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ABSTRACT: Hospital emergency departments are not well prepared to meet the needs of individuals with intellectual disabilities. Negative experiences can be very traumatic, particularly when the emergency visit is because of a behavioural or psychiatric problem. A focus group study was conducted in 2005 in Toronto, Canada with four women with intellectual disabilities who had paid repeated visits to their local emergency department due to a psychiatric or behavioural crisis. These women spoke about not feeling respected, the trauma of being restrained physically or chemically, and about hospital staff not being comfortable working with women with intellectual disabilities. Clinical implications are discussed and recommendations are presented to improve the experience of women who require emergency services in the future.
Journal of Intellectual Disabilities 07/2009; 13(2):87-98.
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ABSTRACT: Background Strains on the mental health system and inaccessible services for individuals with intellectual disabilities (ID) often force caregivers to bring individuals with ID to the emergency department (ED) when in psychiatric crisis. The purpose of this study was to understand the experience of caregivers and adults with ID and mental health issues, according to caregivers’ perspectives.Method Focus groups were conducted with one group of unpaid caregivers (i.e. family members) and two groups of paid caregivers (i.e. staff from community agencies) from Ontario, Canada.Results Caregivers identified a number of issues centering on a lack of services, on respect, on knowledge and on expertise. Diagnostic overshadowing and overmedication were also prevalent concerns.Conclusions Input from caregivers points to deficiencies in the system that lead them to use the ED when other options have been exhausted. A number of recommendations can be implemented to improve the emergency psychiatric care of adults with ID in the ED.
Journal of Applied Research in Intellectual Disabilities 06/2009; 22(4):354 - 362. · 1.38 Impact Factor
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ABSTRACT: Strains on the mainstream mental health system can result in inaccessible services that force individuals with intellectual disabilities into the emergency room (ER) when in psychiatric crisis. The purpose of this study was to identify clinical and systemic issues surrounding emergency psychiatry services for people with intellectual disabilities, from the perspective of hospital staff. Focus groups were conducted with emergency psychiatry staff from 6 hospitals in Toronto, Canada. Hospital staff reported a lack of knowledge regarding intellectual disabilities and a shortage of available community resources. Hospital staff argued that caregivers need more community and respite support to feel better equipped to deal with the crisis before it escalates to the ER and that hospital staff feel ill prepared to provide the necessary care when the ER is the last resort. Input from hospital staff pointed to deficiencies in the system that lead caregivers to use the ER when other options have been exhausted. Both staff and caregivers need support and access to appropriate services if the system is to become more effective at serving the psychiatric needs of this complex population.
Intellectual and developmental disabilities 01/2009; 46(6):446-55. · 1.44 Impact Factor
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ABSTRACT: BackgroundAdults with Autism Spectrum Disorders (ASD) represent a small, but challenging sub-group of patients within Ontario's mental health care system. However, few studies have documented the clinical characteristics of this population and examined how such individuals differ from other psychiatric patients, with or without intellectual disabilities (ID).MethodA secondary analysis of data from the 2003 Comprehensive Assessment Projects from three psychiatric hospitals in Ontario was conducted to describe patients with ASD and ID and to determine how their profile compared to other hospital users.ResultsTwenty-three patients with ASD and ID were matched on gender and patient status (inpatient/outpatient) to individuals with and without ID. Individuals with ASD and ID were similar in terms of demographics to patients with and without ID. However, individuals with ASD and ID were younger, spent more days in hospital and were less likely to have a psychotic disorder diagnosis than both patients with and without ID. Inpatients with ASD and ID were recommended for a higher level of care than hospital service users without ID.ConclusionsClearly, this small sub-group of individuals within the hospital population has high clinical needs that are not always well met.
Research in Autism Spectrum Disorders.
