Incorporate psychiatric impairments into IADLs
Recommendation
Congress should require the Assistant Secretary for Planning and Evaluation (ASPE) within the U.S. Department of Health and Human Services (HHS) to work with mental health stakeholders to examine how instrumental activities of daily living (IADLs) could incorporate psychiatric impairments.[1]
Background/summary
Instrumental Activities of Daily Living (IADLs) are the activities we do every day to maintain an independent lifestyle and are a crucial tool for assessing and ensuring quality of life.[2] They include cooking, cleaning, transportation, laundry, and financial management.[3] IADLs are traditionally closely associated with Activities of Daily Living (ADLs) which are concerned with basic self-care skills such as eating, bathing, and mobility; and both are used by occupational therapists to determine the balance of independence and support a person needs when recovering from a physical or cognitive injury, or older adults facing physical or cognitive decline.[3] While IADLs are assessed for all hospitalized patients, individuals with a mental health or substance use disorder (MH/SUD) may experience challenges beyond IADLs. MH/SUDs can impair a person’s ability to make and hold appointments, shop for basic necessities, and other activities that impact quality of life. Additionally, their IADLs may never be assessed if they are never hospitalized. Those experiencing MH/SUD could benefit from the support IADL assessments and support services offer.
citations
1. CEO Alliance for Mental Health. A Unified Vision for Transforming Mental Health and Substance Use Care. Last Updated August 2022.
2. Kaiser Permanente. Learning About Instrumental Activities of Daily Living (IADLs). Last Updated February 27, 2023.
3. Hui Jun Guo, Amit Sapra. “Instrumental Activities of Daily Living.” National Institutes of Health, National Library of Medicine, National Center for Biotechnology Information. Last Updated November 14, 2022.