What is it about?

Persons with developmental disabilities (DD) are one of the most vulnerable populations because of their complex health needs and because of the challenges they face in accessing health care services. We know that almost half of adults with DD also have a mental illness or addiction disorder, a reality that makes their health and health care situations even more challenging. A better understanding of this group and their use of health care services is important to ensure that they receive high quality care.

In February 2015, researchers leading the study of adults with DD and mental illness and addiction disorders hosted an interactive Town Hall to describe and compare the following groups in terms of their demographics, what kinds of health problems they have, and how they use health care services:

• Individuals with DD plus a mental illness and/or addiction
• Individuals with DD but no mental illness or addiction
• Individuals without DD
  

What did we learn?

The researchers found that nearly half of adults with DD also have a mental illness or addiction disorder. These adults were also found to have a higher prevalence of all chronic diseases studied (asthma, hypertension, chronic obstructive pulmonary disorder (COPD), asthma and congestive heart failure), compared to adults with DD only and adults without DD.

Compared to both adults with DD only and adults without DD, adults with mental illness or addiction disorders were found to have higher use of services (i.e., use of any physician services, emergency department (ED) visits, hospitalizations). They were also more likely to have repeat hospitalizations and visits to the ED within 30 days of leaving hospital or ED.

This free and interactive Town Hall was broadcast live from the Surrey Place Centre in Toronto to 40 Ontario Telemedicine Network (OTN) sites across Ontario and to 93 live webcast connections. Participants in the Town Hall were asked to discuss specifically what has worked well to prevent repeat ED visits or repeat hospitalizations. Responses tended to focus on what was needed in the system. Their suggestions included:

• The need for improved access to appropriate service, supports and staffing in the community–ideally available locally, with accessible hours of operation and with supports to families and for navigation within and across services.
• The important role that primary health care should play in managing and coordinating the health care of individuals with DD, including the early detection of DD itself, mental health and addiction issues and physical health problems.
• The need for training for a range of health and social service providers, including hospital, ED and primary health care staff.
• The use of support/care plans to ensure that care planning is proactive, includes protocols to manage crises and is broadly shared with the individual's circle of care.

Learn more in the Town Hall report Health Care and Mental Illness and Addiction in Developmental Disabilities with more details on the discussion and research findings.

For more information or questions, please email hcardd@camh.ca.

Presenters

Elizabeth Lin (PhD) is an Independent Scientist in the Provincial System Support Program at the Centre for Addiction and Mental Health (CAMH) and an Adjunct Scientist at the Institute for Clinical Evaluative Sciences (ICES). She has served as a consultant for Statistics Canada and the Public Health Agency of Canada and has extensive expertise in using large-scale surveys and administrative data to investigate mental health care use and delivery. Her recent work includes the development and reporting of indicators of gender disparities in depression care in Ontario, as well as a project for the Ministry of Health and Long Term Care describing the socio-demographic, clinical, and institutional characteristics of individuals designated as having alternate level of care or long-stay days in hospital. Email: ElizabethBetty.Lin@camh.ca.

Robert Balogh (PhD, MHSc) is an Assistant Professor at the University of Ontario Institute of Technology, Faculty of Health Sciences.  He completed postdoctoral Fellowships at the Centre for Addiction and Mental Health and the Institute for Clinical Evaluative Sciences with Dr. Yona Lunsky and Dr. Elizabeth Lin acting as supervisors. He has a Master's degree in epidemiology and is a registered physiotherapist. He is experienced in the use of large administrative databases to examine hospitalizations among persons with an intellectual disability. His research interests include primary care and health service models for persons with an intellectual disability. Email: Robert.Balogh@uoit.ca.