What is a Psychosocial Disability?
Psychosocial is one of those great words where the meaning can be found in breaking it down. Psycho; representing a person’s psychological state, and social; meaning society and the environment around us. Psychosocial is used to describe the relationship between an individuals thoughts and behaviours and their environment.
Someone can have a psychosocial disability when their existing mental health condition is negatively impacted by factors in their society or environment, such as poverty, discrimination, trauma and isolation.
Psychosocial disability describes how social, economic and environmental elements can exacerbate three types of conditions; schizoid disorders such as schizophrenia and schizoaffective disorder, anxiety disorders such as OCD, PTSD, agoraphobia and social phobia or mood disorders such as depression and bipolar. The NDIS defines a psychosocial disability as ‘a term used to describe a disability that may arise from a mental health issue. Not everyone who has a mental health condition will have a psychosocial disability, but for people who do, it can be severe and longstanding.’
Someone with a psychosocial disability has shown their mental health condition and the environment around them has created a functional impairment, creating additional barrier to participating in society and their own lives.
Some stats
4.6% of Australians have a psychosocial disability. Of these 1.1 million people, 85.5% have a secondary disability. People with psychosocial disabilities comprise the third largest primary disability group, with 53,123 people, or 11% of NDIS participants.
Two-thirds of people with psychosocial disability had a physical disability, two-fifths had an intellectual disability, and one-third had a sensory disability.
According to the Australian Institute of Health and Welfare data, the ages of those affected are spread relatively evenly, with the highest rate of psychosocial disability among 45-55-year-olds at 27.7% and 55-64-year-olds at 25%.
The rate of active participants with a primary psychosocial disability is almost three times higher for Aboriginal and Torres Strait Islander people than other Australians.
What are examples of psychosocial functions?
Due to psychosocial disabilities deriving from mental health issues, impacts of a psychosocial disability can be episodic and fluctuate in type, severity, and duration. People with a psychosocial disability may experience challenges with communication, social inclusion, housing and employment.
In 2018, the Australian Bureau of Statistic (ABS) examined the prevalence of psychosocial disability in Australia. They found the type of support many people with psychosocial disability required was for cognitive and emotional tasks.
Some of the struggles with everyday life these people reported included memory problems or periods of confusion, social or behavioural issues, anxiety and mental illness.
According to ABS data, of the 1.1 million Australians with psychosocial disability, almost 95.5% reported receiving assistance with at least one everyday activity, with the assistance most often provided by informal supports; a partner, parent or child.
Effects of a psychosocial disability can impact an individual’s ability to participate in daily activities and be in certain environments. They might experience difficulties:
Concentrating and thinking clearly
Maintaining stamina to complete tasks
Coping with time pressure and multiple tasks
Interacting with others
Making or attending plans
Managing stress
Taking care of their physical and mental health
As a result, they can often withdraw or be excluded from social and community participation and find it challenging to participate in educational and workplace settings.
Deakin University interviewed 22 people with a psychosocial disability with an NDIS plan.
A participant from the Hunter Valley in NSW said:
‘Well, I think that an extra-hard part of having a psychosocial disability is that your choices are taken away from you systematically. You’re restrained, secluded, scheduled, your finances are handled by someone else – and you have to take your medication. Your freedom – you have it and then it’s taken away. So, I think a psychosocial disability has a unique quality there and, I think, if I’m articulate, intelligent [and] I have trouble with the NDIS – what hope do other people have?’
We also know the impacts of a psychosocial disability make navigating the health system or NDIS very tricky, and people with a psychosocial disability may struggle to access and participate in mainstream support and services, such as safe housing and tenancies. These barriers exclude individuals from exercising their civil, economic, social and cultural rights, perpetuating a cycle of poor mental health
According to Paul Deany from the Disability Rights Fund:
‘If disability is one of the great human rights challenges of this century, then within this, psychosocial disability remains one of the most challenging and misunderstood areas of disability.’
Stigma
Historically, medical treatment of people experiencing mental health conditions neglected autonomy, institutionalised and involuntary, degrading and violent practices. Whilst medical treatments have drastically changed in the last 50 years, there remain prejudicial beliefs about their ability to participate as full citizens and ability to make important decisions.
The varying and episodic nature of psychosocial disabilities often results in individuals being viewed as ‘unstable beings.’ Combine this assumption with a lack of understanding and misrepresentation continues to aid deep-rooted stereotypes.
In this 2013 research article by BMC International Health and Human Rights, the authors Kleintjes, Lund and Swartz use the term ‘psychosocial disability’ to reinforce the barriers faced by individuals with the disability participating in self-autonomy aren’t due to symptoms of their condition.
‘Rather, barriers arise in substantial part from the way in which the organisation of society tends to limit the personal, social, political and economic power of people with disability, including people with psychosocial disability.’
External shame can manifest into self-stigma, as stigmatised individuals internalise public attitudes and assumptions about their disability. Stigma impacts the drive to seek support, where individuals can be hesitant to disclose symptoms or adopt a mental health or disability label.
From Understanding Mental Ill-health as Psychosocial Disability: Implications for Assistive Technology:
‘In addition to stigma and societal pressures, individuals with psychosocial disabilities are often faced with the fact that these disabilities are, by and large, invisible. This invisibility can lead to concerns that one’s behaviour might be perceived by others as erratic and creates pressure to disclose one’s disability to every new person in charge of their care.’
When individuals with a psychosocial disability in Australia seek NDIS support, what does that look like? We will be detailing more details in our next blog post. Do you know or work with someone with a psychosocial disability?
Please check out our Functional Capacity Assessments: Psychosocial service delivered by NDIS social workers in WA.
Ruby Wheeler