Globally, over a billion people live with a disability. Nearly 80% live in low- and middle-income countries (LMICs). Disability is associated with lower educational attainment, lower employment rates, and limited access to health services. The United Nations’ Convention on the Rights of Persons with Disabilities (UNCRPD) is a landmark global treaty, that came into force in May 2008, to realise the rights of persons with disabilities. The UNCRPD brought a paradigm shift in recognising the need to address barriers affecting persons with disabilities across all spheres of life. The purpose of the Convention, as stated in Article 1, is “to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.” However, despite development in some areas, persons with disabilities continue to experience numerous barriers to their full inclusion and participation, especially in LMICs. In this brief, we reflect on literature reviewed across the Disability Evidence Portal to summarise the core principles that need to be considered in the formulation and implementation of policies and programmes that promote inclusion of persons with disabilities in LMICs.

Parents play a pivotal role in facilitating childhood development and healthcare access for children with disabilities. However, these carers need support to achieve maximum social inclusion and functioning in their communities. In addition to the usual parenting demands, parents of children with disabilities often take on complex care tasks while having to balance other aspects of family life and work commitments. As a result, they may experience additional stresses that may impact on their well-being. However, these effects may be resolved if caregivers are provided with appropriate psychological interventions.

Evidence shows that people with physical, sensory and/or intellectual disabilities (herein referred to as ‘people with disabilities’) are at higher risk of mental health conditions. This may be due to a range of personal, social and economic factors, for example, difficulties in activities and functioning and barriers to social and economic participation experienced by people with disabilities. People with disabilities are also more likely to experience violence, abuse and discrimination, major risk factors for mental health conditions. There is some evidence, mainly from high income countries (HICs), of effective mental health interventions for people with disabilities; including accessible mainstream mental health services and interventions developed/adapted for specific impairment types. However, people with disabilities can face a range of barriers accessing mental health interventions, especially in low- and middle-income countries (LMICs) where mental health services and personnel are sparse. There is increasing evidence around the effectiveness of mental health intervention models in LMICs, including stepped-care and task-shifting programmes, however there is limited information about how to make them disability-inclusive. 

This evidence brief explores what we know about how to improve access to mental health care for people with disabilities in low-resource settings.

Globally, there are 108 million people living with intellectual and development disabilities (IDD). Evidence repeatedly shows that people with IDD are more likely to experience co-morbidities, yet tend to face several barriers to access health care services. This has resulted in a widespread health inequality, with evidence from high-income countries indicating that people with IDD live on average 20 years less compared to those without intellectual disabilities. It is clear that people with IDD are also at substantially higher mortality risk from COVID-19, particularly people with Down Syndrome. The global COVID-19 pandemic has also contributed to further challenges to the physical and mental well-being among people with IDD as well as people with disabilities in general. In this brief, we have summarised the current evidence on strategies that would facilitate the safety and well-being of people with IDD.