A study published in JAMA Network Open reported that adults with intellectual and developmental disabilities (IDD), including autism and Down syndrome, experience significantly higher rates of anxiety and depression compared to the general adult population. The research provides national estimates on mental health symptom prevalence, treatment, and access barriers for this demographic, based on data from 44,000 adults, identifying 796 with likely IDD. This group represents approximately 2.9 million Americans.
Key Findings
The study utilized 2021-2023 data from the U.S. National Center for Health Statistics' National Health Interview Survey. Key findings reveal stark disparities in mental health outcomes and access to care for adults with IDD.
Adults with IDD were nine times more likely to report a diagnosis of anxiety (56.8% compared to 10.6% in the general population) and depression (56.9% compared to 9.9%).
Daily symptom frequency was also elevated, with nearly half (48.9%) of IDD adults experiencing daily anxiety, versus 7.7% of the general population. Similarly, 24.2% of IDD adults experienced daily depression, compared to just 1.3% in the general population.
Regarding treatment, 40% of IDD adults reported receiving counseling or psychotherapy in the past year. During the same period, 40% reported using psychiatric medication for anxiety, and 37% for depression. The authors noted these patterns indicate a greater reliance on medication over counseling.
Cost-related barriers were significantly more prevalent for IDD adults. They were five times more likely to delay therapy due to expense (17.4% versus 3.4%) and to forgo mental health care entirely because of cost (18.6% versus 3.2%).
Senior author Dr. Dimitri Christakis stated that "having insurance, such as Medicaid, does not always translate to access," citing out-of-pocket costs and difficulty in finding providers.
Recommendations
The findings highlight systemic gaps in healthcare for adults with IDD, who have an average lifespan 10 to 20 years shorter than their peers. The study's authors recommend several actions to address these critical issues:
- Increasing Medicaid reimbursement rates for mental health practitioners serving individuals with IDD.
- Integrating disability status into routine public health surveillance.
- Expanding training programs for disability-informed mental health care.
Dr. Christakis underscored the severity of the situation, mentioning that a mental health crisis is affecting people with intellectual and developmental disabilities, similar to the one confronting U.S. teenagers.
"A mental health crisis is affecting people with intellectual and developmental disabilities, similar to the one confronting U.S. teenagers."
The paper's lead author is Anthony Osuna, a clinical psychologist at the UW School of Medicine. The Special Olympics funded the study through grants from the Centers for Health Statistics and other organizations.