confisaludmental

Our study was carried out with a group of residents from an adult care centre who, because of their residency in the centre, have the right to a position in an Occupational Day Centre (ODC). They attend the ODC from Monday to Friday from 9:00am to 5:00pm and return home to the residential care centre which is adjacent, inside the same building. From the very beginning of the quarantine, March 13 2020, a succession of state and regional regulations were directed toward this population, as the COVID-19 situation was evolving.

1. In March 2020, in the most extreme phase of the confinement (total population confinement), the residents of the adult care centre were confined in one large group, in which all residents were permitted to have contact amongst one another. The ODC was closed to everyone inside and outside the residential adult care centre. At this time, having been such an abrupt decision and given the existing general uncertainty, it was decided that certain aspects of the residential care centre would be altered to allow for more flexibility in the timetables (when to wake up and go to sleep, for example), daily activities (organised group activities, like card games, in the dinning hall), and the distribution of men and women, who typically resided on different floors and didn’t coincide during mealtimes, but were now able to interact with a certain degree of freedom. 

2. In May, the residents were divided into fixed groups by floor, meaning residents were only allowed to interact with the other residents pertaining to their specific group. The men occupied one floor, while the women occupied two other floors, one for the older female residents and another separate floor for the younger women. No residents were allowed to access to ODC. This was an major setback compared to the flexibility and the margin of freedom they had enjoyed previously. 3. In June, the residents were allowed to return to the ODC, but only in their fixed living groups, in other words, the men were only permitted to interact among themselves, the older women in their group, and so forth with the younger group of women as well. This only changed the context, so that, instead of being confined to the residential adult care centre, from June on, they were allowed to go to the occupational centre, but again only in their fixed groups without contact from anyone outside of the centre or anyone from the other fixed groups, all while returning to the strict timetables and activities from before the confinement.

4. In November, in the face of new health threats, the residents of the adult care centre lost their access to the ODC for the second time. This time they not only experienced the loss of access to the ODC, but they were also forced to stay in their separated fixed groups and only permitted to interact with the residents from their fixed groups without the possibility to leave the care centre.

5. In January 2021, as the COVID-19 situation improved, the residents were allowed to return to the ODC and the fixed groups were opened up allowing residents to interact with anyone from any of the groups (men and women of any age). 

6. In June 2021, the residents were reunited with their colleagues from the ODC, in other words they were able to see and interact with their colleagues from outside the residential centre, and things began to return to a “new” normal.

7. On July 14, with the outbreak of a new variant of COVID-19, the residents were separated once again into three fixed groups, but they were allowed to continue to attend the ODC. 

• Project Report

impact, quarantine, mental health, adults, intellectual disability

• Asociación Española de Psicologia Clínica y Psicopatología

The present study aims to raise awareness in scientific community of the consequences that a confinement situation can have on a person with Intellectual Functional Diversity (PIFD), specifically on their mental health and support needs. In the beginning, the studies carried out with the neurotypcial population in relation to their mental health and quality life during the quarantine (Brooks et al., 2020; Ribot Reyes et al., 2020) led us to hypothesise, erroneously, that PIFDs, in the most extreme phase of the confinement period, in which the mobility of the entire population was restricted, would present, like the rest of the population, their worst levels of mental and physical health. However, we couldn’t have been further from the truth. The results obtained from the study clearly show that, in this first phase of the confinement period, the well-being of the PIFDs who were confined within the residential care centre (not with their families) had not only shown no signs of deterioration, but rather had shown indications of improvement. These results are completely understandable if we take into account how the resident’s restricted access to difficult information effectively limited their comprehension of the issue at hand and, therefore, making it easier to reduce certain feelings of anxiety and uncertainty that were felt tenfold by those who followed the alarming and contradictory information that was incessantly broadcast and spread via every media platform available. This, along with the opportunity to interact freely amongst themselves and the flexibility in their timetables and obligations, boosted certain dimensions of their quality of life and mental health. However, when the residents were divided into small independent fixed groups, limiting their contact and the space in which they carried out their daily activities, their mental health and quality of life decreased drastically. In vulnerable populations, like PIFDs, a lockdown can induce or increase feelings of loneliness, which, in this case, would have certainly brought on feelings of depression and high levels of anxiety (Bennardi et al. 2019), ultimately contributing to a decline in their quality of life. Also, aligning with the direction we initially had expected, the residents appeared to improve progressively with the relaxation of the health measures and the return to a quasi normality, although not entirely back to pre-pandemic levels. These results seem to align with other investigative reports concerning the general public that echo the psychological aftermath of the quarantine and the global pandemic (Sandín et al, 2020). On the other hand, with respect to the residents’ support needs, the changes in their daily routine and the context in which these changes were made, as well as increased health and safety measures hitherto unheard of, produced, from the start of the pandemic, an increase in the level of required support that did not subside until a situation of greater normality was achieved. Despite this, taking into consideration that this study deals with a collective that faces reality much differently and one in which mental health problems are much more widespread (Vigo et al., 2016), their low levels of quality of life to which their scores digress are worth mentioning, as well as the elevated level of support required for their day-to-day life during the quarantine. All of this goes proves that population with intellectual functional diversity is, in general, more vulnerable to the biopsychosocial impact of diseases and the measures taken to control them (Courtenay, 2020). For this very reason, it will be of vital importance to closely follow their evolution and intervene according to the findings of this study with the aim to alleviate possible consequences that could hinder their vital development and daily abilities.