Emergency Psychiatric Service Use by Individuals With Intellectual Disabilities Living With Family

Abstract

The purpose of this study was to describe the experiences of individuals with intellectual disabilities (ID) and their families in the emergency department (ED). Hospital chart audits were conducted on a sample of 20 individuals with ID living with family who had visited the ED for a psychiatric crisis. Individuals had a combined total of 44 ED visits. Seven (35%) individuals made more than 1 ED visit, with 15% visiting the ED more than 5 times over a 1-year period. Patients received psychiatric consults 64% of the time. Nineteen (43%) visits resulted in inpatient admission, but 32% of the time ED staff sent patients home with no recorded follow-up plans. The key difference between hospitalized and nonhospitalized visits in terms of client characteristics or crisis severity was a greater likelihood of physical aggression in visits resulting in admission. Implications for training of ED staff and a need for community resources are discussed.

Keywords:

• intellectual disabilities
• family
• dual diagnosis
• emergency services
• psychiatric crisis
• mental health

ACKNOWLEDGMENTS

This research was supported by a Canadian Institutes of Health Research operating grant (FRN 79539) along with a new investigator award, awarded to the first author. We thank the participating families and agencies as well as project scientists and staff.