Disabilities - Mental Health

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  1. Criteria for the term disability
    1. The term “disability” includes but is not limited to mental health conditions like anxiety disorders, depression, and bipolar disorder, and PTSD, which are classified as disabilities by the Americans with Disabilities Act (ADA) of 1990.
  2. Increased risk for mental health challenges
    1. Individuals with other types of disabilities, including physical and learning disabilities, are at higher risk for mental health conditions, substance misuse, and suicide. Factors driving increased risk include discrimination, unemployment and financial insecurity, lack of social support, diminished quality of life, substance misuse, and inability to access mental health care. 
  3. Focus on abilities rather than limitations
    1. Storytelling can support the mental health of those living with disabilities by focusing on their abilities instead of limitations; educating the general public about disabilities to decrease stigma and discrimination; highlighting protections and accommodations provided under the American with Disabilities Act (ADA); and portraying the ways individuals with disabilities are creating social support networks and increasing their quality of life. 
This section was written in partnership with RespectAbility.

Storytelling Tips

Portray a Range of Mental Health Experiences
  • Show people with disabilities learning in schools, earning money while working in jobs, engaging in both platonic and romantic relationships, living independent lives, and coping with day-to-day mental health struggles — the same everyday things that nondisabled people do.  
  • People with disabilities deal with the full range of mental health challenges. Use storytelling to broaden the narrative beyond experiences related to the disability itself. 
Depict Effective, Realistic Help-Seeking and Treatment
  • Show characters or cast members with disabilities accessing effective treatment services to provide hope and a starting point. Effective treatment for a physical or sensory disability should include care related to mental health and managing the stress, anxiety, and isolation that can accompany a disability.
    • Not all in-person offices are accessible to those who use wheelchairs, so showing the realities of searching for accessible health care can help better prepare viewers with physical disabilities who are looking for mental health support.
    • Show therapists and doctors with disabilities to encourage help-seeking and provide a positive role model for young people with disabilities. There are very few medical professionals with visible disabilities on screen, which can discourage people with disabilities from reaching out for help and might discourage individuals living with a disability to enter the medical field. 
    • Storytelling that features mental health professionals with disabilities — for example, a therapist in a wheelchair or a therapist who is deaf and uses technology to communicate with patients — can make help-seeking feel more accessible to viewers with disabilities and let young people know that pursuing work in the mental health field is an option for them.
Highlight the Power of Coping Skills and Self-Care
  • Highlight suicide prevention strategies and ways that people with disabilities are finding purpose, connection, support, and effective care — and avoid the implication that suicide is a solution for people with disabilities. It’s important to explore the connection between suicide and disability in our stories, but it’s also important highlight prevention strategies and ways that people with disabilities are finding purpose, connection, support, and effective care.
  • Work with your expert advisor(s) and people with lived experience to make sure the self-care and coping strategies portrayed are healthy and realistic for the specific disabilities your characters or cast members are managing.
  • Some people living with disabilities may turn to unhealthy coping practices, like substance misuse. Portraying healthier coping strategies can offer viewers alternative paths. 
Represent the Complex Causes of Mental Health Challenges
  • Highlight the systemic problems that contribute to mental health challenges faced by people with disabilities. Some systemic factors can contribute to mental health challenges faced by people with disabilities. For example, receiving financial assistance and accommodations can be confusing and require tedious amounts of paperwork. Some studies have even linked the burden of paperwork and completing complicated forms to suicidal ideation and attempts among people with disabilities.
  • Storytelling also can highlight protections and accommodations provided by the Americans with Disabilities Act, which can help people find employment, improve their financial situation, and reduce the impact of discrimination and stigma.
Consider the Impact of Language
  • Ensure you are using current acceptable language regarding disabilities. Acceptable language regarding disabilities has changed over time. Many once widely used terms now are considered offensive and are taken to imply inferiority or have other negative connotations. Other terms are outdated and considered patronizing, including medical or colloquial terms like “inspirational,” “crippled,” “handicapped,” and “special needs,” to name a few. 
  • Generally speaking, the disability community and advocates recommend using identity-first (disabled person) or person-first language (person with cerebral palsy), or straightforward and easily understood terms such as “disability” or “disabled” rather than euphemisms like “differently abled.” When telling a nonfiction story or working on content that represents a real person’s experience, it is best practice to ask them what language they would like to use to describe them. 
  • Remember that people with disabilities are not “victims” and should also not be described as “inspirational” or “courageous” just because they do the same things nondisabled people do. This can stigmatize disabilities and negatively impact mental health.
  • Avoid the implication that people without disabilities are not “normal.” Saying “normal” implies that people with disabilities are “abnormal.” Instead, use terms like “nondisabled,” “does not have a disability,” or “is not living with a disability.” In some cases, the word “typical” can be used to describe a nondisabled condition.
  • Consult your advisors and people with lived experience as well as resources like the National Center on Disability and Journalism’s Style Guide to ensure you are using appropriate language related to specific types of disabilities, and RespectAbility’s Hollywood Disability Inclusion Toolkit.
Move Past Stereotypes
  • Avoid narratives that associate disability with laziness or people taking advantage of the system, which can create harmful stereotypes and negatively impact mental health. People with legitimate disabilities are often blamed for their disability and refused government benefits due to fear people will take advantage of the system. Storytelling can increase understanding about the reality and causes of disabilities, and the challenges people living with these conditions face daily.

Snapshot

According to the Centers for Disease Control and Prevention (CDC), more than 1 in 4 adults (18+) in the U.S. have some type of disability. There are 6 functional disability types (listed from highest to lowest in prevalence): mobility, cognition (which includes mental health), independent living, hearing, vision, and self-care. These disabilities affect all demographics but are more prevalent in women and certain ethnic groups.

Mental health conditions, like anxiety disorders, depression, and bipolar disorder, are classified as disabilities. Furthermore, individuals with other types of disabilities (including physical and learning disabilities) are at higher risk for mental health conditions, substance misuse, and suicide.  

  • Adults with disabilities report experiencing frequent mental distress almost 5 times as often as adults without disabilities.
  • People living with physical disabilities are at least 3 times more likely to experience depression than the general population. 
  • People with disabilities are more likely to have mental health conditions and people experiencing mental health challenges are more likely to report a disability. 
  • Individuals with disabilities are more likely to have substance use disorder and less likely to get help for those disorders because access to appropriate healthcare is limited. 
  • People with disabilities are 4 times more likely to have attempted suicide than those without a disability. 
  • More than one-third of people with disabilities report they’ve experienced discrimination. That number increases to 44% for those with visible disabilities.

There are several reasons why people with disabilities are at higher risk for mental health challenges, including discrimination, unemployment and financial insecurity, lack of social support, diminished quality of life, and lack of access to mental health care. Children with disabilities are 2 to 3 times more likely to be bullied, and are 3 times more likely to be victims of rape or sexual assault than children without disabilities. More than one-third of people with disabilities report they’ve experienced discrimination and that number increases to 44% for those with disabilities that are visible.  

Additionally, society is built in a way that often creates challenges for people with disabilities. For example, even 30 years after the American Disability Act (ADA) was passed, many buildings and societal structures like the New York City subway system are still not accessible for people with physical disabilities.   

In particular, financial hardship is a risk factor for people with disabilities. Even before the COVID-19 pandemic, just 37.6% of working-age people (18 to 64) with disabilities were employed, despite the fact that 70% of working-age people with disabilities would prefer to be working. People with disabilities are much more likely to experience material hardship like food insecurity, inability to pay bills, and inability to afford medical care, than people without disabilities at the same income levels.

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more in part 6