Everyone who supports people with physical disabilities needs to have an understanding of the importance of a healthy mind in combination with the physical needs. While people with physical disabilities will more commonly seek support from their family, support staff, GP and therapists, they are less likely to see psychologists, social workers or other mental health professionals in the first instance.

As people age with cerebral palsy and similar physical disabilities, the effects of pain, fatigue and physical disabilities can have a huge impact on stress and worry. If any other mental health concerns exist, the impact of ageing can compound those issues.

The psychosocial wellbeing of anyone you are supporting therefore needs careful consideration when applying recommendations or implementing interventions for the physical body. For example, in many cases energy conservation has more impact on someone’s mental wellbeing than the physical changes and improvements.

In supporting a person with physical disabilities, the team needs to ask about stress, worry and general wellbeing, it is important not to wait until the person expresses a concern.

Horsman et al (2010) reviewed literature related to psychosocial issues. This review demonstrated that adults with cerebral palsy experience psychosocial issues as they age. These issues related to social support, acceptance by them and others and the concerns related to deterioration and resultant limitations in abilities. The authors also discussed that adjustments to workplaces may be necessary to support people ageing with cerebral palsy to continue to work.

McDermott et al (2005) investigated whether the prevalence of depression differs between those with and without disability. They found a statistically significant increased prevalence in those with a disability as a whole however noted variation in different disability groups. People with cerebral palsy, autism and intellectual disability had a lower prevalence than the control while those post stoke or traumatic brain injury had a higher prevalence. The authors also discussed the likelihood that for those with severe disabilities there is under identification of depression due to the difficulties of recognising the signs.

Ng et al (2003) investigated health care and social isolation on young adults after leaving school. They found that those who had left school and no longer had a co-ordinated school and health network were socially isolated. The authors recommended a co-ordinated approach to supporting transition into adulthood.

References:

Horsman, M., Suto, M., Dudgeon, B., & Harris, S. R. (2010). Ageing with cerebral palsy: psychosocial issues. Age and Ageing, 39(3), 294–299. https://doi.org/10.1093/ageing/afq018

McDermott, S., Moran, R., Platt, T., Issac, T., Wood, H., & Dasari, S. (2005). Depression in adults with disabilities, in primary care. Disability and Rehabilitation, 27(3), 117–123. https://doi.org/10.1080/09638280400007380

Ng, S., Dinesh, S., Tay, S., & Lee, E. (2003). Decreased Access to Health Care and Social Isolation among Young Adults with Cerebral Palsy after Leaving School. Journal of Orthopaedic Surgery, 11(1), 80–89. https://doi.org/10.1177/230949900301100116