Skip to main content

The mental health of young people with disabilities: impact of social conditions

Abstract

Background

Young people with disabilities have poorer mental health than their non-disabled peers. However, people with disabilities are more likely than others to experience financial hardship and low social support, both of which have been linked with poor mental health outcomes. This article explores the extent to which the relatively poor mental health of young people with disabilities is related to the social conditions in which they live.

Methods

Secondary analysis was performed on Wave 6 (2006) of the survey of Household Income and Labour Dynamics in Australia (HILDA). This nationally representative sample included 3,392 young Australians, aged 15–29, of whom 475 reported having a long-term health condition, impairment or disability.

Results

Young people with disabilities reported poorer mental health than their non-disabled peers. However, this relationship was moderated by both social adversity and social support, with minimal differences in mental health observed between the groups under conditions of high social support and low financial hardship.

Discussion

The results suggest that disability represents a potential adversity that may be exacerbated or ameliorated by the effects of wealth/financial hardship and social support.

Conclusion

It may be possible to improve the mental health of disabled people by addressing their social exclusion.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Australian Bureau of Statistics (1997) SF-36 population norms: Australia. ABS, Canberra

    Google Scholar 

  2. Australian Bureau of Statistics (1998) Mental health and wellbeing: profile of adults, Australia, 1997. ABS, Canberra

    Google Scholar 

  3. Australian Bureau of Statistics (2003) Information paper: disability, ageing and carers, Australia: user guide 2003. ABS, Canberra

    Google Scholar 

  4. Australian Bureau of Statistics (2005) Australian social trends 2005. ABS, Canberra

    Google Scholar 

  5. Australian Bureau of Statistics (2007) 20680-indigenous status by age—Australia. ABS, Canberra

    Google Scholar 

  6. Australian Bureau of Statistics (2007) Basic community profile 2006 census community profile series. ABS, Canberra

    Google Scholar 

  7. Australian Bureau of Statistics (2008) Australian social trends 2008: population distribution. ABS, Canberra

    Google Scholar 

  8. Australian Institute of Health, Welfare (2003) Disability prevalence and trends. AIHW, Canberra

    Google Scholar 

  9. Australian Institute of Health, Welfare (2007) Young Australians: their health and wellbeing 2007. AIHW, Canberra

    Google Scholar 

  10. Australian Institute of Health, Welfare (2008) Disability in Australia: trends in prevalence education employment and community living. AIHW, Canberra

    Google Scholar 

  11. Bajekal M, Harries T, Breman R, Woodfield K (2004) Review of disability estimates and definitions. National Centre for Social Research, London

    Google Scholar 

  12. Bethune-Davies P, McWilliam C, Bermen H (2006) Living with the health and social inequities of a disability: a critical feminist study. Health Care Women Int 27:204–222

    Article  PubMed  Google Scholar 

  13. Burchardt T, Le Grand J, Piachaud D (2002) Degrees of exclusion: developing a dynamic, multidimensional measure. In: Hills J, Le Grand J, Piachaud D (eds) Understanding social exclusion. Oxford University Press, Oxford, pp 30–43

    Google Scholar 

  14. Butterworth P, Crosier T (2004) The validity of the SF-36 in an Australian national household survey: demonstrating the applicability of the Household Income and Labour Dynamics in Australia (HILDA) Survey to examination of health inequalities. BMC Public Health, pp 1–11

  15. Cepeda ML, Allen FH, Cepeda NJ, Yang Y-M (2000) Physical growth, sexual maturation, body image and sickle cell disease. J Natl Med Assoc 92:10–14

    CAS  PubMed  Google Scholar 

  16. Claussen B (1999) Alcohol disorders and re-employment in a 5-year follow-up of long-term unemployed. Addiction 94:133–138

    CAS  Article  PubMed  Google Scholar 

  17. Committee on Children with Disabilities and Committee on Psychosocial Aspects of Child and Family Health (1993) Psychosocial risks of chronic health conditions in childhood and adolescence. Pediatrics 92:876–877

    Google Scholar 

  18. Connell RW (1995) Masculinities. Allen and Unwin, Sydney

    Google Scholar 

  19. Crosier T, Butterworth P, Rodgers B (2007) Mental health problems among single and partnered mothers: the role of financial hardship and social support. Social Psychiatry Psychiatr Epidemiol 42:6–13

    Article  Google Scholar 

  20. Einfeld SL, Piccinin AM, Mackinnon A et al (2006) Psychopathology in young people with intellectual disability. JAMA 296:1981–1989

    CAS  Article  PubMed  Google Scholar 

  21. Emerson E, Hatton C (2007) The contribution of socio-economic position to the health inequalities faced by children and adolescents with intellectual disabilities in Britain. Am J Ment Retard 112:140–150

    Article  PubMed  Google Scholar 

  22. Emerson E, Hatton C (2007) Mental health of children and adolescents with intellectual disabilities in Britain. Br J Psychiatry 191:493–499

    Article  PubMed  Google Scholar 

  23. Emerson E, Honey A, Madden R, Llewellyn G (2009) The well-being of Australian adolescents and young adults with self-reported long-term health conditions, impairments or disabilities: 2001 and 2006. Aust J Soc Issues 44:39–53

    Google Scholar 

  24. Fagg J, Curtis S, Stansfeld SA, Congdon P (2006) Psychological distress among adolescents, and its relationship to individual, family and area characteristics in East London. Soc Sci Med 63:636–648

    Article  PubMed  Google Scholar 

  25. Fone D, Dunstan F, Williams G, Lloyd K, Palmer S (2007) Places, people and mental health: a multilevel analysis of economic inactivity. Soc Sci Med 64:633–645

    Article  PubMed  Google Scholar 

  26. Fuhrer R, Stansfeld SA, Chemali J, Shipley MJ (1999) Gender, social relations and mental health: prospective findings from an occupational cohort (Whitehall II study). Soc Sci Med 48:77–87

    CAS  Article  PubMed  Google Scholar 

  27. Gallo LC, Matthews KA (2003) Understanding the association between socioeconomic status and physical health: do negative emotions play a role? Psychol Bull 129:10–51

    Article  PubMed  Google Scholar 

  28. Gannon B, Nolan B (2006) The dynamics of disability and social inclusion in Ireland. The Economic and Social Research Institute, Dublin

    Google Scholar 

  29. Gannon B, Nolan B (2007) The impact of disability transitions on social inclusion. Soc Sci Med 64:1425–1437

    Article  PubMed  Google Scholar 

  30. Goggin G, Newell C (2005) Disability in Australia: exposing a social apartheid. UNSW Press, Sydney

    Google Scholar 

  31. Gortmaker SL, Perrin JM, Weitzman M, Homer CJ, Sobol AM (1993) An unexpected success story: transition to adulthood in youth with chronic physical health conditions. J Res Adolesc 3:317–336

    Article  Google Scholar 

  32. Gray KM, Mohr C (2004) Mental health problems in children and adolescents with intellectual disability. Curr Opin Psychiatry 17:365–370

    Article  Google Scholar 

  33. Headey B, Warren D (2008) Families, incomes and jobs, volume 3: a statistical report on waves 1 to 5 of the HILDA survey. Melbourne Institute of Applied Economic and Social Research, Melbourne

    Google Scholar 

  34. Henderson S, Duncan-Jones P, McAuley H, Ritchie K (1978) The patient’s primary group. Br J Psychiatry 132:74–86

    Article  Google Scholar 

  35. HILDA (2006) HILDA survey annual report 2006. Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne

    Google Scholar 

  36. Jenkins S, Rigg J (2004) Disability and disadvantage: selection, onset and duration effects. J Soc Policy 33:479–501

    Article  Google Scholar 

  37. Kerr DC, Preuss LJ, King CA (2006) Suicidal adolescents’ social support from family and peers: gender-specific associations with psychopathology. J Abnorm Child Psychol 34:103–114

    Article  PubMed  Google Scholar 

  38. Klineberg E, Clark C, Bhui KS, Haines MM, Viner RM, Head J et al (2006) Social support, ethnicity and mental health in adolescents. Soc Psychiatry Psychiatr Epidemiol 41:755–760

    Article  PubMed  Google Scholar 

  39. Kolaitis G (2008) Young people with intellectual disabilities and mental health needs. Curr Opin Psychiatry 21:469–473

    Article  PubMed  Google Scholar 

  40. Kuh D, Power C, Blane D, Bartley M (2004) Socioeconomic pathways between childhood and adult health. In: Kuh D, Ben-Shlomo Y (eds) A life course approach to chronic disease epidemiology. Oxford University Press, Oxford, pp 371–398

    Chapter  Google Scholar 

  41. Luthar SS (2003) Resilience and vulnerability: adaptation in the context of childhood adversities. Cambridge University Press, Cambridge

    Book  Google Scholar 

  42. Marmot M, Wilkinson RG (eds) (2006) Social determinants of health, 2nd edn. Oxford University Press, Oxford

  43. Marshall ML, Barnett RC (1993) Work family strains and gains among two-earner couples. J Community Psychol 21:64–78

    Article  Google Scholar 

  44. McClish D, Penberthy L, Bovbjerg V, Roberts J, Aisiku I, Levenson J, Roseff S, Smith W (2005) Health related quality of life in sickle cell patients: the PiSCES project. Health Qual Life Outcomes 3:50

    Article  PubMed  Google Scholar 

  45. Miauton L, Narring F, Michaud PA (2003) Chronic illness, life style and emotional health in adolescence: results of a cross-sectional survey on the health of 15–20-year-olds in Switzerland. Eur J Pediatr 162:682–689

    Article  PubMed  Google Scholar 

  46. Mont D (2007) Measuring disability prevalence. Social protection discussion papers. World Bank, Washington

    Google Scholar 

  47. Morrell S, Taylor R, Quine S, Kerr C, Western J (1994) A cohort study of unemployment as a cause of psychological disturbance in Australian youth. Soc Sci Med 38:1553–1564

    CAS  Article  PubMed  Google Scholar 

  48. Neumark-Sztainer D, Story M, Resnick MD, Garwick A, Blum RW (1995) Body dissatisfaction and unhealthy weight-control practices among adolescents with and without chronic illness: a population-based study. Arch Pediatr Adolesc Med 149:1330–1335

    CAS  PubMed  Google Scholar 

  49. Patterson J, Blum RW (1996) Risk and resilience among children and youth with disabilities. Arch Pediatr Adolesc Med 150:692–698

    CAS  PubMed  Google Scholar 

  50. Perrin JM (2002) Health services research for children with disabilities. Milbank Q 80:303–324

    Article  PubMed  Google Scholar 

  51. Perry MJ (1996) The relationship between social class and mental disorder. J Prim Prev 17:17–30

    Article  Google Scholar 

  52. Pickett KE, Wilkinson RG (2007) Child wellbeing and income inequality in rich societies: ecological cross sectional study. BMJ 335:1080–1086

    Article  PubMed  Google Scholar 

  53. Sanson-Fisher RW, Perkins JJ (1998) Adaptation and validation of the SF-36 Health Survey for use in Australia. J Clin Epidemiol 51:961–967

    CAS  Article  PubMed  Google Scholar 

  54. Saunders P (2006) The costs of disability and the incidence of poverty. Social Policy Research Centre, University of NSW, Sydney

    Google Scholar 

  55. Sawyer MG, Arney FM, Baghurst PA, Clark JJ, Graetz BW, Kosky RJ, Nurcombe B, Patton GC, Prior MR, Raphael B, Rey J, Whaites LC, Zubrick SR (2000) Mental health of young people in Australia: child and adolescent component of the National Survey of Mental Health and Well-being. Commonwealth Department of Health and Aged Care, Canberra

    Google Scholar 

  56. Sawyer SM, Drew S, Yeo MS, Britto MT (2007) Adolescents with a chronic condition: challenges living, challenges treating. Lancet 369:1481–1489

    Article  PubMed  Google Scholar 

  57. Seigel W, Golden N, Gough J, Lashley M, Sacker I (1990) Depression, self-esteem, and life events in adolescents with chronic illness. J Adolesc Health Care 11:501–504

    CAS  Article  PubMed  Google Scholar 

  58. Smith DM, Langa KM, Kabeto MU, Ubel PA (2005) Health, wealth, and happiness: financial resources buffer subjective well-being after the onset of a disability. Psychol Sci 16:663–666

    Article  PubMed  Google Scholar 

  59. Stam H, Hartman EE, Deurloo JA, Groothoff J, Grootenhuis MA (2006) Young adult patients with a history of pediatric disease: impact on course of life and transition into adulthood. J Adolesc Health 39:4–13

    Article  PubMed  Google Scholar 

  60. Stewart D, Antle BJ, Healy H, Law M, Young NL (2007) Best practice guidelines for transition to adulthood for youth with disabilities in Ontario: an evidence-based approach. CanChild Centre for Childhood Disability Research, Ontario

    Google Scholar 

  61. Varni J, Limbers C, Burwinkle T (2007) Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales. Health Qual Life Outcomes 5:43

    Article  PubMed  Google Scholar 

  62. Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  63. Ware JE, Snow KK, Kosinski M, Gandek B (2000) SF-36 Health Survey: manual and interpretation guide. QualityMetric Inc., Lincoln

    Google Scholar 

  64. Watson N (ed) (2008) HILDA user manual: Release 6. Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne

    Google Scholar 

  65. Watson N, Wooden M (2002) The Household, Income and Labour Dynamics in Australia (HILDA) survey: wave 1 survey methodology. HILDA project technical paper series. University of Melbourne, Melbourne

  66. Wight RG, Botticello AL, Aneshensel CS (2006) Socioeconomic context, social support, and adolescent mental health: a multilevel investigation. J Youth Adolesc 35:115–126

    Article  Google Scholar 

  67. Wilkinson RG (2005) The impact of inequality. The New Press, New York

    Google Scholar 

  68. Wolman C, Resnick MD, Harris LJ, Blum RW (1994) Emotional well-being among adolescents with and without chronic conditions. J Adolesc Health 15:199–204

    CAS  Article  PubMed  Google Scholar 

  69. World Health Organisation (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. World Health Organization, Geneva

Download references

Acknowledgments

This research was the outcome of the collaboration “Achieving Better Health Outcomes for Youth with Chronic Health Conditions: A Pan Disciplinary Approach”. The collaboration was seed-funded by the Australian Research Alliance for Children and Youth, whose support we greatly appreciate. We would also like to thank the other collaborators for their participation and contributions. This paper uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either FaHCSIA or the Melbourne Institute.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anne Honey.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Honey, A., Emerson, E. & Llewellyn, G. The mental health of young people with disabilities: impact of social conditions. Soc Psychiat Epidemiol 46, 1–10 (2011). https://doi.org/10.1007/s00127-009-0161-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-009-0161-y

Keywords

  • Disability
  • Young people
  • Mental health
  • Social support
  • Financial hardship