Epidemiology of mental disability using Indian Disability Evaluation Assessment Scale among general population in an urban area of Puducherry, India

Abstract

Background:There is paucity of information on epidemiology of mental disability in India.Objective:The objective of this study was to assess mental disability, and to study the association between sociodemographic and comorbid chronic conditions with mental disability.Materials and Methods:This community-based cross-sectional study was conducted among ≥5 years age group in an urban area attached to a Tertiary Care Medical Institute in Puducherry, India. Mental disability was assessed using Indian Disability Evaluation and Assessment Scale. Chronic morbid conditions and other associated factors were collected using pretested questionnaire.Statistical Analysis:Univariate and multiple logistic regression analysis.Results:About 2537 subjects were covered with a response rate of 94.1%. Overall, the prevalence of mental disability was found to be 7.1% (181/2537). Among them, majority had mild mental disability (151, 83.4%), followed by moderate (21, 11.6%), severe (8, 4.4%), and profound (1, 0.6%) mental disability. Univariate analysis showed that age group status, marital status, education level, occupation, family type, religion, hypertension, joint pain, backache, current smoking, current alcohol use, and conflicts were associated with mental disability (P < 0.05). Multiple logistic regression analysis showed that male gender (adjusted odds ratio [AOR] =2.064), widowed status (AOR = 27.022), separated/divorced status (AOR = 16.674), currently married status (AOR = 18.487), being illiterate (AOR = 4.352), having 1st–10th standard education (AOR = 2.531), being in an unskilled (AOR = 0.287) or semiskilled/skilled occupation (AOR = 0.025), belonging to a nuclear family (AOR = 1.816), and absence of family conflicts (AOR = 0.259) were significantly associated with mental disability compared to their counterparts.Conclusion:Mental disability is more common in this area. Males, lesser education level, skilled or unskilled occupation, nuclear family, and conflicts were associated with mental disability after adjusting other variables. Multicentric cross-sectional analytical studies will explore the mental disability burden and its associated factors at regional or country level.

Prevalence of disability using rapid assessment of disability toolkit among adult residents of rural Delhi, India

“…Other studies using rapid assessment of disability toolkit or otherwise, in India or abroad have also reported low level of education attainment in persons with disability. 8,11,13,15,[20][21][22] Marital status…”

“…Other studies conducted in India and other countries worldwide also reported the poor level of employment status of persons with disability. 6,15,19,20,[24][25][26][27][28][29][30] Ganesh et al reviewed 32 studies which reveal that occupation plays a major role as a determinant of disability. 26…”

Strengthen mental health services for universal health coverage in India

“…In a research paper published in this issue of the journal, Kumar et al . [ 8 ] report the degree of disability associated with mental health conditions and linkage with other health conditions in the general population. This study was conducted in a small geographical area, which is a key limitation of the findings, especially when the National Mental Health Survey 2015–2016 report is available and provides information on epidemiology, and health systems challenge on mental health in India.…”

“…underlines that the mental illnesses are often associated with disabilities. [ 8 ] In addition, both mental illnesses and disabilities are health and social challenges. The mental illnesses are among the leading causes of ill health and disability worldwide.…”

“…The present study's findings are a reminder for important issues which otherwise tend to be forgotten. [ 8 ] The NHP 2017 has concrete and actionable points on mental health such as to (a) accelerate creation of specialists through public financing, (b) establish network of community members to provide psychosocial support to strengthen mental health services at primary level facilities, and (c) leverage digital technology where access to qualified psychiatrists is difficult. [ 15 ] This is a quantum jump from previous NHP, which had focused mainly on treatment of common mental health issues and strengthening institutions.…”