Barriers and Enablers to Accessing Mental Health Services for People With Intellectual Disability: A Scoping Review

Whittle, Erin; Fisher, Karen R.; Reppermund, Simone; Lenroot, Rhoshel; Trollor, Julian N.

doi:10.1080/19315864.2017.1408724

Cited by 124 publications

(115 citation statements)

References 36 publications

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“…First, results revealed that individuals with ID‐only had significantly more frequent ED visits during adolescence than individuals in the PC group after controlling for sex, race/ethnicity, and insurance status. This finding speaks to the barriers to healthcare utilization faced by individuals with ID‐only, which include a lack of specially trained clinicians [Whittle, Fisher, Reppermund, Lenroot, & Trollor, ], difficulties navigating the healthcare system [Hanlon et al, ; Whittle et al, ], and communication barriers [Hanlon et al, ]. Interestingly, although those with ID‐only had significantly more ED visits during adolescence than the PC group, those with ASD + ID did not.…”

Section: Discussionmentioning

confidence: 99%

Emergency department utilization and monetary charges in adolescents with autism spectrum disorder, intellectual disability, and a population comparison group

et al. 2019

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Adolescents with autism spectrum disorder (ASD) and/or intellectual disability (ID) may utilize the emergency department (ED) more frequently than individuals in the general population. This study compared ED utilization and charges during adolescence among four groups of individuals: ASD‐only, ASD + ID, ID‐only, and a population comparison (PC) group. ED visits occurring during age 12–17 years were examined to identify non, low, and high utilizers. Logistic regression was used to compare groups on the odds of having at least one ED visit during adolescence. Generalized linear models were used to compare groups on number of ED visits and total charges, stratified by low and high ED utilization. Descriptive examination of presenting diagnoses was performed. Individuals with ID, with or without co‐occurring ASD, were significantly more likely to have at least one ED visit during adolescence. Among high ED utilizers, the ID‐only group had the most frequent ED visits but had significantly lower charges than the ASD‐only group. Individuals with ASD‐only and ASD + ID differed from the ID‐only and PC groups in presenting diagnoses. No differences between groups in number of ED visits or charges were observed among low utilizers. ID, with or without ASD, increased the odds of visiting the ED during adolescence. Adolescents with ID‐only had the most frequent ED visits, but individuals with ASD‐only had the highest ED charges and tended to be seen for psychiatric concerns. Further research is warranted to better characterize and meet the healthcare needs of individuals with ASD and/or ID during adolescence. Autism Res 2019, 12: 1129–1138. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Frequent emergency department (ED) visits strain medical resources and are costlier than primary and urgent care. Our findings show that adolescents with intellectual disability (ID) may use the ED frequently for nonurgent conditions. Adolescents with autism spectrum disorder, without ID, use the ED less frequently but incur higher charges. Further research is needed to understand how to meet the unique needs of these populations in primary care to prevent overuse of the ED.

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Section: Discussionmentioning

confidence: 99%

Emergency department utilization and monetary charges in adolescents with autism spectrum disorder, intellectual disability, and a population comparison group

et al. 2019

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“…In provision of psychiatric services to people with intellectual disability, several factors result in patients and carers experiencing difficulty in attending out-patient appointments. 1 As intellectual disability services often cater for large geographical areas, these factors include inconvenient travel. 2 In the UK, there is an emphasis on finding efficiencies and providing cost reductions to address the political austerity agenda.…”

Section: Introductionmentioning

confidence: 99%

Telepsychiatry in intellectual disability psychiatry: literature review

Madhavan

2019

BJPsych Bull

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Aims and MethodThe aims of this review were to explore the effectiveness and patient and provider acceptability of telepsychiatry consultations in intellectual disability, contrasting this with direct face-to-face consultations and proposing avenues for further research and innovation. Computerised searches of databases including AMED and EMBASE were conducted.ResultsFour USA studies of intellectual disability telepsychiatry services have been reported. The majority (75%) focused on children with intellectual disability. Sample sizes ranged from 38 to 900 participants, with follow-up from 1 to 6 years. Outcome measures varied considerably and included cost savings to patients and healthcare providers, patient and carer satisfaction and new diagnoses.Clinical implicationsThe innovations summarised suggest a requirement to further explore telepsychiatry models. Despite some promising outcomes, there is a relative dearth in the existing literature. Further studies in other healthcare systems are required before concluding that telepsychiatry in intellectual disability is the best approach for providing psychiatric services to this population.Declaration of interestNone.

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“…Therefore, it has become imperative to understand the health care needs of students with disabilities [26][27][28]. For instance, listening to students' experiences, their challenges and needs when accessing health services is an opportunity to examine their priorities and preferences in health service planning.…”

Section: Introductionmentioning

confidence: 99%

In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

Abodey

Vanderpuye

Mensah

et al. 2020

BMC Health Serv Res

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Background: Accessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana. Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. Results: The study identified three themesaccessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care. Conclusion: The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.

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Barriers and Enablers to Accessing Mental Health Services for People With Intellectual Disability: A Scoping Review

Cited by 124 publications

References 36 publications

Emergency department utilization and monetary charges in adolescents with autism spectrum disorder, intellectual disability, and a population comparison group

Emergency department utilization and monetary charges in adolescents with autism spectrum disorder, intellectual disability, and a population comparison group

Telepsychiatry in intellectual disability psychiatry: literature review

In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

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