Emergency Department Staff Knowledge and Practice of Caring for Individuals with Intellectual Disabilities Seeking Mental Health Care

Individuals with intellectual disabilities have limited access to out-patient community-based mental health care. Emergency departments have become a fundamental entry for patients with intellectual disabilities to receive mental health care, leaving patients with intellectual disabilities being frequent users of the emergency department when compared to those without intellectual disabilities. The purpose of this study is to examine and unpack the knowledge, practice, and professional experience of emergency department staff regarding patients with intellectual disabilities seeking mental health care. The study aims to contribute to understandings about the ways in which emergency department staff utilize the emergency department space, time, and resources, and how this utilization impacts how responsive and supportive care is provided to patients with intellectual disabilities. Semi-structured face-to-face and phone interviews were conducted with seven emergency department social workers, registered nurses, and physicians from four emergency departments in Calgary, Canada. A qualitative descriptive study design was employed to collect, analyze, and describe and interpret findings. Emergency department staff described: the emergency department standard practice and procedures, environment, conflicting demands, professional and personal experience in the emergency department, and the ways these descriptions helped or hindered their ability to provide responsive and supportive care to patients with intellectual disabilities. Guided by a critical disability theoretical framing and the author’s experience as a disability service professional, the author has unpacked descriptive findings to illuminate that: the emergency department is not the place for any patient with or without an intellectual disability to receive adequate mental health care, the emergency department prioritizes physical health over mental health, emergency department staff do not have adequate time, space, resources, and academic or clinical training to provide responsive and supportive care, further illuminating how the knowledge, practice, and professional experience of emergency department staff additionally contribute to the marginalization of individuals with intellectual disabilities in various systems and practices, particularly the emergency department.

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