Double whammy

People with physical impairments and users of mental health services may each be receiving increased attention, but in a recent study Julia Smith has examined whether mental health services in the UK are currently meeting the needs of individuals who fall into both categories

While working as a social worker in an adults’ physical disability team over the last ten years, I became increasingly aware of the lack of services available to people with physical impairments and mental health problems.

This led me to examine the personal experiences of 12 women with physical impairments who had also used mental health services. From the study, several themes emerged and several areas were highlighted in which such services might be enhanced in the future.
The study showed how most women had found it hard to access appropriate information and had come up against structural barriers, especially before implementation of the Disability Discrimination Act. Women who waited up to a year for support or a needs assessment spoke of feeing frustrated and let down by services.

While women said that their general practitioner had helped them get access to services, three quarters also described their GP’s response as “poor”. Many women felt GPs prescribed medication too readily and thought consultations were too short.

Most women who used mental health support were disappointed at what they saw as a lack of awareness and understanding of disability by the professionals they came in contact with. Routinely, professionals tended to assume that the mental health difficulties women were experiencing were linked directly to their physical impairment.

Women stressed the importance of professionals recognising the potential effect of inaccessible environments and attitudes towards disability on mental health in the long term. But all women also recognised that improvements in attitudes towards disability, and improved access to the environment over recent decades, had had a good effect on their mental well-being.

Women welcomed the opportunities now available for social contact with others, thus reducing what, for some, had been several years of enforced social isolation. But most felt they hadn’t had enough contact time with the service or professional they needed.

Disappointingly, only two women recalled positive experiences of working with mental health professionals. This had occurred where professionals were prepared to listen to the woman’s own perceptions of her difficulties and the factors she believed were contributing to it.

There were mixed reports of using statutory services but more positive reports of using the voluntary sector. Respondents valued the availability of support groups for the opportunity they gave to talk to others who were experiencing similar difficulties.

Women with experience of acute mental distress likewise emphasised the vital role played by groups such as the Samaritans. They expressed concern, however, that recent increases in the demands on voluntary services were limiting the flexibility they had previously provided.

Women also wished to see a reduction in waiting times for support. Long waits had harmed their confidence in services. They also thought that working with one dedicated professional rather than a pool would produce better outcomes, as would more flexible responses to different mental health difficulties and the severity of distress.

Recent years have seen increased recognition of the mental health support needs of different groups of women, but this has not been so for women who also have physical impairments. The time has come for this to change.

• This is an edited summary. The full text can be read at leeds.ac.uk/disability­archive