OREGON STATE UNIVERSITY
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Please note that we use a combination of person-first (e.g., person with a disability) and identity-first language (e.g., disabled person) in this article in acknowledgment of differing preferences within the disability community. When speaking to an individual it is always best to ask if they prefer person-first or identity first language.
This article does include information relating to suicide and suicidal behavior. If you or someone you know may be struggling with suicidal thoughts, you can call 988 for free, confidential support from the National Suicide Prevention Lifeline. For ASL services, click the “ASL Now” button at https://988lifeline.org/. For services in Spanish, call 988 and press option 2.
Two well-known definitions of disability are from the Americans with Disabilities Act (ADA) and the World Health Organization (WHO).
The Americans with Disabilities Act (ADA) was passed in 1990 and provides a legal definition of disability in which a person with a disability is someone who had/has or appears to have a “physical or mental impairment that substantially limits one or more major life activity”. Examples of major life activities include eating, sleeping, reading, standing, and communicating. The Americans with Disabilities Act (ADA) also provides legal protections for people with disabilities by prohibiting discrimination in the workplace, school, transportation, and places open to the public.
In contrast, the World Health Organization defines disability as the “interaction between individuals with a health condition, with personal and environmental factors including negative attitudes, inaccessible transportation and public buildings, and limited social support”. This definition highlights the role of environmental, social, and other systems-level factors in the experience of disability.
Disability does not have a specific “look” and a disability may or may not be visible. Both mental health conditions and substance use disorders can qualify as a disability under the Americans with Disabilities Act (ADA) and the World Health Organization (WHO) definitions.
People with disabilities are disproportionately impacted by mental health conditions. During a 2020 survey, 56.5% of disabled people reported frequent symptoms of anxiety or depression compared to 28.7% of people without disabilities. This survey also found that 30.6% of disabled people reported serious suicidal ideation compared to 8.3% of non-disabled people. Another study found that in the last month, disabled adults were 4.6 times more likely to report frequent mental distress than adults without disabilities. These findings highlight clear mental health disparities that are influenced by the social and structural factors discussed later in this section.
About 56.5% of disabled people report frequent symptoms of anxiety or depression compared to 28.7% of people without disabilities.
This graphic is based on data from an article published in the Morbidity and Mortality Weekly Report (MMWR).
Around 30.6% of disabled people report serious suicidal ideation compared to 8.3% of people without disabilities.
This graphic is based on data from an article published in the Morbidity and Mortality Weekly Report (MMWR).
People with disabilities are also disproportionately impacted by alcohol and drug use disorders and again face barriers to finding and accessing treatment services. Disabled people are more likely to experience chronic pain or have a mental illness, both of which can increase the likelihood of alcohol and drug use disorders as well as alcohol or drug misuse. Additionally, people with disabilities are about 11% more likely to have used prescription opioids in the last year compared to non-disabled people, which can increase a person’s risk of developing opioid use disorder.
While opioid misuse is highly researched, research into opioid misuse and disability is relatively new. So far, this research has shown that disabled people were significantly more likely than non-disabled people to misuse opioids for pain relief and less likely to receive treatment for an opioid use disorder. A qualitative study from the perspective of disabled people who misused opioids highlighted the stigma and barriers they faced to accessing or receiving treatment. Some of the barriers highlighted included inaccessible programing, needing a personal care attendant, financial costs, transportation barriers, and programs limiting or not allowing medications. This underlines the need for inclusive, accessible, and comprehensive chronic pain management and opioid use disorder treatment. Comprehensive pain management is a multidisciplinary approach to pain management that incorporates approaches such as “physical therapy, emotional and spiritual support, cognitive behavioral therapy, and non‐opioid pharmacotherapies”.
An example of a current project working to address these disproportionate impacts is the Mental Health Rights Project by Disability Rights Oregon. The Mental Health Rights Project is working to decriminalize mental illness, promote community-based options and independence, and improve conditions in jails and prisons for people with mental health conditions or in mental health crisis. The objectives and priorities of the project are determined by the Mental Health Advisory Council and the Board of Directors. The Mental Health Advisory Council consists of a combination of people with mental health conditions, their families, mental health providers, knowledgeable community members, and attorneys.
