Confinement due to coronavirus: People with autism and other mental problems can leave home

What happens to people with autism spectrum disorders (ASD) or other problems when they stay home for so many days? The Government has changed the confinement restrictions for them. Who and how can get out?

Since the Government decreed the state of alarm and confinement at home on March 14, associations of people affected by autism and other mental illnesses, began to convey concern about the effects that this isolation can have on many of the patients. And the requests and negotiations with the Ministry of Social Rights and the Ministry of Health also began to allow people who present behavioral alterations and disruptive behaviors to go out on the street with a therapeutic nature.

Today the Autism Spain Confederation (which includes more than 70 associations) and the CERMI (Spanish Committee of Representatives of People with Disabilities) have seen how the article of this decree was modified, which now allows all these people to circulate on the street, always and when the necessary measures to avoid contagion are respected. And they value this measure very positively, “which will undoubtedly help improve the quality of life of people with ASD and their families.” This is what Raquel Valle, Responsible for Rights and Good Practices of the Autism Spain Confederation points out.

WHY DOES BEING AT HOME AFFECT THEM SO MUCH?

According to the psychotherapist Mª José Muñoz, for people, especially children, who suffer from an autism spectrum disorder (ASD), movement is vital. “They need movement as much or more than the air they breathe! And it is not vital in a metaphorical sense, but literally: these people, faced with continuous frustration, can attack themselves, hitting themselves, throwing things at themselves, or attack those who they surround him. They can turn and turn and turn, making circles, to the despair of themselves and those around them. ”

The psychotherapist also clarifies that we are not talking about childhood tantrums in which we can explain to them that they cannot go out, and invent stories or stratagems to change the subject and convince them with other games or activities. Many times, when you try to explain something to them, they automatically put their hands on their ears because they neither can nor want to hear anything that is said to them.

Obviously we will find degrees but, “if we modify their rituals, question them or force them to perform them in another order, that floods them with anguish and uneasiness that will end in self-harm or strongly disturbing reactions.”

HOW DOES IT AFFECT THEM?

The technical director of Autismo España, Ruth Vidriales, explained to us how confinement and changing routines can affect people with autism spectrum disorder (ASD):

• They may experience high levels of stress and anxiety.
• Manifest an increase in oppositional and defiant behaviors that lead to contravening the established measures (for example, insisting on leaving home to go to their educational center or day care service, even though they know that it is closed).
• Present significant self-regulation difficulties, which cause an increase or intensification of self and / or hetero aggressions to family members or main support figures.
• Experiencing a worsening of comorbid mental health conditions (anxiety, depression, suicidal thoughts), which may put their physical integrity at risk, especially of those who live alone or have a reduced circle of support.

It is important to note that this situation affects not only people with ASD themselves but also their relatives and close people with whom they live who can also:

• Experiencing high levels of stress, distress, and anxiety.
• Present feelings of hopelessness and lack of control of the situation.
• Experience significant difficulties in managing the family situation and the behavior of your family member with ASD.
• Present significant difficulties in reconciling the situation of staying at home with their work activity, including teleworking.

WHO ELSE DOES IT AFFECT?

Within the ASD we find, in addition to people with autistic autism, those who suffer from Asperger”s Syndrome, whose characteristics are somewhat different, but still have similar traits. Mª José tells us that their worlds are absolutely rigid and orderly: “Within them everything has to fit together and if any element fails, their fury is unleashed towards what they are doing, towards themselves, or towards objects. They are calm and sociable while that their rhythm, space and time are not touched. ”

In another order of pathologies we can find people who suffer from OCD, an obsessive compulsive disorder, whose compulsion, for example, is to walk and count lines, go down and climb steps, etc. “Having them confined would unbalance them mentally, since for them it is a way of mitigating the anxiety they feel if they do not do these ceremonials, which could create mental crises that require psychiatric hospitalization.”

DO YOU NEED AUTHORIZATION TO GO OUT?

Although measures have not been dictated at the moment on whether it is necessary to have some type of accreditation , from the Confederación Autismo España and the CERMI (Spanish Committee of Representatives of People with Disabilities) recommend taking (if they have) these documents:

• The official certificate of recognition of Disability. In the case of having a recognized disability.
• Prescription of a health or social professional. In the case of having it.
• Copy of the Instruction of March 19, 2020, of the Ministry of Health, which establishes interpretive criteria for the management of the health crisis situation caused by COVID-19.
• Complementary medical, psychological or social reports describing individual needs and / or the existence of behavioral difficulties. In the case of having them.

LET TAKE SPECIAL CARE OF THEM

In general, we could say that any psychological disorder or disability can be aggravated by confinement since, for many of these people, going out, being distracted and not thinking about the problems that concern them, are mechanisms for not sinking.

But the psychotherapist Mª José Muñoz tells us more: “Let”s think about hypochondriacs who, normally, are all the time imagining that their pains are mortal. Or about how the paranoid feel, whose pathology leads them to think that the whole universe is conspired against them, when they hear a lot of theories about the origin of this virus. If these people also feel watched and restricted in their movements, the possibilities of crisis will multiply. ”

There is no doubt that all these groups have professionals who treat them and who can monitor them, but if we also find political-social measures that help mitigate these exceptional situations, they will also help to prevent the mental consequences of citizens from being become unlivable and irreparable.

Raquel Valle, points out that it is essential that we become aware of the right of these people with behavioral disorders such as the TEA, and of their companions, to be able to circulate exceptionally and due to force majeure on public roads. And so the reprimands and insults that they are receiving for the fact of going out to the streets during these days cease.

It also demands that the professionals of the day and care centers be provided with the appropriate material so that they can carry out their work without fear for their safety. And that the rights and special care of these patients are respected in cases of hospitalization, taking measures to preserve the emotional and physical well-being of people with ASD and the professionals who care for them, assessing the possibility that they are accompanied by higher force.