Yes, Intellectually Disabled People Have the Wherewithal to Be Depressed

About 10 years ago, I was talking to a family member of an adult with an intellectual/developmental disability (IDD) who had just been diagnosed with major depressive disorder (MDD). They expressed surprise at this diagnosis, and I explained that IDD adults are more likely than the general population to experience depression. The individual looked at me and stated, “Oh, I didn’t know they had the wherewithal to be depressed.”

This statement stuck with me as it came from someone who truly cared for their disabled family member, but who had missed their significant signs of emotional distress.

More recently, I was speaking with a colleague who completes service eligibility assessments for the IDD community. I asked how often they connected people to mental health services. They told me that they always ask, but most family members laugh off the question and say that the person being assessed “doesn’t have the wherewithal to benefit from mental health therapy.” I walked away from that conversation, feeling deeply disappointed that after 10 years, this was still the attitude towards the IDD community receiving mental health services. I was also struck by the repeated use of the word “wherewithal,” being used to discuss this topic.

What Do They Mean by "Wherewithal?"

The definition of wherewithal is means or resources. When people use this word to describe human beings and their mental health, they mean that the person doesn’t have the intellectual means or resources to struggle with their mental health or to benefit from mental health treatment. As someone who has supported the IDD community for two decades, I am still taken aback by the ableism they face.

Contributing Factors to Higher Rates of Mental Health Struggles

The IDD community has plenty of reasons that they may struggle with heir mental health:

• Adults with IDD are more likely to live in poverty. They are often on SSI, meaning that they receive a little monthly income, but are limited in how much they can make and save. Those who have jobs are usually paid minimum wage, or subminimum wage, which is legal in the United States.
• Many are unable to live independently. If they cannot or do not want to live with family, they often have to have caregivers. Caregivers are often underpaid and undertrained, which causes a host of issues. They also usually have to live with a roommate because they cannot afford to pay for housing on their own. This often means living with another disabled adult whom they may not like or get along with.
• This community is socially isolated. They often cannot drive, so are dependent on others to take them places. This makes it difficult to be social, make friends, or find romantic partners. Often, the only people they interact with are family members or paid caregivers.
• Some IDD adults are not their own guardians. What this means depends on the person’s state of residence. I have practiced in at least one state where guardianship essentially means that in the eyes of the law, they are children and have little right to self-determination.
• The IDD population often has complex physical health needs that exacerbate poor mental health.
• The community experiences higher rates of abuse, are more likely to be involved in the legal system, are more likely to have their children removed by social services, and generally experience a host of other adverse experiences.

I could go on listing stressors that IDD adults face, but will suffice it to say that a person does not need a high IQ to be distressed by any of these situations.

Over the years, my clients have made it clear that they notice they are poor or have no real career, that they are alone, that they have little chance to get married, have a family, or live independently, that they have little right to self-determination, that they have chronic pain or other health issues, and that they are mistreated and undervalued by most of society.

It does not take a lot of “wherewithal” to look around and notice that your life is not great.

Two women enjoying a relaxed conversation on a sofa in a bright room filled with plants

Source: Cliff Booth / Pexels

Intellectually Disabled People Should Not Be Kept From Accessing Treatment

As for whether this population can benefit from mental health therapy, there are a lot of factors to consider. It is important to find a therapist who has some competency and who uses therapy interventions that are made specifically for this population. This is a potential barrier to quality mental health care as there is a lack of training for professionals in mental health programs, and there are few available resources created specifically to treat this community. However, just because it may be difficult to find resources and quality mental healthcare does not mean that there are no resources out there.

IDD youth and adults have higher rates of mental health struggles than the general population and at minimum, should be given the opportunity to at least try therapy. I cannot think of any other group that is kept from accessing or even trying mental health therapy, however we as a society routinely use someone’s IQ score to do just that.

Maybe it is not the IDD community that does not have the wherewithal, i.e. the means and resources here. Maybe it is society. If so, it’s time for society to put aside the ableism and do better.

To find a therapist, visit the Psychology Today Therapy Directory.