COVlD-19, stigma, and people with disabilities: A mental health perspective

Raktim Swarnakar, Shreya Santra

Raktim Swarnakar, Department ofPhysical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India

Shreya Santra, R. G. Kar Medical College and Hospital, Kolkata 700004, India

Abstract Discrimination is an age-old ‘illness’ irrespective of its context. Stigma is a common factor that has been associated with disability and coronavirus disease 2019. The public health impact of stigma on differently-abled people during this pandemic is not known and it is a poorly investigated and neglected area. It is important to address the current research need in the concerned area and its implications for public health policymaking and changes in practices that it requires. Together we can win the war against pandemics if we reduce the mental distancing in all perspectives.

Key Words: COVID-19; Stigma; Disability; Mental health; Public health

TO THE EDlTOR

“Viruses do not discriminate and neither should we”[1].

Jack Zipes write of the forest in this tale, the forest, or the great wide world, is the domain83 where the tailor is given a chance to change and where his fate is decided84 (Brothers, 86-87)

Globally, coronavirus disease 2019 (COVID-19) has become a public health emergency. In such crisis,rumors, misinformation, fear, and lack of proper public health awareness make fertile soil for the stigma to grow incessantly[2]. Unfortunately, from historical ages to the modern era, infectious diseases and disabilities are independently associated with the social stigma. COVID-19 has already made a negative impact on mental health and stigma has just aggravated it. It is well known that people with disabilities face discrimination and stigma in different spheres of life and such a pandemic situation resulted in greater difficulty in individuals with disabilities than the able-bodied population.

Stigma invariably leads to concealment of COVID-19 symptoms and delayed treatment, which leads to greater dissemination of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among the public. Many disabling conditions like people with spinal cord injury are particularly vulnerable to SARS-CoV-2 infection. People with disabilities already had physical barriers[3], but the pandemic has added mental and attitudinal barriers due to social stigma. In the context of pandemic crisis, such social stigma severely affects the mental health of people with disabilities. COVID-19 already has hampered social participation due to social distancing and has limited functional involvement due to home confinement and lockdown[4]. Moreover, vaccine inequity may also create further issues which need attention beforehand[5]. Furthermore, social stigma becomes an extra hindrance for better functionality and participation of these populations.

He stood there for a long time, until he heard her moving quietly. He found her sitting on the edge of their bed, her head bent, her hands gripping the mattress76.

Author contributions:Swarnakar R contributed to conception and design; Swarnakar R and Santra S contributed to literature search and writing.

We, healthcare professionals from every domain, should keep closer surveillance so that the physical distancing does not become a mental distancing.

Currently, COVID-19 is known to be associated with stigma. Previously, it was known that disability is also associated with stigma.

Worldwide COVID-19 cases crossed 336 million, and the population with disability crossed one billion[6,7]. Putting this situation in the public and mental health perspective, COVID-19 has set a newnormal life whereas people with disabilities lead a new-normal life with different ability, and eradicating social stigma from this ‘new-normal life’ is each and everyone’s responsibility.

What is the current understanding of this topic?

15. None of them suited her: Snow White s eating of the food, testing of the beds, and discovery by the dwarfs is similar to Goldilocks trespassing upon the Three Bears, albeit with different results. HAHReturn to place in story.

What does this Letter-to-Editor add to the literature?

Open-Access:This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

What are the implications for mental health practice?

This letter would address the current research need in the concerned area and this would have implications for public health policymaking and changes in practices that it needs.

FOOTNOTES

Social stigma in the context of mental health not only damages its victim but becomes also detrimental to the whole public health domain. Social stigma among individuals with disabilities during a pandemic can be prevented by: (1) Public health awareness program through proper information,education, and communication; (2) breaking the misconceptions about COVID-19; (3) considering people with disabilities as differently-abled; (4) improving provision of telerehabilitation emphasizing psychiatric telerehabilitation during the pandemic; (5) identifying barriers and planning to overcome them; and (6) online social-engagement, peer-group formation, and motivational sessions to boost morale and improve the mental well-being of individuals with special needs and disabilities.

ORClD number:Raktim Swarnakar 0000-0002-7221-2825; Shreya Santra 0000-0002-6754-2694.

The public health impact of stigma on differently-abled people during the COVID-19 pandemic is not known and is a poorly investigated area currently.

Country/Territory of origin:India

Conflict-of-interest statement:Raktim Swarnakar and Shreya Santra declare no conflicts of interest for this letter.

S-Editor:Wang LL

One day, a letter regarding6 a school reunion came to my house. Lying to my wife that I was going on a business trip, I went back to participate in the reunion. After the reunion, I went down to the old shack7, which I used to call a house, just out of curiosity8. There I found my mom fallen on the cold ground. I did not shed4 a single tear.

My mother, at the time, was not even aware that I was interested in writing, or if she had somehow found out about it, she took little notice. When I arrived back home tat evening, she didn’t ask how the evening had gone. I placed the one-hundred-dollar check on the breakfast table where she would see it when she awoke in the morning -- and went immediately to bed.

L-Editor:Wang TQ

P-Editor:Wang LL