Over-Representation of Individuals with Intellectual and Developmental Disabilities in Long-Term Psychiatric Hospitalizations

Recent research conducted by ICES and the Center for Addiction and Mental Health (CAMH) reveals that individuals with intellectual and developmental disabilities (IDD) are significantly over-represented among long-term psychiatric hospital inpatients in Ontario. Specifically, more than 20% of patients who have remained hospitalized for over a year are diagnosed with IDD. The study analyzed data as of September 30, 2023, and found that out of 1,466 patients occupying mental health beds for extended periods, 322 had IDD.

Patients with IDD tend to be younger and more likely to have diagnoses like psychotic disorders, with nearly 40% also being autistic. These individuals frequently face challenges such as needing physical restraint, seclusion, and having limited access to specialized units tailored for their needs—only 5% are in units specifically designed for people with IDD. Moreover, a significant proportion lack social and familial contacts that could support their discharge, making transitions back into the community difficult.

The findings highlight the necessity for increasing specialized support and training for hospital staff to better serve patients with IDD. Improving outpatient mental health services, housing options, and community supports can help prevent unnecessary long hospital stays and facilitate smoother transitions. As Yona Lunsky, ICES scientist, emphasizes, substantial investments are needed to build capacity and foster collaboration between hospitals, community services, and social sectors.

Key insights include:

• Over 20% of long-stay patients are individuals with IDD.
• Patients with IDD are typically younger and more prone to psychosis and autism.
• They experience higher rates of restraint and seclusion and are less often placed in specialized units.
• More than half lack sufficient social or family support to aid discharge.

Addressing these issues through capacity building, training, and community-based supports is crucial for improving care and reducing extended hospitalization for individuals with IDD. Resources are available through the H-CARDD program at CAMH to aid in supporting these patients transition out of hospital. The study, titled "Long-stay psychiatric inpatients with and without intellectual and developmental disabilities: an Ontario population-based study," is published in the September edition of The Canadian Journal of Psychiatry.