Audit of requests for disability certification of adults received at a tertiary care general hospital psychiatry unit

Abstract

Background: Persons with disability (PwD) are entitled to certain benefits from the State on grounds of being disabled. With the recent enactment of the Rights of PwD Act, 2016, and increased efforts to provide assistance to persons with certifiable disabilities, data pertaining to disability requests can be useful to understand the way in which services are utilized. Materials and Methods: This study is an audit of the disability certificates issued to all subjects with age ≥18 years between 2016 and 2019 at a tertiary care general hospital psychiatry unit, and discusses the pattern and profile of the certificates. Results: A total of 356 patients were issued disability certificates (2016–2019). The mean age of the subjects was 32.8 (±11.2) years and about 30% of them were females. Intellectual disability (58.3%) was the most common diagnosis, followed by schizophrenia and related disorders (31%), while all other disorders constituted a smaller proportion (11%) of the sample. About 60% of the subjects had moderate disability, 37.4% had severe disability, and 1.7% had profound disability. Conclusion: A large majority of the certificates were issued to subjects with intellectual disability. Patients with severe mental illnesses are probably not accessing the disability benefits optimally. This audit also points to under-representation of women as well as an overall underutilization of services by individuals with mental disability.

Longitudinal assessment of disability amongst patients of bipolar and unipolar depressive disorders presenting to a tertiary care center in North India

“…However, on categorizing the scores according to the benchmark disability (>40%) as defined in the Rights of Persons with Disability Act, 2016 (RPWD), significant differences could be seen on 12-month follow-up, where significantly higher percentage of individuals with the diagnosis of BD fell within the cut-off of benchmark disability as compared to UD. This explains the prevailing clinical practice of a greater number of certificates being issued to patients with BD than UD (Chadda et al, 2021; Jadhav et al, 2021). These findings could be associated with or even confounded by certain results from the study, such as higher education level and shorter duration of illness in UD group (however duration of illness did not show any significant correlations with IDEAS or LHS scores), and greater number of past hospitalizations in BD group.…”

“…Mental disability is not visible and thus there is decreased awareness about the government schemes for the needy. Patients usually do not avail disability benefits optimally and there is overall underutilization of the services (Chadda et al, 2021). It is important for the clinicians to identify the predictors of disability, which can then be targeted for intervention and rehabilitation.…”