3390/ jcm10245953 Mathias, K., Rawat, M., Philip, S., & Bansal, R. (2020). “We’ve got through hard times before”: Acute mental distress and coping among disadvantaged groups during COVID-19 lockdown in North India—A qualitative study. International Journal for Equity in Health, 19(1), 12. https://doi.org/ 10.1186/s12939-020-01194-6 McKinney, E. L., McKinney, V., & Swartz, L. (2021). Access to healthcare for people with disabilities in South Africa: Bad at any time, worse during COVID-19? South African Family Practice, 63(1), 4. https://doi.org/ 10.4102/safp.v63i1.5226 Na, L., & Yang, L. (2022). Psychological and behavioral responses during the COVID-19 pandemic among individuals with mobility and/or self-care disabilities. Disability and Health Journal, 15, 101216. https://doi.org/ 10.1016/j.dhjo.2021.101216 Panchal, N., Kamal, R., Orgera, K., & Alker, J. (2020). The implications of COVID-19 for mental health and substance use. Kaiser Family Foundation. https:// www.kff.org/report-section/theimplications-of-covid-19-for-mentalhealth-and-substance-use/ Poudel, K., & Subedi, P. (2020). Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal. International Journal of Social Psychiatry, 66(8), 748-755. https:// doi.org/10.1177/0020764020942247 Rojas-Rueda, D., & Morales-Zamora, E. (2021). Built environment, transport, and COVID-19: A review. Current Environmental Health Reports, 8(2), 138-145. https://doi.org/10.1007/ s40572-021-00301-4 Sandya, P., Shetty, K. V., Jaise, J., & Kumar, K. (2022). Stress and burden among caregivers of persons with bipolar affective disorder during the COVID19 pandemic in India. Asian Journal of Social Health and Behavior, 5(1), 51. https://doi.org/10.4103/ ajshb.ajshb_15_22 Shetty, K. V., & Bamney, M. U. (2022). The impact of COVID-19 on mental health. Indian Journal of Mental Health and Neurosciences, 3(1), 55-60. Shetty, K. V., Amaresha, A. C., Bamney, U., & Shah, S. (2022). Stigma among COVID-19 patients in South India: A cross-sectional study. Indian Journal of Psychiatry, 64(4), 345-353. https:/ / d o i . o r g / 1 0 . 4 1 0 3 / psychiatry.IndianJPsychiatry_123_22 Shetty, K. V., Desai, M., Srivastava, A., & Naik, R. (2022). Medical and psychological comorbidity among COVID-19 patients during the first wave in Dharwad District of South India: A crosssectional study. Archives of Mental Health, 23(1), 62-68. https://doi.org/ 10.4103/amh.amh_14_22 Shetty, K. V., Sridharan, P., Kumar, S., & Prasad, G. (2020). Domestic violence among married couples during COVID 19 lockdown in an urban setting: A cross-sectional survey. Indian Journal of Mental Health and Neurosciences, 3(1), 45-52. https://doi.org/10.4103/ ijmhn.ijmhn_10_20 Smith, C., Tani, M., Yates, S., & Thornton, K. (2022). Successful school interventions for students with disability during COVID-19: Empirical evidence from Australia. The AsiaPacific Education Researcher. https:/ /doi.org/10.1007/s40299-022-00600- 5 Toquero, C. M. D. (2020). Inclusion of people with disabilities amid COVID-19: Laws, interventions, recommendations. Multidisciplinary Journal of Educational Research, 10(2), 158-177. https://doi.org/ 10.17583/remie.2020.5870 Tsamakis, K., Tsiptsios, D., Ouranidis, A., & Spanou, M. (2021). COVID-19 and its consequences on mental health. Experimental and Therapeutic Medicine, 21, 1-1. https://doi.org/ 10.3892/etm.2020.9215 Uddin, M. J., Alam, M. T., Ahmed, H. U., & Rahman, M. M. (2020). Mental health and psychosocial support (MHPSS) in COVID-19 outbreak. Bangladesh Journal of Infectious Diseases, 7(S1), S45-S47. https://doi.org/10.3329/ bjid.v7iS1.50247 Usher, K., Durkin, J., & Bhullar, N. (2020). The COVID 19 pandemic and mental health impacts. International Journal of Mental Health Nursing, 29(2), 315- 317. https://doi.org/10.1111/ inm.12726

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