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Melbøe L, Kane AA. With the best intentions: Implications on self-determination during Covid-19 restrictions. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13257. [PMID: 38813709 DOI: 10.1111/jar.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND In times of crisis, the interests of the individual might be sacrificed for the health and safety of others. The aim of this study was to explore the situation under Covid-19 for persons with intellectual disabilities, focusing on implications on the right to self-determination within health protection. METHOD To understand how the relevant legal framework was governed by authorities and service providers during the Covid-19 pandemic, we have performed semi-structured interviews with 19 service providers in municipal home care services. RESULTS Many residents were provided adequate and adapted information about Covid-19, but very few were involved in the introduction and implementation of infection control measures. CONCLUSIONS Our study has revealed how a crisis such as the pandemic not only puts the health of people with intellectual disabilities at risk, but also challenges their right to self-determination.
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Affiliation(s)
- Line Melbøe
- Faculty of Health Science, Department of Social Education, UiT The Arctic University of Norway, Harstad, Norway
| | - Aina Aune Kane
- Faculty of Humanities, Social Sciences and Education, Department of Child Welfare and Social Work, UiT The Arctic University of Norway, Tromsø, Norway
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Guan Q, Garg R, McCormack D, Lunsky Y, Tadrous M, Campbell T, Gomes T. Impact of COVID-19 on psychoactive medication use among individuals with intellectual and developmental disabilities in Ontario, Canada: A repeated cross-sectional study. Disabil Health J 2024:101649. [PMID: 38876963 DOI: 10.1016/j.dhjo.2024.101649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/31/2024] [Accepted: 06/06/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Evidence for worsening mental health among individuals with intellectual and developmental disabilities (IDD) during COVID-19 sparked concerns for increased use of psychoactive medications. OBJECTIVE To examine the impact of COVID-19 on psychoactive medication use and clinical monitoring among individuals with IDD in Ontario, Canada. METHODS We conducted a repeated cross-sectional study among individuals with IDD and examined weekly trends for psychoactive medication dispensing and outpatient physician visits among those prescribed psychoactive medications between April 7, 2019, and March 25, 2023. We used interventional autoregressive integrated moving average models to determine the impact of the declaration of emergency for COVID-19 (March 17, 2020) on the aforementioned trends. RESULTS The declaration of emergency for COVID-19 did not significantly impact psychoactive medication use among individuals with IDD. Provision of clinical monitoring remained relatively stable, apart from a short-term decline in the weekly rate of outpatient physician visits following the declaration of emergency for COVID-19 (step estimate: 21.26 per 1000 individuals [p < 0.01]; ramp estimate: 0.88 per 1000 individuals [p = 0.01]). When stratified by mode of delivery, there was a significant shift towards virtual care (step estimate: 78.80 per 1000 individuals; p < 0.01). The weekly rate of in-person physician visits gradually increased, returning to rates observed prior to the COVID-19 pandemic in January 2023. CONCLUSION Although access to clinical care remained relatively stable, the shift towards virtual care may have negatively impacted those who encounter challenges communicating via virtual mediums. Future research is required to identify the support systems necessary for individuals with IDD during virtual health care interactions.
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Affiliation(s)
- Qi Guan
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St. 4th floor, Toronto, Ontario, M5T 3M6, Canada; ICES, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St., Toronto, Ontario, M5B 1T8, Canada
| | - Ria Garg
- ICES, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St., Toronto, Ontario, M5B 1T8, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St., Toronto, Ontario, M5S 3M2, Canada
| | | | - Yona Lunsky
- ICES, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada; Department of Psychiatry, University of Toronto, 250 College St. 8th floor, Toronto, Ontario, M5T 1R8, Canada; Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
| | - Mina Tadrous
- ICES, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St., Toronto, Ontario, M5S 3M2, Canada; Women's College Research Institute, 76 Grenville St., Toronto, Ontario, M5S 1B2, Canada
| | - Tonya Campbell
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St., Toronto, Ontario, M5B 1T8, Canada
| | - Tara Gomes
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St. 4th floor, Toronto, Ontario, M5T 3M6, Canada; ICES, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St., Toronto, Ontario, M5B 1T8, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St., Toronto, Ontario, M5S 3M2, Canada.
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Bakken TL. The effects of lockdown of work and activities for adults with multiple, complex needs including sensory impairments during the pandemic in 2020. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:578-587. [PMID: 38305233 PMCID: PMC11059831 DOI: 10.1177/17446295241232030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
Sheltered work and leisure activities were locked down in at the Signo centre in March 2020 because of the COVID-19 pandemic. The Signo centre is a Norwegian national centre for adults with multiple, complex needs, including severe sensory loss/impairments. Tension and uncertainty rapidly spread among relatives and workers. To explore the impacts of the pandemic on residents, 24 adults living in Signo Vivo answered a semi-structured interview together with their primary worker. Additionally, reports on staff injuries and PRN medication between April and Aug of 2020 were compared to the period before the lockdown. The reports from the interviews included fewer stressful events for the participants, more rest and sleep, more time spent in their own apartments, and more time with smaller groups of workers. The reports on staff injuries and PRN medication showed decreased occurrence.
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Affiliation(s)
- Trine Lise Bakken
- National Advisory Unit for mental health in Intellectual Disability, Oslo University Hospital, Norway
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Koks-Leensen MC, Menko A, Raaijmakers F, Fransen-Kuppens GA, Bevelander KE. An Accessible Web-Based Survey to Monitor the Mental Health of People With Mild Intellectual Disability or Low Literacy Skills During the COVID-19 Pandemic: Comparative Data Analysis. JMIR Public Health Surveill 2024; 10:e44827. [PMID: 38607229 PMCID: PMC11176870 DOI: 10.2196/44827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/30/2024] [Accepted: 03/20/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and related control measures affected the mental health of all populations. Particular subgroups are underrepresented in mainstream surveys because they are hard to reach, and study measurements are not adapted to their skills. These subgroups include people with lower cognitive and literacy skills, such as people with mild intellectual disability (MID), who were considered vulnerable during the COVID-19 pandemic given their low socioeconomic status, small social networks, increased risks of health problems, and difficulties understanding health-related information. OBJECTIVE This study examines the impact of the COVID-19 pandemic on mental health among people with MID or low literacy skills compared with those predominantly represented in national surveys. METHODS A repeated cross-sectional study of people with MID or low literacy skills and a general population sample was conducted in the Netherlands. An easy-read web-based survey was co-designed with, and tested among, people with MID or low literacy skills and conducted in 3 rounds within 1 year of the COVID-19 pandemic (T1: November to December 2020, T2: March to April 2021, and T3: September to October 2021). The survey contained questions about demographics and 6 aspects of mental health: feeling happy, feeling energized, feeling stressed, worry, feeling lonely, and sleeping problems. RESULTS Our adapted survey and recruitment procedure enabled 1059 persons with MID or low literacy skills to participate (T1: n=412, 38.9%; T2: n=351, 33.1%; and T3: n=296, 28%). They were significantly younger, had a lower level of education, and more often than not were born outside the Netherlands compared to the general population sample (P<.001). Approximately half of them (604/1059, 57.03%) received professional care. They displayed poorer mental health scores than the general population sample. The percentages of people with MID or low literacy skills who reported more negative feelings in T1 ranged from 20.6% (85/412) reporting feeling lonely often or almost always to 57.8% (238/412) reporting feeling happy almost never or sometimes. The general population sample's percentages were 5.4% (160/2930) and 32.2% (941/2918), respectively. Although scores improved over time in both populations, the disproportional effects remained. CONCLUSIONS General COVID-19-related restrictions for the entire Dutch population affected people with MID or low literacy skills more negatively than the general population. Our study underscores the relevance of including these subpopulations in public health research because they are often overlooked in regular health data. An accessible web-based survey particularly targeted at this population enabled us to do so, and we reached a group of respondents significantly different from regular survey participants. This survey's results provided insights into the health of people with MID or low literacy skills and gained knowledge to be used by care organizations and policy makers to reduce health disparities during a pandemic and in general.
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Affiliation(s)
- Monique Cj Koks-Leensen
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, Netherlands
| | - Anouk Menko
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative AMPHI - Integrated Health Policy, Nijmegen, Netherlands
| | - Fieke Raaijmakers
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative AMPHI - Integrated Health Policy, Nijmegen, Netherlands
- Safety and Health Region Gelderland-Midden, Arnhem, Netherlands
| | - Gerdine Aj Fransen-Kuppens
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative AMPHI - Integrated Health Policy, Nijmegen, Netherlands
- Municipal Health Service Gelderland Zuid, Nijmegen, Netherlands
| | - Kirsten E Bevelander
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, Netherlands
- Academic Collaborative AMPHI - Integrated Health Policy, Nijmegen, Netherlands
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Koenig J, McLean KJ, Bishop L. Psychological distress and mental health diagnoses in adults by disability and functional difficulty status: Findings from the 2021 national health interview survey. Disabil Health J 2024:101641. [PMID: 38816306 DOI: 10.1016/j.dhjo.2024.101641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 05/08/2024] [Accepted: 05/12/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Evidence suggests that disabled people have worse mental health than non-disabled people, but the degree to which disability contributes to mental health is unclear. OBJECTIVE This paper uses 2021 National Health Interview Survey (NHIS) data to estimate the association between disability and depression and anxiety diagnoses as well as psychological distress among adults. METHODS We calculated disability population prevalence and mental health diagnoses and associated symptoms among 28,534 NHIS respondents. Logistic regressions estimated the odds of depression or anxiety diagnoses and recent psychological distress, controlling for disability and mental health diagnoses. We measured disability using binary and continuum measures of functional disability with the Washington Group Short Set on Functioning. RESULTS Disabled people have significantly greater odds of both depression and anxiety diagnoses compared to non-disabled people. Those with high functional disability have 552 % greater odds of an anxiety diagnosis (95 % CI: 5.61-7.58; p < 0.01) and 697 % greater odds of a depression diagnosis (95 % CI: 6.97-9.12; p < 0.01) compared to those with no functional disability. Similarly, those with any level of functional disability are more likely to have elevated psychological distress in the past 30 days compared to those with no functional disability. CONCLUSIONS Findings support the idea that mental health is worse for disabled people compared to non-disabled people, with increasing functional disability associated with worse mental health. This suggests that mental health is not being adequately addressed for those with the greatest functional disability. Future work should seek to better understand the systemic causes of disparities.
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Affiliation(s)
- Jamie Koenig
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, 1350 University Ave, Madison, WI 53706, USA; Waisman Center, 1500 Highland Ave, Madison, WI 53705, USA.
| | - Kiley J McLean
- A.J. Drexel Autism Institute, 3020 Market St #560, Philadelphia, PA 19104, USA
| | - Lauren Bishop
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, 1350 University Ave, Madison, WI 53706, USA; Waisman Center, 1500 Highland Ave, Madison, WI 53705, USA
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Redquest B, Clark CA, Sanguino H, Lunsky Y, Hutton S, Weiss J, Davies T, McMorris CA. The feasibility of an adapted virtual mindfulness intervention for Special Olympics athletes and their caregivers. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13229. [PMID: 38644053 DOI: 10.1111/jar.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 02/22/2024] [Accepted: 03/08/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Virtual mindfulness may be helpful for individuals with intellectual disabilities in the context of COVID-related disruptions of in-person programming, such as Special Olympics (SO). This study examined the feasibility of a virtual mindfulness intervention for SO athletes and their caregivers. METHOD SO athletes (n = 44) and their caregivers (n = 29) participated in a 6-week adapted virtual mindfulness intervention. Athletes completed mindfulness and well-being questionnaires prior to, immediately following, and 3-months post-intervention. Caregivers completed questionnaires assessing their own stress, mindfulness, and well-being, as well as athlete mental health. Exit interviews were conducted immediately following the intervention. RESULTS The intervention was feasible in terms of demand, implementation, acceptability, and limited testing efficacy. There were significant improvements in athlete well-being and mental health, and caregiver stress and mindfulness post-intervention. CONCLUSIONS Adapted virtual mindfulness groups may be an effective intervention in improving the well-being of adults with intellectual disabilities and their caregivers.
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Affiliation(s)
- Brianne Redquest
- School and Applied Child Psychology, Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
| | - Chris A Clark
- School and Applied Child Psychology, Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
| | - Hangsel Sanguino
- School and Applied Child Psychology, Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
| | - Yona Lunsky
- Azrieli Neurodevelopmental Centre, Centre for Addiction and Mental Health (CAMH), Ontario, Canada
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Sue Hutton
- Azrieli Neurodevelopmental Centre, Centre for Addiction and Mental Health (CAMH), Ontario, Canada
| | - Jonathan Weiss
- Department of Psychology, York University, Toronto, Canada
| | - Tom Davies
- Special Olympics Canada, Toronto, Ontario, Canada
| | - Carly A McMorris
- School and Applied Child Psychology, Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
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Lunsky Y, Lake J, Thakur A. The Power of Partnerships to Identify and Address Mental Health Concerns Experienced by Adults With Intellectual and Developmental Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:96-100. [PMID: 38411240 DOI: 10.1352/1944-7558-129.2.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
There are significant research gaps with regard to understanding and addressing the mental health concerns of adults with intellectual and developmental disabilities (IDD) and their families. In this article, we reflect on research we have carried out about mental health and IDD prior to and during the pandemic in Ontario, Canada. We aim to address how partnering with people with IDD, family caregivers, service providers, and policy makers can help accelerate needed progress in this area. We conclude with some lessons learned during the pandemic about what to emphasize in building and maintaining such partnerships.
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Affiliation(s)
- Yona Lunsky
- Yona Lunsky, Johanna Lake, and Anupam Thakur, Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health and Temerty Faculty of Medicine, University of Toronto
| | - Johanna Lake
- Yona Lunsky, Johanna Lake, and Anupam Thakur, Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health and Temerty Faculty of Medicine, University of Toronto
| | - Anupam Thakur
- Yona Lunsky, Johanna Lake, and Anupam Thakur, Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health and Temerty Faculty of Medicine, University of Toronto
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8
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Friedman C. The Impact of Emergency Pandemic HCBS Funding on the Continuity and Security of People with Intellectual and Developmental Disabilities. J Autism Dev Disord 2024; 54:1068-1077. [PMID: 36484965 PMCID: PMC9734720 DOI: 10.1007/s10803-022-05859-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
This study's aim was to examine the impact of pandemic emergency Home- and Community-Based Services (HCBS) payments on the continuity and security of people with intellectual and developmental disabilities (IDD). Using a multilevel logistic regression, we analyzed secondary Personal Outcome Measures interviews from 738 people with IDD (March 2020 through April 2022), and state pandemic emergency HCBS payment data from 16 states. The odds of people with IDD experiencing continuity and security during the pandemic increased by 3% for every 1% states increased their payment rates, and by 398% when states offered retainer payments. Increased reimbursement rates and retainer payments can help providers maintain operations and promote the continuity and security of people with IDD.
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Affiliation(s)
- Carli Friedman
- CQL | The Council on Quality and Leadership, 100 West Road, Suite 300, Towson, MD, 21204, USA.
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9
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Safar Y, Formuli F, Volpe T, St John L, Lunsky Y. "Everything has changed since COVID": Ongoing challenges faced by Canadian adults with intellectual disabilities during waves 2 and 3 of the COVID-19 pandemic. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241229364. [PMID: 38266144 DOI: 10.1177/17446295241229364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
The COVID-19 pandemic has disrupted the lives of people with intellectual disabilities in many ways, impacting their health and wellbeing. Early in the pandemic, the research team delivered a six-week virtual group-based program to help Canadian adults with intellectual disabilities cope and better manage their mental health. The study's objective was to explore ongoing concerns among individuals with intellectual disabilities following their participation in this education and support program. Thematic analysis was used to analyze participant feedback provided eight weeks after course completion. Twenty-four participants were interviewed in January 2021 and May 2021 across two cycles of the course. Three themes emerged: 1) employment and financial challenges; 2) navigating changes and ongoing restrictions; and 3) vaccine anticipation and experience. These findings suggest that despite benefiting from the program, participants continued to experience pandemic-related challenges in 2021, emphasising the need to continually engage people with intellectual disabilities.
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Affiliation(s)
- Yousef Safar
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Fatima Formuli
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tiziana Volpe
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Laura St John
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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10
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Sellitto T, Fraser-Thomas J, Bassett-Gunter RL, Lee V, Lunsky Y, Balogh R, Weiss JA. The role of thriving in mental health among people with intellectual and developmental disabilities during the COVID-19 pandemic in Canada. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13177. [PMID: 37987194 DOI: 10.1111/jar.13177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 09/20/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The COVID-19 pandemic has had a negative impact on the mental health of people with intellectual and developmental disabilities. Numerous pandemic-related stressors experienced by people with intellectual and developmental disabilities may have impacted their ability to thrive, which has been linked to mental health outcomes. The current study examined the associations among COVID-19 stressors, thriving, and mental health problems among youth and adults with intellectual and developmental disabilities. METHOD Caregivers of 159 people with intellectual and developmental disabilities between 12 and 35 years of age from Canada completed an online questionnaire. RESULTS A mediation analysis revealed that COVID-19 stressors were positively associated with mental health problems, and that thriving partially mediated this association. CONCLUSION Our findings suggest that experiences of thriving may be an important target for mental health support for people with intellectual and developmental disabilities.
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Affiliation(s)
- Teresa Sellitto
- Department of Psychology, York University, Toronto, Ontario, Canada
| | | | | | - Vivian Lee
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert Balogh
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, Toronto, Ontario, Canada
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Gur A, Soffer M, Blanck PD, Quinn G, Rimmerman A. Pre- and Post-COVID-19 Outcomes for Israelis With Intellectual and Developmental Disabilities in the Community. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:454-467. [PMID: 38011742 DOI: 10.1352/1934-9556-61.6.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/27/2022] [Indexed: 11/29/2023]
Abstract
This study is among the first pre-post examinations to explore differences in subjective well-being, adaptive and maladaptive behavior, close relationships, community integration, family members' satisfaction with residential and community living settings, and family contact before and after the COVID-19 outbreak. Participants demonstrated better life satisfaction and adaptive behavior before COVID-19 than after COVID-19. Participants reported closer relationships with family members and peers before COVID-19 and closer relationships with staff members after COVID-19. The findings reveal mixed, although mostly negative, effects of the pandemic on people with intellectual and developmental disabilities in the community in Israel, in accord with extant comparative research.
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Voermans MAC, den Boer MC, Wilthagen T, Embregts PJCM. Long-term social restrictions and lack of work activities during the COVID-19 pandemic: impact on the daily lives of people with intellectual disabilities. Disabil Rehabil 2023; 45:4122-4132. [PMID: 36398471 DOI: 10.1080/09638288.2022.2147227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 11/05/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Lockdowns due to the Covid-19 pandemic may have had a disproportionate impact on the daily lives of people with intellectual disabilities. Many of them had to deal with limited social contacts for an extended period. This study explores in depth how people with intellectual disabilities in the Netherlands experienced their daily lives, in particular due to lack of access to regular work activities. MATERIALS AND METHODS Eight participants with intellectual disabilities were interviewed. Interpretative Phenomenological Analysis (IPA) was employed in conducting and analysing interviews. RESULTS AND CONCLUSIONS Analysis yielded three overarching themes that are conceptually linked. Participants experienced a prolonged lack of social connections that resulted in experiences of social isolation and feelings of loneliness. This led to different kinds of struggles: either internal struggles involving negative thoughts or depressive feelings, or a perceived threat to their autonomous position in society. Meanwhile participants had to sustain their sense of self-worth in the absence of work activities. The findings emphasise the importance of social opportunities through the access to work activities for people with intellectual disabilities. Interventions are suggested to help reverse the increased social inequalities and enhance rehabilitation via work activities for people with intellectual disabilities.IMPLICATIONS FOR REHABLITATIONMore awareness may be raised among authorities, employers and the general public about the significant value people with intellectual disabilities attribute to meaningful social connections, in particular through work activities.Also, more awareness may be raised about the potential adverse effects of the loss of work activities and social connections on the quality of life of people with intellectual disabilities.Providing social support to others may help people with intellectual disabilities to construct social valued roles, either in or outside the work situation.Professionals and employers can support people with intellectual disabilities to find opportunities to provide social support to others.It is important to invest in sustainable and innovative post-pandemic community participation initiatives and particularly in accessible post-pandemic employment support, for example by organising paid in-company training placements.It is essential that professionals support people with intellectual disabilities to enhance their sources of resilience and coping strategies, that may have diminished as a result of the pandemic.
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Affiliation(s)
- Moniek A C Voermans
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
- Amarant, Healthcare Organisation for People with Intellectual Disabilities, Tilburg, the Netherlands
| | - Maria C den Boer
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Ton Wilthagen
- Public Law and Governance, Tilburg Law School, Tilburg University, Tilburg, the Netherlands
| | - Petri J C M Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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Rechner L, Harvey K, Lancaster S, Horney J. How COVID-19 impacted people with disabilities: A qualitative study in Delaware. PUBLIC HEALTH IN PRACTICE 2023; 6:100424. [PMID: 37675127 PMCID: PMC10477798 DOI: 10.1016/j.puhip.2023.100424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/25/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023] Open
Abstract
Objectives The COVID-19 pandemic created unprecedented challenges for people with disabilities and their caregivers and service providers. An assessment of how the COVID-19 pandemic, and the public health response to it, inequitably impacted the health and well-being of people with disabilities is needed to improve preparedness for future public health emergencies. Interviews were conducted with the goal of documenting the impacts of COVID-19 on community-dwelling individuals in Delaware. Study design Qualitative interviews using a structured interview guide. Methods In November and December 2022, interviews were conducted with individuals with disabilities, their caregivers, governmental and non-profit service providers, and elected representatives in Delaware. Interviews focused on obtaining information related to COVID-related threats to maintaining good health, affordable and accessible housing, work, educational opportunities, transportation, and community belonging during the pandemic. Interview transcripts were inductively analyzed. Results Five themes were identified including changes to, or loss of, home-based medical and other services, changes in daily routines that impacted access to work and education, limits on access to transportation, financial strains and housing issues, and mental health concerns. Conclusions The COVID-19 pandemic impacted nearly all aspects of the lives of people with disabilities. COVID-19 presented long-term, existential threats to progress made toward independent living, meaningful work, and financial, health, and educational equity for people with disabilities.
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Affiliation(s)
- L. Rechner
- Epidemiology Program, University of Delaware, 100 Discovery Blvd, Newark, DE, 19713, United States
| | - K.E. Harvey
- Developmental Disabilities Council, 410 Federal Street, Dover, DE, 19904, United States
| | - S. Lancaster
- Developmental Disabilities Council, 410 Federal Street, Dover, DE, 19904, United States
| | - J.A. Horney
- Epidemiology Program, University of Delaware, 100 Discovery Blvd, Newark, DE, 19713, United States
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14
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Gil-Llario MD, Díaz-Rodríguez I, Fernández-García O, Estruch-García V, Bisquert-Bover M, Ballester-Arnal R. Mental Health of People with Intellectual Disabilities Living in Residential Care before, during, and after Lockdown. Behav Sci (Basel) 2023; 13:695. [PMID: 37622835 PMCID: PMC10451193 DOI: 10.3390/bs13080695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/14/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The impact of the COVID-19 on the well-being of people with intellectual disabilities (PID) has been little studied. METHODS We analyzed its impact with a cohort study quantitatively analyzing anxiety, depression, organic symptoms, quality of life, and support needs in 24 PID, aged 19-74 years (x¯ 40, σ = 13.09), living in a residential center, before, during, and after the pandemic. RESULTS Their mental health improved unexpectedly at the onset of the lockdown although there was an increase in organic symptoms. But, with the progress of the lockdown, their mental health deteriorated drastically. On the contrary, as expected, their quality of life and support needs worsened from the beginning of the lockdown until the country returned to normality, a time when there was a general recovery, without reaching pre-pandemic levels. These results show that the mental health of PID was affected differently to that of people without intellectual disabilities.
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Affiliation(s)
- María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (M.D.G.-L.); (I.D.-R.); (O.F.-G.); (M.B.-B.)
| | - Irene Díaz-Rodríguez
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (M.D.G.-L.); (I.D.-R.); (O.F.-G.); (M.B.-B.)
| | - Olga Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (M.D.G.-L.); (I.D.-R.); (O.F.-G.); (M.B.-B.)
| | - Verónica Estruch-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (M.D.G.-L.); (I.D.-R.); (O.F.-G.); (M.B.-B.)
| | - Mar Bisquert-Bover
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (M.D.G.-L.); (I.D.-R.); (O.F.-G.); (M.B.-B.)
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, 12006 Castellón, Spain;
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15
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Shogren KA. Presidential Address, 2022-Dismantling Systemic Barriers: Re-Envisioning Equity and Inclusion. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:520-529. [PMID: 36454612 DOI: 10.1352/1934-9556-60.6.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
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16
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Jyonouchi H, Geng L, Rossignol DA, Frye RE. Long COVID Syndrome Presenting as Neuropsychiatric Exacerbations in Autism Spectrum Disorder: Insights for Treatment. J Pers Med 2022; 12:jpm12111815. [PMID: 36579544 PMCID: PMC9695881 DOI: 10.3390/jpm12111815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
COVID-19 causes not only severe respiratory symptoms, but also long-term sequelae, even if the acute-phase symptoms are minor. Neurological and neuropsychiatric symptoms are emerging as major long-term sequalae. In patients with pre-existing behavioral symptoms, such as individuals with autism spectrum disorders (ASD), the emergence of neuropsychiatric symptoms due to long COVID can be difficult to diagnose and manage. Herein, we present three ASD cases who presented with markedly worsening neuropsychiatric symptoms following COVID-19 exposure and subsequent difficulty in managing the post-COVID neuropsychiatric symptoms. Case 1 contracted SARS-CoV-2 during the early stages of the pandemic and treatment targeting COVID-19-induced immune activation was delayed. Case 2 was asymptomatic in the acute stage of a confirmed COVID-19 exposure, but still developed significant neuropsychiatric symptoms. Case 3 demonstrated a difficult course, partly due to pre-existing immune dysregulation and prior use of multiple immunomodulating agents. In cases 1 and 3 for whom serial blood samples were obtained, notable changes in the production of inflammatory and counter-regulatory cytokines by peripheral blood monocytes were observed. The presented cases illustrate the profound effects of COVID-19 on neuropsychiatric symptoms in ASD subjects and the difficulty of managing long-COVID symptoms.
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Affiliation(s)
- Harumi Jyonouchi
- Saint Peter’s University Hospital (SPUH), New Brunswick, NJ 08901, USA
- Correspondence:
| | - Lee Geng
- Saint Peter’s University Hospital (SPUH), New Brunswick, NJ 08901, USA
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17
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Rawlings GH, Beail N. Long-COVID in people with intellectual disabilities: A call for research of a neglected area. BRITISH JOURNAL OF LEARNING DISABILITIES 2022; 51:BLD12499. [PMID: 36247098 PMCID: PMC9538317 DOI: 10.1111/bld.12499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/28/2022] [Accepted: 08/09/2022] [Indexed: 06/16/2023]
Abstract
Background Long-COVID (also known as post-coronavirus-19 syndrome) is a term used to describe symptoms that people experience following their recovery from the COVID-19 virus. The severity of long-COVID is well recognised, with healthcare providers commissioning services to diagnose and treat those affected, as well as funded research into the condition. Methods We performed a systematic search for relevant articles but were unable to find any research on long-COVID in people with intellectual disabilities. Due to the lack of data, we have only been able to make extrapolations from what is known about the condition within the general population. Findings We provide an overview of long-COVID and its potential relevance to people with an intellectual disability. We have focused specifically on symptoms or signs, prevalence, risk factors and treatments of the condition in this group, highlighting areas for clinical practice and future research from a psychosocial perspective. We raise serious questions about our current understanding and the availability of the evidence-based to inform treatments tailored towards this population. Conclusion This is the first report that we are aware of on the topic of long-COVID in people with an intellectual disability. The lack of research is preventing us from gaining a greater understanding of how the condition impacts people with an intellectual disability.
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Affiliation(s)
| | - Nigel Beail
- Clinical Psychology UnitUniversity of SheffieldSheffieldUK
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18
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Forslund T, Fernqvist S, Tegler H. Parents with intellectual disability reporting on factors affecting their caregiving in the wake of the COVID‐19 pandemic: A qualitative study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1380-1389. [PMID: 36207144 PMCID: PMC9537890 DOI: 10.1111/jar.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
Background Parents with intellectual disability are vulnerable to parenting stress and overwhelming life events. The COVID‐19 pandemic constitutes a potentially overwhelming event, but there is little knowledge concerning the effects on parents' caregiving. The present study aimed to fill this gap. Method Semi‐structured interviews with 10 Swedish parents with intellectual disability were analysed using thematic analysis. Results One broad caregiving‐related theme: increased caregiving demands and reduced resources for coping resulting in strained parent–child interactions and relationships. Four subthemes highlighted influential factors: pandemic information, professional support, social relationships and informal support, and children's school activities. Strained parent–child interactions were particularly common in the absence of adapted pandemic information, if professional and informal support were compromised, and if the parents had dealt with school‐related changes. Conclusions Findings support contextual models of caregiving and a stress‐resources perspective, and emphasise the importance of adapted information and support to parents with intellectual disability during crises.
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Affiliation(s)
- Tommie Forslund
- SUF‐Resource Center, Region Uppsala Uppsala Sweden
- Department of Psychology Stockholm University Stockholm Sweden
| | - Stina Fernqvist
- Centre for Social Work (CESAR), Department of Sociology Uppsala University Uppsala Sweden
| | - Helena Tegler
- Centre for Social Work (CESAR), Department of Sociology Uppsala University Uppsala Sweden
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19
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Lake JK, Volpe T, St. John L, Thakur A, Steel L, Baskin A, Durbin A, Chacra MA, Lunsky Y. Mental health and COVID-19: The impact of a virtual course for family caregivers of adults with intellectual and developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:677-689. [PMID: 35915874 PMCID: PMC9539047 DOI: 10.1111/jir.12965] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/06/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted family caregivers of adults with intellectual and developmental disabilities (IDD). This study evaluated a virtual course for family caregivers from across Canada, focused on supporting the mental health and well-being of adults with IDD and their families. The evaluation examined the feasibility and acceptability of the course, as well as the impact of the intervention on participants' overall health and well-being. METHODS The 6-week virtual course, informed by a parallel Extension for Community Healthcare Outcomes (ECHO) course for service providers, combined didactic instruction with applied activities. A total of 126 family caregiver course participants consented to be part of the research evaluation delivered over three cycles between October 2020 and April 2021. Attendance was measured at each weekly session. Satisfaction was assessed weekly and post-program. Learning, self-efficacy, and well-being were assessed pre- and post-course, and again at follow-up (8 weeks post-course). Mixed-effects models assessed changes between and within individuals across time. RESULTS Participants had consistent attendance, low-dropout rates, and reported high satisfaction, with 93% of participants reporting that their expectations for the course were met. Compared with pre-course, participants reported improved self-efficacy and well-being post-course, which were maintained at follow-up. CONCLUSIONS An interactive and applied virtual education course delivered to a large group of family caregivers of adults with IDD was both feasible and acceptable. It positively impacted participants' well-being by offering much needed mental health support and creating a peer-led community of practice.
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Affiliation(s)
- J. K. Lake
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
| | - T. Volpe
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - L. St. John
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Thakur
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
- Surrey PlaceTorontoCanada
| | - L. Steel
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Baskin
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Durbin
- Li Ka Shing Knowledge Institute, St. Michael's HospitalTorontoCanada
| | - M. A. Chacra
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - Y. Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
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20
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St John L, Volpe T, Jiwa MI, Durbin A, Safar Y, Formuli F, Thakur A, Lake J, Lunsky Y. 'More together than apart': The evaluation of a virtual course to improve mental health and well-being of adults with intellectual disabilities during the COVID-19 pandemic. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1360-1369. [PMID: 35899843 PMCID: PMC9353296 DOI: 10.1111/jar.13024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/27/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND To address the growing concerns over poor mental health experienced by adults with intellectual disabilities due to the COVID-19 pandemic, a national virtual mental health course was delivered and evaluated. METHODS This mixed methods study utilized both qualitative and quantitative assessments. Participants were 27 adults with intellectual disabilities who participated in the 6-week course. Participants completed measures of self-efficacy and well-being at three time points and qualitative satisfaction measures at post and follow-up. RESULTS Attendance was high and the course was feasible and acceptable to participants. Positive changes related to mental health self-efficacy were detected (p = .01), though mental well-being did not improve. CONCLUSION The study provided evidence for the feasibility and value of the course for this population. Future research should examine how virtual courses could support the population in terms of pandemic recovery and how courses may work for individuals who are less independent.
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Affiliation(s)
- Laura St John
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Tiziana Volpe
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Muhammad Irfan Jiwa
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Anna Durbin
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada.,Department of Psychiatry, Temertry Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Yousef Safar
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Fatima Formuli
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Anupam Thakur
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temertry Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Johanna Lake
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temertry Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temertry Faculty of Medicine, University of Toronto, Toronto, Canada
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