I believe Twitch needs to do better with how they handle mental health policies. I couldn't find any mention on Twitch's website mentioning having any support for those with disabilities, either physical or mental. From what I have researched online, companies as large as Twitch should have some sort of adherence to the Disabilities Act.
I recently emailed Twitch asking for a refund because of gift sub purchases I made during a Manic episode during a mental health crisis. Those who suffer from severe Mania can be known to knock down a wall in their house to start a home business as they suffer from delusions of grandeur and then when the episode wears off and they realize they don't even know how to run a business or invent whatever it is they thought they had an idea for and are now left with damage to their home. Mania causes you to lose touch with reality and not understand the consequences of your actions and can be quite disastrous to a person's life.

After being denied support, I sent this message:
"I understand corporate policies, but I'm a person who can't afford to feed himself with mental health issues and you're telling me essentially that a Community based company like Twitch would prefer to keep $200 over one of their viewers of over 8 years?
Please can I have this matter escalated, it's very important.
Thank you for your consideration"
Their response was as follows:

"We have reviewed your case thoroughly and can confirm that unfortunately, we cannot provide any additional insight to your request outside of what we already provided in the previous responses. As a result, we will be closing the case in this thread. We apologize for any inconvenience this may have caused you." and mentioning to submit another ticket and/or post here.
I am not trying to accuse any specific employee, but it comes across as Twitch being indifferent to mental health issues in your community. Mental health issues are rarely obvious in nature, especially online. If you're just reviewing chat logs on the account, you're not going to necessarily be able to tell what a person is going through. This was during a very dark time in my life and because of this I could have ended up homeless. Others aren't as lucky as I was to have someone who covered my share.

Thank you and God Bless.