Local emergency room no substitute for good mental health care

Study examines hospital use by people with intellectual disabilities

In crisis, many Canadians with intellectual disabilities and mental health problems turn to hospital emergency rooms for help. Now, more than 30 community agencies from Toronto, Peel regions and Kingston are participating in a study funded by the Canadian Institutes of Health Research (CIHR) and led by Dr. Yona Lunsky, of CAMH’s Dual Diagnosis Program, to better understand the factors that cause many adults with intellectual disabilities to use their local emergency room when experiencing a psychiatric crisis

Individuals with intellectual disabilities make up 1-3 percent of the population in Canada and they often have mental health problems. Access to appropriate healthcare is limited both by their disability and also the lack of suitably trained mental health care providers. “There’s a shortage of services for these people,” says Dr. Lunsky, adding, “There needs to be more training for psychiatrists, psychologists and family medicine doctors.”

More than 30 agencies are participating in a study led by Dr. Yona Lunsky, Dual Diagnosis Program, on hospital use by people with intellectual disabilities. Postdoctoral candidate Jonathan Weiss (right) is interviewing families in a separate component of the study.

Clients with intellectual disabilities face the additional problem of having potential help split between the health and social services sectors. These fields function very differently, making it confusing and stressful for individuals with intellectual disabilities and their caregivers to seek help. Consequently, the emergency room may be the only place these individuals feel they can turn to when they need mental health services.

Dr. Lunsky is looking at how hospital staff members decide whether these individuals should be admitted, or sent back home. She hopes to better understand the experience of a person with a disability and their caregiver if they visit a hospital when in crisis.

This project should help empower people with intellectual disabilities when using hospital services and also serve as a guide for caregivers in educating families and front line hospital workers about how best to use emergency services for those under their care. Findings from the project should also inform policy on how to treat this most vulnerable population so that their mental health needs can be appropriately met in the future.

Postdoctoral candidate Jonathan Weiss, a former student of Dr. Lunsky’s, is leading another aspect of this study. His work, also funded by CIHR, focuses on interviewing families of individuals with intellectual disabilities who have experienced a crisis to learn more about how families could be better served in the future.