Abstract
BackgroundDepression and anxiety are highly prevalent, but often unrecognized in adults with vision impairment (VI) or blindness. The purpose of this study was to explore visually impaired and blind adults’ views on facilitators and barriers in recognizing and discussing mental health problems.MethodsSemi-structured interviews, based on the Integrated Model for Change, were conducted with 16 visually impaired or blind adults receiving support from three Dutch low vision service organizations. Interview data was analyzed using the framework approach.ResultsParticipants perceived their focus on practical support with regard to their VI, lack of mental health literacy, and misattribution of symptoms of depression or anxiety as barriers for recognizing mental health problems. With regard to discussing mental health problems, they perceived difficulties in acknowledging their VI and mental health problems due to feelings of vulnerability and inequality. Participants mentioned that their social support system and healthcare providers (could) facilitate them in recognizing and discussing mental health problems. However, participants thought that healthcare providers currently often lacked the knowledge, skills and attitude to recognize and discuss this topic with their clients.ConclusionOur findings suggest that visually impaired and blind adults may experience several barriers to recognize, acknowledge and discuss mental health. Healthcare providers and social support systems seem essential for them in reducing these barriers. However, there might be a mismatch between the needs of visually impaired and blind adults and healthcare providers’ knowledge, skills and attitude. Training healthcare providers may improve detection of depression and anxiety in adults with VI or blindness, and enhance clinician-patient communication on mental health.
Highlights
Current estimates of people who are blind or have moderate or severe vision impairment, are around 338 million, and are expected to increase to 535 million people by the year 2050 [1]
Two domains were added based on the input that was gathered: (5) social support system and (6) healthcare provider’s role
Our findings showed that an active problem solving coping strategy seemed to assist visually impaired and blind adults in being able to discuss symptoms with a healthcare provider
Summary
Current estimates of people who are blind or have moderate or severe vision impairment, are around 338 million, and are expected to increase to 535 million people by the year 2050 [1]. One in three experience subthreshold symptoms of depression and/or anxiety [2,3,4,5], indicating clinically significant symptoms but no actual disorder Based on these prevalence estimates, approximately 100,000 visually impaired or blind adults living in the Netherlands experience subthreshold depression and/or anxiety [6, 7]. These prevalence estimates are significantly higher compared to the general population [2]. In visually impaired and blind adults, having (subthreshold) depression can lead to decreased healthrelated and vision-related quality of life and visual functioning [8]. The purpose of this study was to explore visually impaired and blind adults’ views on facilitators and barriers in recognizing and discussing mental health problems
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