Reframing disability-inclusive care: Integrating chronic pain and mental health

Chronic pain is a major driver of global morbidity. Evidence shows that people with disability experience substantially higher levels of pain than those without disability. Yet far less attention has been given to the experiences of people with disability who subsequently develop chronic pain unrelated to their primary impairment. Also, chronic pain and mental health conditions frequently overlap, which further exacerbates physical, emotional, social and economic disadvantage while perpetuating health inequities for people with disabilities. Despite the observed overlap, chronic pain, disability and mental health are typically addressed within separate clinical, research and policy frameworks. This oversight has important considerations for health systems, patient care and disability-inclusive policy development. It also obscures their cumulative burden, limiting the capacity to respond effectively. In this commentary, we argue that recognizing chronic pain and mental health conditions within disability-inclusive health systems is imperative for advancing more coordinated, person-centred and equitable health responses for people with disabilities. PERSPECTIVE: Chronic pain in people with disability often remains overlooked, particularly when unrelated to the primary disabling condition. Intersecting chronic pain, disability and mental health conditions intensify inequity, yet are still addressed within disconnected systems of care, research and policy. Integrated, person-centred approaches are essential to advancing equitable and effective care.