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Researchers call for health-care changes to help adults with developmental disabilities

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Adults with developmental disabilities, such as autism and Down syndrome, in Ontario are having a harder time accessing healthcare even though they have more health issues than people without developmental disabilities, according to research done at the Institute for Clinical Evaluative Sciences (ICES) and the Centre for Addiction and Mental Health (CAMH).

“This group of individuals is a silent minority in the healthcare system, but now instead of relying on anecdotal evidence, we finally have the big picture on their health and the health services that they use,” says Yona Lunsky, lead author of the Atlas on the Primary Care of Adults with Developmental Disabilities in Ontario.

The atlas, the largest study of its kind, found there are over 66,000 adults with developmental disabilities under age 65 in Ontario. Adults with developmental disabilities live in poorer neighbourhoods and have higher rates of physical and mental health problems than other Ontario adults. They receive multiple medications for these health issues, which are not always well monitored. While they are as likely to see their family physician as other adults, they are more likely to visit emergency departments and to be hospitalized.

“These individuals don’t get the same level of preventive care, such as cancer screening, and not all of their chronic health issues are managed as well as they should be. In general, their care is not consistent with what health-care guidelines recommend for adults with developmental disabilities," says Lunsky, a clinician scientist at CAMH, an adjunct scientist at ICES and director of the Healthcare Access Research and Developmental Disabilities (H-CARDD) research program.

“Although the level of care was good during emergencies, there was a recurring mantra of ‘patch her up and send her out until the next time’. We felt then, as we do now, that there needs to be a better process that connects hospitals, caregivers, family doctors and patients with a focus on long-term intervention, thereby reducing the need for emergency hospitalization,” says Roger Oxenham, father of a young adult with developmental disabilities.

Researchers are recommending strategies to enhance the overall health and well-being of individuals with developmental disabilities. They include:

  • Enabling primary care providers to more easily offer guideline-recommended care
  • Addressing the broader health system issues and pathways to care, and
  • Making people with developmental disabilities and their families and paid staff active partners in care, giving them the tools they need

The H-CARDD program has two projects underway to improve health outcomes for adults with developmental disabilities: the primary care project with family health teams and the emergency care project

Lunsky will be speaking at Health and Wellbeing in Developmental Disabilities: Engaging Healthcare Professionals conference in Toronto on November 12 and 13.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

For the latest ICES news, follow us on Twitter: @ICESOntario

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 the area of addiction and mental health. 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. Fully affiliated with the University of Toronto, CAMH is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit www.camh.ca.

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