Question 1(a)

A disability is any condition of the body or mind (impairment) that makes it more difficult for
the person with the condition to do certain activities (activity limitation) and interact with the
world around them (participation restrictions).

Although “people with disabilities” sometimes refers to a single population, this is actually a
diverse group of people with a wide range of needs. Two people with the same type of disability
can be affected in very different ways. Some disabilities may be hidden or not easy to see.

According to the World Health Organization, disability has three dimensions

1. Impairment in a person’s body structure or function, or mental functioning; examples of

impairments include loss of a limb, loss of vision or memory loss.
2. Activity limitation, such as difficulty seeing, hearing, walking, or problem solving.
3. Participation restrictions in normal daily activities, such as working, engaging in social
and recreational activities, and obtaining health care and preventive services.

Disability can be:

 Related to conditions that are present at birth and may affect functions later in life, including
cognition (memory, learning, and understanding), mobility (moving around in the
environment), vision, hearing, behavior, and other areas. These conditions may be
o Disorders in single genes (for example, Duchenne muscular dystrophy);
o Disorders of chromosomes (for example, Down syndrome); and
o The result of the mother’s exposure during pregnancy to infections (for example,
rubella) or substances, such as alcohol or cigarettes.
 Associated with developmental conditions that become apparent during childhood (for
example, autism spectrum disorder and attention-deficit/hyperactivity disorder or ADHD)
 Related to an injury (for example, traumatic brain injury or spinal cord injuryexternal icon).
 Associated with a longstanding condition (for example, diabetes), which can cause a
disability such as vision loss, nerve damage, or limb loss.
 Progressive (for example, muscular dystrophy), static (for example, limb loss), or
intermittent (for example, some forms of multiple sclerosis

Disability and Health Related Conditions

Studies have shown that individuals with disabilities are more likely than people without
disabilities to report:

 Poorer overall health.

 Less access to adequate health care.
 Smoking and physical inactivity.

People with disabilities need health care and health programs for the same reasons anyone else
does to stay well, active, and a part of the community.

Although a smaller percentage than people without disabilities, most people with disabilities
report their health to be good, very good, or excellent. Being healthy means the same thing for all
of us getting and staying well so we can lead full, active lives. That means having the tools and
information to make healthy choices and knowing how to prevent illness. For people with
disabilities, it also means knowing that health problems related to a disability can be treated.
These problems (also called secondary conditions) can include pain, depression, and a greater
risk for certain illnesses.

Secondary Conditions

People with disabilities often are at greater risk for health problems that can be prevented. As a
result of having a specific type of disability, such as a spinal cord injury, spina bifida, or multiple
sclerosisexternal icon, other physical or mental health conditions can occur. Some of these other
health conditions are also called secondary conditions and might include:

Bowel and Bladder

Some disabilities, such as spinal cord injuries, can affect how well a person’s bladder and bowel
works.
Fatigue

Fatigue is a feeling of weariness, tiredness, or lack of energy. Fatigue can affect the way a person
thinks and feels. It can also interfere with a person’s activities of daily living.

Injury

Injuries including unintentional injury, homicide, and suicide—are the leading cause of death for
people 1 through 44 years of age. The consequences of injuries can include physical, emotional,
and financial consequences that can affect the lives of individuals, their families, and society.

Mental Health and Depression

Mental health is how we think, feel, and act as we cope with life. People with disabilities report
higher rates of stress and depression than people without disabilities. There are different ways to
treat depression. Exercise can be effective for some people. Counseling or medication also might
be needed.

Overweight and Obesity

Children and adults with disabilities are less likely to be of healthy weight and more likely to be
obese than children and adults without disabilities. Overweight and obesity can have serious
health consequences for all people.

Pain

Pain is commonly reported by people with many types of disabilities. For some, pain can affect
functioning and activities of daily living. The length of time a person experiences pain can be
classified as either long term (also called chronic) or short term.

Pressure Sores or Ulcers

Pressure ulcers also known as bed sores, pressure sores, or decubitus ulcers—are wounds caused
by constant pressure on the skin. They usually develop on body parts such as the elbow, heel,
hip, shoulder, back, and back of the head.
People with disabilities who are bedridden or use a wheelchair are at risk for developing pressure
sores.

Learning Disabilities

Learning disabilities are disorders that may affect a person’s ability to understand or use spoken
or written language, do mathematical calculations, coordinate movements, or direct attention.
Learning disabilities can be lifelong conditions and some people can have several overlapping
learning disabilities. Other people can have a single, isolated learning problem that has little
effect on their lives.

Musculoskeletal Disorders

Musculoskeletal disorders include problems such as back pain, joint injuries, tendinitis, and
repetitive strain. Musculoskeletal injuries can cause temporary or even permanent disability,
leaving some individuals unable to move around easily. Work-related musculoskeletal disorders
are the leading cause of disability for people during their working years.

Substance Abuse

Alcohol, tobacco, illicit drugs, and prescription medications all can be substances of abuse.
People with disabilities might have multiple risk factors that can increase their chances for
substance abuse.

Violence

Violence is a serious public health problem in Uganda. People with disabilities are 4 to 10 times
more likely to become victims of violence, abuse, or neglect than people without disabilities.
Children with disabilities are more than twice as likely to be physically or sexually abused as
children without disabilities.
Question 1(b)

Therapies for intellectual disabilities and unproven treatments

Various therapeutic services can improve a person's adaptive behavioral skills. These therapies
are helpful for many people with intellectual disabilities (ID, formerly mental retardation).

Occupational therapy

 Meaningful and purposeful activities;

 Self-care (e.g., grooming, dressing, feeding, bathing);
 Employment activities and skills;
 Leisure activities (e.g., knitting, playing games);
 Domestic activities (e.g., cooking, cleaning, laundry).
Speech therapy

 Improves communication skills;

 Improves receptive and expressive languages skills;
 Improves speech articulation;
 Improves vocabulary.
Physical therapy

 Enhances quality of life by maximizing mobility and self-locomotion;

 Provides adaptive solutions to mobility problems;
 Increases sensory integration
Outdated, Unproven 'Treatments' for Intellectual Disabilities
Effective skills training and educational approaches for people with intellectual disabilities (ID,
formerly mental retardation) have already been discussed. These approaches are concrete,
systematic, and straightforward. These evidence-based practices are supported by a large body
scientific research. In this section, we review several so-called 'treatments.' As we have
emphasized, there is no 'treatment' for a disability. At best, some medical treatments are effective
at reducing the symptoms of the conditions causing the disability. Nonetheless, unsubstantiated
claims are made about alternative treatments. There are no reliable research studies to support
claims of effectiveness.

Orthomolecular therapy: We all know diet and nutrition are important for good health. Just
like many other folks, some people with IDs don't eat a healthy diet. In these cases, nutritional
supplements may be beneficial. However, diet and nutritional supplements have not been proven
to enhance cognitive functioning, performance, or learning in individuals with IDs.
Orthomolecular therapy claims vitamins and minerals can treat (reverse) a number of different
conditions including IDs. Proponents of orthomolecular therapy contend that cognitive disorders
can be improved by 'molecular balance' via nutritional supplements. These claims have not been
substantiated using accepted scientific methods.

Medications: Medications are legitimately prescribed when neurocognitive disorders are the
root cause of the disability. Currently, no medication can treat the entire spectrum of disorders
that cause IDs. Nonetheless, the use of "nootropic" medicines (i.e., 'smart drugs') to improve
people's learning abilities is a growing area of interest. At this time, there is insufficient evidence
to suggest that nootropic drugs facilitate learning in persons with IDs.

Talk therapy: Talk therapy refers to psychotherapy. Psychotherapy is useful for many
psychiatric disorders. However, psychotherapy cannot treat, arrest, or cure disabilities. Some
types of psychotherapy may be a helpful adjunct for some people with mild ID, and who have
psychiatric disorder such as depression. Nonetheless, psychotherapies have not proven effective
for people with ID. Such therapies rely on a person's cognitive, emotional, and verbal abilities in
order to promote change. Therefore, people with ID are not good candidates for such therapies.

Genetic manipulations: Someday it may be possible to use genetic manipulations. This area of
research attempts to correct the genetic causes of some IDs. However, this promising area of
research is still in its infancy.

Question 2(a)

Mental Illness
The American Psychiatric Association defines mental illness as a health condition that involves
“changes in emotion, thinking, or behavior or a combination of these.”1 If left untreated, mental
illnesses can have a huge impact on daily living, including your ability to work, care for family,
and relate and interact with others. Similar to having other medical conditions like diabetes or
heart disease, there is no shame in having a mental illness, and support and treatment are
available.

Signs and Symptoms of mental disability

Everyone experiences peaks and valleys in their mental health. A stressful experience, such as
the loss of a loved one, might temporarily diminish your psychological well-being. In general, in
order to meet the criteria for mental illness, your symptoms must cause significant distress or
interfere with your social, occupational, or educational functioning and last for a defined period
of time.

Each disorder has its own set of symptoms that can vary greatly in severity, but common signs of
mental illness in adults and adolescents can include:

 Excessive fear or uneasiness: Feeling afraid, anxious, nervous, or panicked

 Mood changes: Deep sadness, inability to express joy, indifference to situations, feelings
of hopelessness, laughter at inappropriate times for no apparent reason, or thoughts of
suicide

 Problems thinking: Inability to concentrate or problems with memory, thoughts, or

speech that are hard to explain

 Sleep or appetite changes: Sleeping and eating dramatically more or less than usual;
noticeable and rapid weight gain or loss

 Withdrawal: Sitting and doing nothing for long periods of time or dropping out of
previously enjoyed activities

It's important to note that the presence of one or two of these signs alone doesn't mean that you
have a mental illness. But it does indicate that you may need further evaluation.
If you're experiencing several of these symptoms at one time and they're preventing you from
going about your daily life, you should contact a physician or mental health professional.

Question 2(b)

Psychotherapy

Psychotherapy can help treat challenges and symptoms relating to mental health and emotions.

Also known as talk therapy, psychotherapy aims to help a person understand their feelings and
equip them to face new challenges, both in the present and the future.

Psychotherapy is similar to counseling, and the two can overlap. However, the former tends to
look more deeply, addressing the underlying causes of a person’s problems as well as how to
solve them.

To see positive results, a person will usually need to understand the need for change and be
willing to follow the treatment plan as the specialist advises. They will also need to find a
suitable therapist they can trust.

Psychotherapy can help when depression, low self-esteem, addiction, bereavement, or other
factors leave a person feeling overwhelmed. It can also help treat bipolar disorder, schizophrenia,
and certain other mental health conditions.

There are many approaches to psychotherapy.

Some forms last for only a few sessions, while others may continue for months or years,
depending on the person’s needs. Individual sessions usually last for around 45–90 minutes and
follow a structured process.

Sessions may be one-to-one, in pairs, or in groups. Techniques can include talking and other
forms of communication, such as drama, story-telling, or music.

A psychotherapist may be:

 a psychologist
  a marriage and family therapist
 a licensed clinical social worker
 a licensed clinical professional counselor
 a mental health counselor
 a psychiatric nurse practitioner
 a psychoanalyst
 a psychiatrist
Benefits

Psychotherapy can help people in a range of situations. For example, it may benefit someone
who:
 has overwhelming feelings of sadness or helplessness
 feels anxious most of the time
 has difficulty facing everyday challenges or focusing on work or studies
 is using drugs or alcohol in a way that is not healthful
 is at risk of harming themselves or others
 feels that their situation will never improve, despite receiving help from friends and
family
 has experienced an abusive situation
 has a mental health condition, such as schizophrenia, that affects their daily life
Some people attend psychotherapy after a doctor recommends it, but many seek help
independently.

There are several styles of and approaches to psychotherapy. The sections below will outline
these in more detail.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) helps a person understand and change how their thoughts
and behaviors can affect the way they feel and act.

CBT can help people with many issues, including:

  depression
 anxiety
 post-traumatic stress disorder
 eating disorders
 low self-esteem
Interpersonal therapy
Under this approach, a person learns new ways to communicate or express their feelings. It can
help with building and maintaining healthy relationships.

For example, if someone who responds to feeling neglected by getting angry, this may trigger a
negative reaction in others. This can lead to depression and isolation.

The individual will learn to understand and modify their approach to interpersonal problems and
acquire ways of managing them more constructively.

Psychodynamic therapy

Psychodynamic therapy addresses the ways in which past experiences, such as those during
childhood, can impact a person’s current thoughts and behaviors. Often, the person is unaware
that this influence is even present.

Identifying these influences can help people understand the source of feelings such as distress
and anxiety. Once they identify these sources, the psychotherapist can help the person address
them. This can help an individual feel more in control of their life.

It is similar to psychoanalysis but less intense.

Family therapy

Family therapy can provide a safe space for family members to:

 express their views

 explore difficult feelings
 understand each other
 build on existing strengths
  find solutions to problems
This form of psychotherapy can be useful when problems stem from family relationships, or
when a child or young person is facing difficulties.
Relationship therapy is another type of psychotherapy. It is very similar to family therapy, but a
person may instead wish to present to therapy with their partner to address issues within a
relationship.

Group therapy

Group therapy sessions usually involve one therapist and around 5–15 participants with similar
concerns, such as:

 depression
 chronic pain
 substance misuse
The group will usually meet for 1 or 2 hours each week, and individuals may also attend one-on-
one therapy.
People can benefit from interacting with the therapist but also by interacting with others who are
experiencing similar challenges. Group members can also support each other.

Although participating in a group may seem intimidating, it can help people realize that they are
not alone with their problem.

Online therapy

Many people are now opting for online therapy, otherwise known as telehealth. This can have
many benefits, especially for someone who:

 has mobility problems

 cannot find a suitable specialist in their area
 has difficulty fitting therapy into their schedule
 does not feel comfortable with face-to-face communication
Other types

There are many other types of psychotherapy, including:

 animal-assisted therapy
 creative arts therapy
 play therapy
References
Physical Disabilities, California State University, Northridge

"Invisible Disabilities: List & Information" (PDF). Disabled World. October 28, 2015. Retrieved
February 15, 2021.

Stuart H (September 2006). "Mental illness and employment discrimination". Current Opinion in
Psychiatry. 19 (5): 522–6. doi:10.1097/01.yco.0000238482.27270.5d. PMID 16874128.
S2CID 45821626

World Health Organization, World report on disability, 2011.

Reeve, Donna (2002). "Negotiating Psycho-Emotional Dimensions of Disability and their

Influence on Identity Constructions" (PDF). Disability & Society. 17 (5): 493–508.
doi:10.1080/09687590220148487. S2CID 17324956. Retrieved April 19, 2016.

"For many, disability is part of what it means to be human". Financial Times. May 11, 2018.
Retrieved August 14, 2018.