Abstract
Individuals with psychiatric illness believe that voting is important. However, these individuals have lower rates of voting when compared to the general population. A survey of psychiatrically hospitalized adult patients was conducted to assess perceptions of and barriers to voting in patients with psychiatric illness. Data from 113 surveys was analyzed. A majority of survey participants agreed that they cared about voting, that their vote made a difference, and that their vote was important. 74% of individuals reported previously experiencing at least one barrier when exercising their right to vote. The most commonly experienced barriers reported were not having enough information to make an informed choice, not knowing where to vote, not having transportation, and not being registered to vote. Individuals who encountered a higher number of barriers in the past had a higher chance of encountering barriers more often. In conclusion, a high percentage of individuals with mental illness severe enough to warrant hospitalization have experienced barriers to voting, with many experiencing multiple barriers. Reduction of these barriers is important, as voting and the resultant public policies can directly affect this population’s mental health and access to both mental and physical healthcare services.
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A portion of this data was presented at the Mental Health Services Conference in October 2023.
References
American Public Health Association (2022). Advancing health equity through protecting and promoting access to voting, Policy number 20229, Retrieved November 8, 2022, from https://www.apha.org/Policies-and-Advocacy/Public-Health-Policy-Statements/Policy-Database/2023/01/18/Access-to-Voting.
Amiel-Lebigre, F. (2003). Psycho-social determinants for psychiatric hospitalization for neurotic disorders in women—a case-control study. Social Psychiatry and Psychiatric Epidemiology, 38(6), 317–325. https://doi.org/10.1007/s00127-003-0634-3.
Bergstresser, S. M., Brown, I. S., & Colesante, A. (2013). Political engagement as an element of social recovery: A qualitative study. Psychiatric Services (Washington D C), 64(8), 819–821. https://doi.org/10.1176/appi.ps.004142012.
Bhugra, D. (2016). Social discrimination and social justice. International Review of Psychiatry (Abingdon England), 28(4), 336–341. https://doi.org/10.1080/09540261.2016.1210359.
Bosquet, A., Medjkane, A., Voitel-Warneke, D., Vinceneux, P., & Mahé, I. (2009). The vote of acute medical inpatients: A prospective study. Journal of Aging and Health, 21(5), 699–712. https://doi.org/10.1177/0898264309338297.
Brown, C. L., Raza, D., & Pinto, A. D. (2020). Voting, health and interventions in healthcare settings: A scoping review. Public Health Reviews, 41, 16. https://doi.org/10.1186/s40985-020-00133-6.
Commonwealth of Pennsylvania. (2023) 55 Pennsylvania Code § 5100.54 manual of rights for persons in treatment. Retrieved November 7, 2023, from https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter5100/chap5100toc.html.
Compton, M. T., & Shim, R. S. (2015). The social determinants of mental health. American Psychiatric Association Publishing.
Cutlip, A. C., Bankston, W. B., & Lee, M. R. (2010). Civic community and nonmetropolitan white suicide. Archives of Suicide Research: Official Journal of the International Academy for Suicide Research, 14(3), 261–265. https://doi.org/10.1080/13811118.2010.494145
Executive Order 14019 (2021). Executive order on promoting access to voting. Retrieved on November 7, 2023, From https://www.whitehouse.gov/briefing-room/presidential-actions/2021/03/07/executive-order-on-promoting-access-to-voting/.
Fabina, J., & Scherer, Z. (2022). Voting and registration in the election of November 2020 (P20-585), U.S. Census Bureau. https://www.census.gov/content/dam/Census/library/publications/2022/demo/p20-585.pdf.
Grade, M. M., Reardon, A. W. T., Ha, Y. P., Steinhart, A., & Martin, A. F. (2023). The healthy democracy kit: Design, implementation, uptake, and impact of a novel voter registration toolkit for healthcare settings. BMC Public Health, 23(1), 962. https://doi.org/10.1186/s12889-023-15800-x.
Graziane, J., Dalke, K. B., Mikoluk, C., Laux, T., Pradhan, S., Zhu, J., Zug, D., Noel, J., Bowen, J. L., & Kunkel, E. J. S. (2023a). Promoting health equity through voter support activities for the inpatient psychiatric population. Community Mental Health Journal, 59(3), 498–506. https://doi.org/10.1007/s10597-022-01033-6
Graziane, J. A., Ghahramani, A., Bowen, J. L., Horton, S., Swigart, A., Kunkel, E., & Dalke, K. B. (2023b). Psychiatry’s obligation to promote voting among patients with mental illness. Psychiatric Services (Washington D C). https://doi.org/10.1176/appi.ps.20230006
Hassell, H. J. G., & Settle, J. E. (2017). The differential effects of stress on voter turnout. Political Psychology, 38(3), 533–550.
Health and Democracy Index. (2022) Retrieved December 27, 2022, from https://democracyindex.hdhp.us/data/
Kamens, S. R., Blum, E., & Styron, T. H. (2019). Voting rights for persons with serious mental illness in the U.S. Pyschiatric Rehabilitation Journal, 42(2), 197–200.
Kelly, B. D., & Nash, M. (2019). Voter participation among people attending mental health services in Ireland. Irish Journal of Medical Science, 188(3), 925–929. https://doi.org/10.1007/s11845-018-1921-z.
Landwehr, C., & Ojeda, C. (2021). Democracy and depression: A cross-national study of depressive symptoms and nonparticipation. American Political Science Review, 115(1), 323–330. https://doi.org/10.1017/S0003055420000830.
Lickiss, S., Lowery, L., & Triemstra, J. D. (2020). Voter registration and engagement in an adolescent and young adult primary care clinic. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 66(6), 747–749. https://doi.org/10.1016/j.jadohealth.2019.11.316
Liggett, A., Sharma, M., Nakamura, Y., Villar, R., & Selwyn, P. (2014). Results of a voter registration project at 2 family medicine residency clinics in the Bronx, New York. Annals of Family Medicine, 12(5), 466–469. https://doi.org/10.1370/afm.1686.
Matsubayashi, T., & Ueda, M. (2014). Disability and voting. Disability and Health Journal, 7(3), 285–291. https://doi.org/10.1016/j.dhjo.2014.03.001.
McIntyre, J., Khwaja, M., Yelamanchili, V., Naz, S., & Clarke, M. (2012). Uptake and knowledge of voting rights by adult in-patients during the 2010 UK general election. The Psychiatrist, 36(4), 126–130. https://doi.org/10.1192/pb.bp.110.033662.
Melamed, Y., Doron, A., Finkel, B., Kurs, R., Behrbalk, P., Noam, S., Gelkopf, M., & Bleich, A. (2007). Israeli psychiatric inpatients go to the polls. The Journal of Nervous and Mental Disease, 195(8), 705–708. https://doi.org/10.1097/NMD.0b013e318123fc10.
Nash, M. (2002). Voting as a means of social inclusion for people with a mental illness. Journal of Psychiatric and Mental Health Nursing, 9(6), 697–703. https://doi.org/10.1046/j.1365-2850.2002.00539.x.
National Voter Registration Act of 1993. (1993) Civil rights division, US Department of Justice. Retrieved November 7, 2023, from https://www.justice.gov/crt/national-voter-registration-act-1993-nvra
Neiman, J., Giuseffi, K., Smith, K., French, J., Waismel-Manor, I., & Hibbing, J. (2015). Voting at home is associated with lower cortisol than voting at the polls. PloS One, 10(9), e0135289. https://doi.org/10.1371/journal.pone.0135289
Okwerekwu, J. A., McKenzie, J. B., Yates, K. A., Sorrentino, R. M., & Friedman, S. H. (2018). Voting by people with mental illness. The Journal of the American Academy of Psychiatry and the Law, 46(4), 513–520. https://doi.org/10.29158/JAAPL.003780-18
Pabayo, R., Liu, S. Y., Grinshteyn, E., Cook, D. M., & Muennig, P. (2021). Barriers to voting and access to health insurance among US adults: A cross-sectional study. The Lancet Regional Health – Americas, July 30(2), 100026. https://doi.org/10.1016/j.lana.2021.100026.
Roick, C., Heider, D., Kilian, R., Matschinger, H., Toumi, M., & Angermeyer, M. C. (2004). Factors contributing to frequent use of psychiatric inpatient services by schizophrenia patients. Social Psychiatry and Psychiatric Epidemiology, 39(9), 744–751. https://doi.org/10.1007/s00127-004-0807-8.
Ruxin, T. R., Ha, Y. P., Grade, M. M., Brown, R., Lawrence, C., & Martin, A. F. (2022). The Vot-ER healthy democracy campaign: A national medical student competition to increase voting access. Academic Medicine: Journal of the Association of American Medical Colleges, 97(1), 89–92. https://doi.org/10.1097/ACM.0000000000004381
Schriner, K., Ochs, L. A., & Shields, T. G. (1997). The last suffrage movement: Voting rights for persons with cognitive and emotional disabilities. Publius, 27(3), 75–96.
Siddique, A., & Lee, A. (2014). A survey of voting practices in an acute psychiatric unit. Irish Journal of Psychological Medicine, 31(4), 229–231. https://doi.org/10.1017/ipm.2014.53.
Walker, A. M., Klein, M. S., Hemmens, C., Stohr, M. K., & Burton, V. S., Jr. (2016). The consequences of official labels: An examination of the rights lost by the mentally ill and mentally incompetent since 1989. Community Mental Health Journal, 52(3), 272–280. https://doi.org/10.1007/s10597-015-9941-x
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Graziane, J.A., Dalke, K., Swigart, A. et al. Empowering Psychiatric Inpatients to Vote: Perceptions of Voting and the Barriers Encountered. Community Ment Health J (2024). https://doi.org/10.1007/s10597-024-01241-2
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DOI: https://doi.org/10.1007/s10597-024-01241-2