Examining service complexity in children with intellectual disability and mental health problems who receive inpatient or outpatient services

ABSTRACT

Background: This study examined predictors of service complexity in children with comorbid intellectual developmental disorder (IDD) and mental health concerns. We examined whether patient type, safety risk, exposure to trauma, and family dysfunction were related to service complexity.

Method: The study had a cross-sectional design, wherein trained clinicians assessed 330 outpatient and inpatient children with IDD and mental health problems using an interRAI ChYMH-DD instrument.

Results: Inpatients experienced a greater prevalence of abandonment by caregiver than outpatients. The patient type defined relationships between age, family dysfunction, safety risk, cumulative trauma, and service complexity. Specifically, in a multivariate model, older age, higher family dysfunction, higher safety risk, and higher cumulative trauma predicted higher service complexity in outpatients but not inpatients.

Conclusions: In addition to older age, poly-victimisation, family dysfunction, and safety risk need to be considered when predicting service complexity in this population.

KEYWORDS:

• InterRAI
• service complexity
• intellectual developmental disorder
• mental health
• risk factors

Acknowledgements

The authors would like to thank the assessors and agencies for contributing to this research. We would like to thank the Child and Parent Resource Institute for their assistance in the training across the Province of Ontario. Special thanks to the children and families who contributed their time to the project. Without their commitment, this research would not be possible.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Natalia Lapshina http://orcid.org/0000-0002-3221-7162

Additional information

Funding

This work was supported by the Donation from The London Community Foundation, $100,000 CAD awarded to Dr S. L. Stewart.