Study finds adults with developmental disability and comorbid psychiatric disorder are frequent ED users
Researchers from the Institute for Clinical Evaluative Sciences (ICES) and the Centre for Addiction and Mental Health (CAMH) recently completed the first Ontario-wide study of emergency department (ED) use by adults with dual diagnosis (developmental disability and comorbid psychiatric disorder), comparing their ED use to those with developmental disability and no psychiatric disorder, to people with psychiatric disorder but no developmental disability, and to the general adult population. Researchers found that adults with developmental disability had higher rates of ED visits when compared to adults without developmental disability. The dual diagnosis group was most likely to visit the ED at least once in two years (55 per cent) and this group also had the highest proportion of “frequent users” (16 per cent versus 5 per cent of adults with psychiatric disorder only).
“The first visit to the ED is an emergency,” says Principal Investigator, Dr. Yona Lunsky, Clinician Scientist at CAMH and Adjunct Scientist at ICES. “But recurrent visits can represent our failure as a system to respond to individuals who we know are at risk. If one in two adults with dual diagnosis is going to visit the ED at least once in two years, we need to prepare them and hospitals better, and we also need to consider how we can prevent these types of visits.”
These findings suggest that the needs of people with dual diagnosis are not being well met in the community. “We need to pay more attention to how we serve this vulnerable group both in and out of the hospital,” says Lunsky.
See “Are Adults with Developmental Disabilities More Likely to visit EDs?” May 2011, American Journal of Emergency Medicine, Volume 29, Issue 4, 463-465.
Click on mediasite.otn.ca to see an in-depth presentation by Dr. Yona Lunsky entitled “Adults with Dual Diagnosis in the Emergency Department.”
For useful clinical tools on preventing and managing emergencies in adults with developmental disabilities, go to www.surreyplace.on.ca.