What Makes the Difference in People's Lives When They Have a Mental Disorder?

Int J Public Health. 2018 Jan;63(1):57-67. doi: 10.1007/s00038-017-1047-5. Epub 2017 Nov 25.


Objectives: The objective of this study was to identify which environmental factors are the most responsible for the disability experienced by persons with mental disorders and whether they differ (1) from those in cardiovascular diseases, chronic respiratory conditions, diabetes, and cancer, and (2) depending on the capacity level-a proxy for the impact of health conditions on the health state of individuals.

Methods: Nationally representative data from 12,265 adults in Chile collected in 2015 with the WHO Model Disability Survey was analyzed.

Results: The availability of personal assistance, frequency of receiving personal assistance, and assistive devices for mobility were the most important environmental factors across mental and other non-communicable diseases. Perception of discrimination and use of health services were also prominent factors. There was a huge overlap between the factors found relevant for mental and other non-communicable diseases, but a substantial variability depending on the intensity of difficulties in capacity.

Conclusions: This study challenges the appropriateness of disease-specific approaches and suggests that considering intrinsic capacity levels is more informative than focusing on diagnosis alone when comparing needs and barriers that affect the performance in daily life of specific groups of individuals.

Keywords: Disability, public health; Environmental health; Mental health; Non-communicable disease.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Chile / epidemiology
  • Disabled Persons / psychology*
  • Disabled Persons / statistics & numerical data
  • Environmental Health*
  • Female
  • Health Services Accessibility
  • Health Services Needs and Demand
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Noncommunicable Diseases / epidemiology
  • Surveys and Questionnaires