Patients with learning disabilities visiting psychiatric ED may be sent home with no recorded follow up plans


Researchers in this Canadian study looked at the factors associated with the use of psychiatric emergency services by people with learning disabilities who were living with their family. They conducted an audit of hospital chart audits for a sample of 20 such individuals with learning disabilities who had visited the emergency department (ED) at the hospital for a psychiatric crisis. They found that the 20 individuals had a combined total of 44 emergency department visits. Seven of the twenty had made more than 1 visit, with 3 people having visited the emergency department more than 5 times over a 1-year period. Of those that had been to the ED, received psychiatric consults were given 64% of the time. Nineteen visits resulted in inpatient admission, but remarkably, for over a quarter of the time, staff at the ED sent patients home with no recorded follow-up plans. The researchers found that the key difference in terms of patient characteristic or crisis severity between hospitalised and non-hospitalised visits was a greater likelihood of physical aggression which resulted in visits to the ED ending in admission. The authors consider the need for additional training for ED staff and discuss the additional community resources to support individuals and their families that might be needed to reduce the need for ED visits. Emergency Psychiatric Service Use by Individuals With Intellectual Disabilities Living With Family, Lunsky Y et al, in Journal of Mental Health Research in Intellectual Disabilities, 4, 3, 172-185

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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