What happens when people with autism go to emergency

TORONTO, July 18, 2017 /CNW/ - A study by the Centre for Addiction and Mental Health (CAMH) of 284 teens and adults with autism has found that almost one in four  (22.2 per cent) had been to an emergency department at least once in the past year.

"Practically every week I hear about someone on the spectrum who is in crisis and gets involved with emergency services," says lead author Dr. Yona Lunsky, Clinician-Scientist in Adult Neurodevelopment Services and Director of the Health Care Access Research and Developmental Disabilities (H-CARDD) Program at CAMH.

The study authors suggest that the rate of emergency department visits could be brought down if there were better supports for people with autism in the at-risk groups and better training of emergency department staff to deal with the complex challenges people with autism present.

"Because the strongest predictor of future emergency visits is previous use, that first visit is an opportunity to put a plan into place," says Dr. Lunsky. "How can families be more prepared before they go to the hospital and how can hospitals be more equipped to support them when they come?"

The study, just published in BMJOpen, found three main predictors of future emergency department visits:

  • Having had an emergency visit in the year prior to the study period

  • Elevated family distress at the start of the study period

  • Two or more negative life events just before the start of the study period

Other variables like age, gender and autism severity did not predict future emergency visits, highlighting the need to consider how to support all teens and adults with autism, and not just certain subgroups.

"If we ask them, we can identify which families are most distressed. If they aren't already visiting their local emergency department, this study tells us that it is likely they may do so soon," says Dr. Lunsky. "So what can we do now to address their distress and prevent an emergency from occurring?"

The study looked at both medical and psychiatric emergencies and found that different issues predicted each type of emergency. According to the authors there can sometimes be overlap between the two.

"It may seem like a psychiatric emergency where the patient is getting very angry and acting out, but there could be an underlying medical condition that is not being treated," says Dr. Lunsky. "Or it could start out as a medical emergency, but the hospital process is so stressful it becomes a psychiatric emergency.  Sometimes it's not entirely clear whether it's one or the other."

Some practical steps for patients and their families recommended by Dr. Lunsky include bringing a health information passport detailing the person with autism's medical history and triggers, and having emergency department clinicians conduct an "exit interview" prior to discharge and connecting to community supports for ongoing care.

There are also many resources that have been developed for emergency departments to help them improve the care of their patients with autism and other developmental disabilities.

To download broadcast quality clips of Dr. Lunsky, and video of the CAMH Emergency Department, check out this link.

The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital, as well as one of the world's leading research centres in its field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please follow @CAMHnews and @CAMHResearch on Twitter.

SOURCE Centre for Addiction and Mental Health

For further information: or to arrange an interview please contact: Sean O'Malley, Media Relations, CAMH, 416 535 8501 x36663, media@camh.ca

RELATED LINKS
http://www.camh.ca

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