Gooty Shirisha : Mental Health and Well-being of the Student with Disabilities

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Title: Gooty Shirisha : Mental Health and Well-being of the Student with Disabilities
extracted text: 2022-23
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Community Health Learning Programme

Gooty shirisha

A Report on the Community Health Learning Experience

School of Public Health Equity and Action
(SOPHEA)

Society for Community Health Awareness Research and Action
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ACKNOWLEDGEMENT
I would like to express my special thanks to my parents who supported me in the
entire Journey of my fellowship in sochara. My sincere gratitude to my mentors
Karthik and Uma for valuable Guidance and mentorship throughout my journey.
I would like to thank all the CHLP Team who were part of my journey from the
beginning to till date Thanks for taking all the time and helping fellows and being
as a constant support. I would like to thank all my facilitators and fellows who
made my learning journey fruitful. I would like to thank my Project team member
Sriram for his support and contribution to the Project. I would like to thank my
stake holders and students who have participated in the Project and made it
successful. A big thank you to all of them and always greatful for the Amazing
Learning Experience which have laid a strong foundation about knowledge in
Community health .

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TITLE

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01

Acknowledgement

01

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Part A: CHLP Learning Report

04-08

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Part B: CHLP Community Based Health Action
Reflection Project report

09-17

04

Photographs

18

05

Reerences

19

06

Annexures

20-23

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CHLP JOURNEY:
Looking Human health problems at Lab Microscope point of view dealing with
Human Malignant Tissues every day has created an interest in community health
to look at Problems faced by Humans in Real life. It led me to Pursue My Masters
in Public health. During My Post Graduation in Public health. I understood the
importance of community health and how crucial it is to have an understanding
of community health Problems and people ideas and Beliefs towards Health care.
It has given me a better understanding about Indian health care system. Personal
experience during COVID 19 and Learnings from my post-graduation in public
health Prompted me not just want to sit back and see things happening without
doing anything. I really wanted to be a key part in attempting to change the world
in a better way and saving many lives.
Then I started searching about how I can build my foundation in community
health through Google search engine I got to know about Sochara unique learning
program with a motto Health for all. Then I went through sochara official website
the past projects done by sochara in Karnataka and various states were Extremely
good, Then I decided I’m at the right place this fellowship will give me
multidimensional perspective about health care and will give me a strong
foundation about community health.This inspired me to know more about
community health and I have been a Part of SOCHARA Learning Programme
which taught me more about community health i have applied for fellowship I
got selected and today here I’m writing my report at the End of my fellowship
Honestly from bottom of my heart Joining this fellowship was the best decision I
have ever made. This 9 month fellowship has completely transformed me into a
better person both professionally and personally. My learning objective of chlp
program was have better understanding of health for deeper and more meaningful
work.

MY AREA OF INTERESTS WERE:







Mental health
Women health
Communicable diseases
Disability
Non communicable diseases
Urban Health

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MY PERSONAL LEARNING OBJECTIVES OF CHLP:
 To understand the concept of community as a whole and knowledge about
community in Health Perspective.
 To know about Indian health care system
 To Understand the Importance of social determinants in health and how does
social determinants play a key role in health.
 To develop an understanding about mental health and how can we promote
mental health and well -being in India.
 To gain knowledge about Project management, Proposal writing, Fund
raising.
 To develop skills to work with community and learn about various community
health Approaches.

My CHLP journey was an Eye opener addressing various aspects affecting health.
My learning objectives were fulfilled it gave me a multidimensional perspective
towards Indian health care system. It taught me various aspects of the community
and community health is an approach where the community comes together and take
responsibility for their own health in a shared manner. Role of Public health
Specialist becomes important as the point of contact with the community is not just
creating awareness but also as an agent of change.
Every module what we have been taught is very uniquely and systematically
designed. Each module has a take away message. First few modules have laid strong
basic foundations of community health and gave me a broader picture of community
health .social determinant of health module has a given in-depth understanding and
best part of this module is SEPCE analysis very beautifully explained with real life
examples. Best part of my learning experience in sochara was facilitators teach us
with real life examples. Some of my favourite modules were comprehensive health
care, women’s health and mental health .Mental health module was extremely good
it started with basics and gave us a complete picture of mental health. We had even
a demonstration of counselling process. Some assignments were extremely helpful
one of the assignment given to us a visit a nearby hospital and have a look at waste
management process and note it down. This assignment taught me importance of
waste management and what the real situation in hospitals is and I will never forget
which bin to discard which waste because first we have been taught what waste
management in the class is and then we have real life experience in the hospital. This
assignment helped in my real job experience also .Additional learning materials
shared are very helpful I really thank to the team and facilitators who have shared it.
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Additional learning material and video lectures have really help me a lot in my
Professional career and even in the competitive exam. CHLP journey taught me how
to balance between studies and work life. The initial days of my journey in CHLP
was very tough I was in my last semester of MPH I couldn’t balance out things very
well .Later on LMS helped me a lot it has all live sessions recorded we can go
through every module in our own self-paced learning mode. Most of my weekends
were very productive I use to cover whatever I have missed. Live sessions were the
best part of this entire journey we get an opportunity to interact with facilitators and
fellow’s questions were very interesting. Learning management system used in
sochara is very friendly we have a mobile based app moodle we can access all the
content from mobile. This helped me a lot. Some of the best unique things about
sochara were all the fellows and facilitators were very friendly and everyone were
treated like friends. I think in India sochara is the only place where we don’t use the
word sir or mam irrespective of age academic qualification everyone were like
friends and people are very humble I feel fortunate to be a part and have an
opportunity to learn with various background group of people .one more unique
feature of sochara they encourage fellows to participate and speak in their own
language if any fellow faces any challenge to express it in English they are
encouraged to speak in their own mother tongue or whichever language they are
comfortable.
Mentorship program in chlp was very helpful any doubt or any help mentor played
a key role in my journey. My journey in chlp wouldn’t be smooth without Uma and
Karthik they played a key role whenever I need a help they are just a message far
away.my initial mentor Uma taught me more about c wash she use to share her
experience with c wash projects and various projects she was involved. She taught
me how to balance between work life and studies. When Uma left Karthik has been
assigned as my mentor very fortunate to work under his guidance. He gave me an
outline of disability and shared his rich work experience in field. All the inputs
whatever he has given helped me to finalize the project .one quality I learned from
my mentor Karthik sir is he welcomes all kind of opinions and ideas and addresses
them with all the patience. Initially I was very confused about my Project work how
to do a community health action Reflection Project and how to Approach community
Karthik sir have simplified it he shared his experiences with the community I don’t
have any experience in working with Persons with Disabilities earlier. My mentor is
the one who taught me about it and gave a clear picture. Even the Module learning
have Played a key-role in Understanding and working with the Project.
my major take away message from chlp learning program is whatever we have learnt
about the community if we apply it in real life situations in a small community we
can see major changes in health and wellbeing of community and we will be a step
forward towards our common goal health for all.
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MODULE LEARNINGS AND REFLECTIONS:
CHLP is a unique learning program which laid strong foundation about
community and health in over a Period of nine months. Modules that interested
me the most were mental health, Women’s health, Nutrition, Comprehensive
health care, biomedical waste management. When working with marginalized
communities My learning from Social determinants of health module played a
key role .How social determinants of health poverty education and many other
determinants played a key role in health care access utilization in the community
.Community health Approach module opened up new horizons and created a rich
experience in the chlp learning program. Many modules gave me a concept of
health as a holistic concept like family structure, culture, attitude Socioeconomic
status were equally important .My learning from Mental health module has been
a ice breaker for many myths it gave me insights about mental health care access
and it taught me about various mental health programmes in India and community
mental health programs. As a Public health professional when I’m working in any
mental health program all the learnings from CHLP mental health module would
help me a lot. We had a Demonstration of counselling session during our live
session .Facilitator taught us in a very simplistic manner .During 1 St and 2nd wave
of COVID 19 I realized importance of mental health and how important it is to
make people aware about mental health problems my major take away from this
module seek mental health care when in need of it Mental health matters. I
understood the ground reality of community and their perceptions towards mental
health care. I have been able to work on my emotions and maintain balance of
family & Education, career and to lead a happy life. I got a better understanding
about empathy, to be patient listener to develop an optimistic attitude. I started
talking about mental health and wellbeing importance to my own family members
and my own friends. Community health module gave me insight about tribal
culture and development of health care in Tribal areas. As a working public health
professional I consider it very important to work with marginalised communities
and vulnerable population. Videos and additional learning material have shed
light about tribal culture in India and how important it is to address and upbring
the community. One video shared in this module about courage and motivation
of Tribal women Pushpa forming self-help groups and banning the License to sell
alcohol was very Inspiring .One strong decision taken by one women in the
community have helped and saved many lives in the community. Looking
community through community health lens health promotion and health
education awareness need to be emphasized as well as presence of community
health workers to empower the community and make them aware about their
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rights and Responsibilities towards their health as a first step. Women’s health
module has given a picture of women’s health status in India it taught me
differences between gender and sex and throwed light on women’s health and
various diseases women face and reasons behind it .I have a strong intuition
towards women welfare and women empowerment since my college days. This
module showed how can we work towards women health and make them lead a
better healthier happy life. I’m shocked by seeing Indian tuberculosis statistics
it’s very crucial to know as a budding public health professional. Waste disposal
has been beautifully taught with assignment it had impacted me a lot every health
care Professional must be aware of it. Lack of knowledge about disposal of
biomedical waste leads to problem. As a Health care Professional this module
made me perfect in discarding waste in Appropriate Bin. If I want to discard
Plastic my brain tells go to Red Bin – Thanks to facilitator for making us very
clear with assignment. Axioms of community health gave me an outline of
Importance of community health Approach in the Health care and ideas to How
can we Implement it through Simple steps. Due to Globalization and Rapid
transition due to Advancement of technologies, Life style practices Non
communicable disease burden has increased drastically NCD Module Taught me
how can we reduce the non-communicable disease burden how can we practice
healthy living and avoid Palliative care has taught me psychological aspects of
pain social aspects of Pain, spiritual aspects of pain, how can Pain management
be done and End of Life care Process Before Joining sochara I had no clue about
Palliative care but after learning from this module I understood what is Palliative
care how important it is. Nutrition module taught me importance of nutrition for
health it plays a key role in maintaining good health in New born child to older
Adult. It is very essential to eat good nutritious rich food. According to World
health organization todays generation are having high Prevalence of Obesity and
Prone to NCDS at very young age due to eating Processed foods containing high
sugar content, Addicting to Junk Excessive eating pattern due to life style changes
.This Module has hit on the nail focusing on importance of vitamins minerals
carbohydrates and various diseases related to nutrition. Women are prone to
higher rates of malnutrition and anaemia in India due to lack of Proper Nutrition.
This module have impacted a major change in my eating patterns I make sure my
plate is green with leafy vegetables I prefer home cooked food avoided eating
Junk and eating in a right manner. Project management, Proposal writing and
Fund raising modules will be extremely helpful in my research career it taught
me an simplistic art of how beautifully to write a Proposal with key focus.

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COMMUNITY HEALTH ACTION REFLECTION PROJECT
TITLE:
Mental health and well-being of the students with disabilities: Barriers to
accessible and inclusive education at higher education level, Telangana

PRINCIPLE INVESTIGATORS: Sriram and Shirisha
Sriram is a Phd Public health scholar working on Disability and Shirisha is a Mph
Student from University of Hyderabad. We worked together as a team Both the
members have Equally contributed in the Project. Shirisha worked on students
with Visual impairments sriram worked on students with Physical disabilities.

BACKGROUND:
 University of Hyderabad is the community we have selected, it is one of the
Premiere institute in Telangana Here students from various different
backgrounds come here for Education and progress in life.
 Every year students from various states in India are selected through the
common entrance exam (CUET) conducted by National Testing Agency and
are given admission based on Indian government reservation policy.
 Every year Person with Disabilities students gets 5% Reservation in all the
courses and based on their performance in Entrance exam and the government
of India rules students are given admission.
 In the University of Hyderabad there are around 140 students with disabilities
in the current academic 2022-2024.

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TARGET GROUP OF POPULATION: Students with disabilities.
According to the world health organization, Disability is part of being human.
Almost everyone will temporarily or permanently experience a disability at some
point in their life. Over 1 billion people – about 15% of the global population –
currently experience disability, and this number is increasing (1) . Disability can
harm the quality of life and is an important health indicator that can have a heavy
social impact with long-term institutionalization and increased use of medical
care. According to the third edition of the survey by the NCPEDP 0.56 % of
Disabled students studying in higher education system to the total students (8) .
The Persons with Disabilities Act (1995) stressed equal access for higher
education. Later on in 2016 The Rights of Persons with Disabilities Act, 2016
Stressed on inclusive education. Other Health Programmes like Bal Swaasthya
karyakaram (RBSK), Sarva Shiksha Abhiyan (SSA), Inclusive Education of
Children and Youth with Disabilities (IECYD), Inclusive Education of the
Disabled at Secondary Stage (IEDSS) and Teacher Preparation in Special
Education (TEPSE) are highlighted as significant steps taken by the country to
ensure maximum opportunity for persons with disability. However, many of these
programmes focused on early identification, intervention .University Grants
Commission (UGC) through a scheme of Higher Education for Persons with
Special Needs (HEPSN) brought a new beginning in the field of higher education
for people with disabilities with the salient objective as equal opportunity offices
at all universities which will offer disability support services. This scheme also
included a barrier-free environment and various other disability educational
assistance and teacher training programmes at the Higher education level.
However, the implementation of programmes and schemes were not highly
successful in India, and hence students with disability entering into the higher
education level were facing difficulties5. People with disabilities are at higher risk
of mental health issues as compared to their nondisabled counterparts. According
to a study done in 2018, around 32.9% of adults with disabilities experience
frequent mental distress (Anxiety, Depression and Stress). The frequency is
almost 5 times more as compared to adults without disabilities 9. University
students are a special group of people that are enduring a critical transitory period
in which they are going from adolescence to adulthood and can be one of the most
stressful times in a person’s life. Self-esteem has a prominent role in mental health
and personality balance. This evaluation is believed to be relevant to the
individual’s optional adjustment and functioning. Self-esteem with reference to
disability can be defined as a disabled person evaluating his/her capacity to
perform in the society. Low self-esteem unsettles human's balance and vitality
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and negatively influences the efficacy, efficiency learning and creativity of
disabled humans. It is characterized by the feeling of inadequate, guilt, shyness,
social inhibition, independency, helplessness, masked hospitality, withdrawal,
complainer, tendency to downgrade others, reduced ability, accepting
unfavourable assessment as accurate, vulnerability and interpersonal problem4.
Stress is anything that poses a challenge or a threat to our well-being. It has been
defined as a process in which environmental demands exceed the adaptive
capacity of an organism resulting in psychological and biological changes that
may place persons at risk for disease. Anxiety is a psychological and
physiological state characterized by cognitive, somatic, emotional, and
behavioural components. These components combine to create an unpleasant
feeling that is typically associated with uneasiness, fear, or worry. Anxiety is a
generalized mood condition that occurs without an identifiable triggering
stimulus, while many symptoms of depression include, persistent sad, anxious or
‘‘empty” feelings, feelings of hopelessness, feelings of guilt, worthlessness
and/or helplessness, irritability, restlessness, and loss of interest in activities or
hobbies once pleasurable. Depression is also a very serious problem among
Students with Disability. A review of psychological distress among disabled
students found a high prevalence of depression and anxiety, with levels of
psychological distress consistently higher than in the general population It is
important to identify the prevalence, and risk factors of stress among disabled
students, which not only affect their health but also their academic achievements
at different points of time in their study period.

OBJECTIVES OF THE PROJECT:
1. To Enhance Disabled friendly Accessibility and Inclusion in the Higher
education level
2. To Educate and create Awareness on Existing Government schemes and
Facilities provided to Students with disabilities
3. To find out the rate of prevalence of depression, stress, anxiety among the
students at higher educational level
4. To sensitise the students without disabilities, highlight the need for physical,
informational and service accessibility and adoption of inclusive attitude,
policies and practices.

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OBJECTIVE OF THE INTERVENTION/ COMMUNITY HEALTH
ACTION INITIATIVE:
The main aim of this study is to promote mental health and wellbeing among
students with disabilities and to live happily in disability friendly campus.

STAKEHOLDERS OF THE PROJECT:
1. University Administration Department
2. University of Hyderabad Empowered Committee for Differently abled
persons
3. University of Hyderabad Dean Students Welfare
4. University of Hyderabad Psychological counsellors (Male and Female)

COMMUNITY ENGAGEMENT PROCESS:
We had 4 community visits to the community
1st visit: This visit we made an Effort to Build Rapport with the community we
introduced ourselves we explained the purpose of the visit and what we are doing
what is the motto behind the Project .In the first meeting with a group of 20 People
we made a casual discussion about since how long they were in campus what is
their academic background what are the major changes observed in the campus
before covid 19 and after covid 19 Pros and cons.
2nd visit: This visit we were familiar to them they were bit friendly with us so we
interacted with them about how was their experience in campus. Do they face any
difficulties in classes, Hostels or Food courts or any other places in the campus
.our campus is closed for 2 years due to covid 19 we asked questions regarding
how was campus before covid 19 and after covid 19 .This visit we asked about
what are community felt needs we made a list of them

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Before 3rd and 4 visit we approached various departments in university to
seek Permission at all levels.

1ST LEVEL-Empowered Committee for Differently abled persons

University of Hyderabad

2ND LEVEL-Dean Students Welfare
University of Hyderabad

3rd Level-Psychological counselors
University of Hyderabad

4th Level- IEC Approval from
University of Hyderabad

5th level -Students
with Disabilities

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There is an official committee in university of Hyderabad for Differently abled
Persons called ECDAP (Empowered committee for Differently abled Persons.
This committee has chairman and governing body which works for the welfare
of Students with Disabilities. This committee includes professors from various
departments altogether they work for a motto of welfare of students with
Disabilities.
We Approached the chairman of the committee to discuss about the Project .He
was very positive about the project and he told it will definitely benefit to the
students as we will get data about our positives and negatives we will work on
our negative aspects and we will strengthen it .He gave us few instructions and
suggestions to go further .His suggestions were to obtain informed consent and
follow ethical guidelines and to maintain Privacy confidentiality of each
participant .He told us to Meet the ECDAP receptionist she will give us a list of
students with Disabilities so that it will help us .He told to meet Dean students
welfare to obtain Permission .
Meeting with Dean of students Welfare:
We met dean of student welfare we told him EDCAP Chairman sir has forwarded
us to you .We explained in-brief about the Project .We had a lengthy conversation
he told us very interesting things about university achievements towards the
welfare of Students with Disabilities and he told us UoH awarded for improving
the cause of accessibility, for the differently abled National Centre for Promotion
of Employment for Disabled People (NCPEDP) has awarded the University of
Hyderabad the NCPEDP MphasiS Universal Design Awards 2016 in Category C
(Companies and Organizations) along with organizations such as Indigo Airlines,
the National Informatics Centre and SAP Labs, in recognition of the exemplary
work towards the cause of accessibility and thus ensuring a life of equality and
dignity for the differently abled. He Encouraged us and Meeting ended with a
Positive note.
Meeting the University Counsellors: There are Two counsellors in University
of Hyderabad Psychological unit who works and counsels students for the
welfare. they take part in various mental health and well being activities in the
University. We have briefed them about the community health Action reflection
Project they will play a key role in mental health objective of the project.

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After taking all the Permissions Mentioned we went for the third and four
visits we interacted with students with Disabilities.
No of Students interviewed: 38
 Out of 38 Students 18 students were Students with Visual Impairments
 20 Students were with Physical Disabilities.
 In-depth interview and Focus group discussion are the Methods followed to
collect data about what are community felt needs.
 Focus group discussion has been done at the Final visit to Finalise community
Priorities.
 2 Focus group discussion one for the students with visually impairments and
one for the Students with Physical disabilities.

Students with visual Impairments Students with Physical Disabilities
Focus group Discussion:
Focus group Discussion:
No of Participants: 8

No of Participants: 12

Moderator: Shirisha

Moderator: Sriram

Notetaker: Sriram

Notetaker: Shirisha

Results of focus group discussion : Everyone Participated expressed their views
in terms of academics, Hostel activities ,Health care Facilities ,Life after covid
19, Access to Library ,Food courts, Social relations, Behaviour and Attitude of
their colleagues and other students with them. Finally Focus group discussion
ended with a note They except Empathy towards them not Sympathy. This Focus
group discussion has led us to frame objective about sensitisation of students
without disabilities to make them aware through blind fold walk on world white
cane day. Students with disabilities expressed their views about Accessibility of
services in the campus we(Shirisha& Sriram) along with the other students we
have listed out all the commonly used areas like canteen ,library ,classrooms, food
court whether they are Disabled friendly or not ?Various students have
participated in it.

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COMMUNITY IMPLEMENTATION:
 Sensitization to Students without Disabilities has been done through a
blindfold walk on world cane day to create awareness in the community.
 Process: Major Key role played in organising Blindfold walk was by Dean
Student’s welfare and ECDAP (Empowered committee for Differently abled
Persons) chairman and team.
 They have circulated poster to all the departments and made sure that People
are Aware about the Date, Time and Venue Prior information has been given
to all the students.
 Many students have participated there were Student volunteers who came
forward to help they helped in blindfolding and made sure that road is free
from vehicles.
 Almost 30 minutes there stopped vehicles and kept road free of moving
passengers.
 Dean of Students welfare commenced it the walk went on soothingly many
students expressed their feelings how difficult it is to walk for a few minutes
with blindfolded they understood how their colleagues would feel – it Really
made my day when I heard their feelings and sense of Awareness among them
a small change in one person also would help the Needy is the Major Lesson
I have learnt .
 Soon after the Session All the Students and Professors who Participated in the
Walk gathered in the conference hall Dean of student’s welfare have addressed
the gathering he gave a small speech and shared his views. The Session Ended
 Educating about various government schemes and facilities to students by an
expert with the help of dean student welfare association.
 Campus library reading room food courts hostels mess every place has been
monitored to assess whether all the areas which commonly used by students
are disability friendly or not a detail report has been written and Will be
submitted to DSW (Dean students welfare).
 Assessing mental health status among students with disability and submitting
it to university which helps many students access Counselling services and
talk to the needy when in need.

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IMPACT OF THE COMMUNITY HEALTH ACTION:
 This project played a key role in addressing community needs it worked as
platform to express community needs
 Blind fold walk have created awareness to all the people in the community.
 Session on Existing schemes and programs provided by the government of
India to PWD students had a major impact.
 University committee have Positively responded once the detailed report is
submitted they will definitely work and address and Promote Mental health
and wellbeing among students .

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Awareness program conducted in university of Hyderabad to stdents

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REFERENCES:

1. https://www.who.int/health-topics/disability
2. WHO. World Health Organization
3. Fauzi, Muhammad Faris, et al. "Stress, anxiety and depression among a cohort
of health sciences undergraduate students: The prevalence and risk factors."
International journal of environmental research and public health 18.6 (2021):
3269.
4. Wahed, Wafaa Yousif Abdel, and Safaa Khamis Hassan. "Prevalence and
associated factors of stress, anxiety and depression among medical Fayoum
University students." Alexandria Journal of medicine 53.1 (2017): 77-84.
5. Mushtaq, Shahnawaz, and Deoshree Akhouri. "Self esteem, anxiety, depression
and stress among physically disabled people." The International Journal of
Indian Psychology 3.4 (2016): 125-132.
6. Tinklin, Teresa, Sheila Riddell, and Alastair Wilson. Disabled students in higher
education. Vol. 32. Centre for Educational Sociology, 2004.
7. McMillan, Julie M., and Jane M. Jarvis. "Mental health and students with
disabilities: A review of literature." Journal of Psychologists and Counsellors in
Schools 23.2 (2013):
8. Biswas, Abhijit. "Assessment of Depression, Anxiety and Stress of the students:
A comparative study between disability and non-disability students at higher
education level."
9. https://timesofindia.indiatimes.com/home/education/disabled-students-countin-indianinstitutions-at-0-56-per-cent/articleshow/46808219.cms
10. Cree, Robyn A., et al. "Frequent mental distress among adults, by disability
status, disability type, and selected characteristics—United States, 2018."
Morbidity and Mortality Weekly Report 69.36 (2020): 1238.

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ANNEXURES

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