Mental Disorders

What makes the difference in people’s lives when they have a mental disorder?

Kaloyan Kamenov, Maria Cabello, Carolina Saskia Ballert, Alarcos Cieza, Somnath Chatterji, SENADIS, Jerome Bickenbach, Jose Luis Ayuso-Mateos*, Carla Sabariego

Abstract

Introduction: Persons with mental disorders experience high levels of disability in their daily life. Knowledge of the environmental factors impacting the level of disability is therefore essential to understand and influence disability. The objective of this study was to identify which aspects of the environment are the most responsible for the disability experienced by persons with MDs and whether they differ 1) depending on the severity level of the difficulties and 2) among mental health problems,

Unfortunately, there are very few such surveys, and WHO and the World Bank (WB) began in 2012 to develop the Model Disability Survey (MDS) to fill this gap (17). Recently, data from a pilot study of the MDS was used to propose a method for identifying EFs with the highest impact on the performance of activities in daily life for different populations (17). MDS data of representative population samples offer an invaluable platform to study the EFs most commonly associated with MDs, in order to identify targets for public health interventions. These data offer the possibility to determine whether the EFs associated with MDs have the same impact on diabetes, cancer, CVD and chronic respiratory diseases. Since most countries focus their public health interventions on these NCDs, this information would give us a sense of the extent to which these intervention also meet the needs of people with MDs. Using data of the implementation of the MDS as a national survey in Chile, this study will focus on the following

The first group consisted of 12 hindering or facilitating aspects of the general environment – health facilities, places to socialize, shops/banks in the neighborhood, places of worship, transportation, dwelling, terrain/climate of place of living, lighting of place of living, noise in the surroundings, crowds in the surroundings, workplace, and educational institution. Participants were asked whether these aspects of the environment were making it easy or hard for them to do things they need or want to do. The answers were rated with a 5-point Likert scale, where one means very easy and five means very hard. The second group of EFs assessed the level of personal Assistance. Personal assistance was represented by two questions–frequency of received personal assistance and use and need of assistance. Use and need of assistance was combined into one categorical variable with four possible answers – “person has but needs additional assistance”, “person has assistance and does not need any additional assistance”, “person has no assistance but would need some”, and “person has no assistance and does not need any”. The same applied for the third group, where the use of assistive devices related to mobility (e.g. crutches, adapted vehicle), seeing (glasses, lenses), hearing (hearing aid, TV with subtitles), work (elevator, comfortable chair), education (scanner and printer, laptop), home (door