Life events and emergency department visits in response to crisis in individuals with intellectual disabilities.
Six recent life events sharply raise the odds that adults with ID will end up in the emergency department during a crisis.
01Research in Context
What this study did
The team asked the adults with intellectual disability about recent life events. They also checked who had gone to the emergency room after a crisis in the past year.
They used a short survey anyone can give in clinic. The goal was to see if certain life bumps raise the odds of an ED trip.
What they found
Any recent life event doubled the chance of an ED visit. Six events stood out: moving house, fighting with caregivers, police contact, being out of work over a month, recent abuse, or drug use.
If one of these happened, the person was far more likely to land in the ER during a later meltdown or psychiatric crisis.
How this fits with other research
van Schrojenstein Lantman-de Valk et al. (2006) already showed that negative life events predict later behavior problems and depression in the same group. Lunsky et al. (2011) now links those same events to real-world crisis service use, extending the chain from stress to hospital.
Cooper et al. (2011) found that living in a poor neighborhood also drives ED visits. The two studies look opposite—one blames social context, the other blames personal events—but they measure different things. You need both lenses: where the client lives and what just happened to them.
Matson et al. (2008) warned that life events matter yet proof was thin. This 2011 survey adds hard numbers, moving the field from "maybe" to "count it."
Why it matters
Add six quick questions to your intake: new house, caregiver conflict, police, job loss, abuse, substance use. A "yes" flags high crisis risk. Build extra support, teach coping skills, and loop in the medical team before the next meltdown becomes an ambulance ride.
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02At a glance
03Original abstract
BACKGROUND: Stressful life events have been linked to psychopathology in the general population, but few studies have considered the relationship between life events and psychopathology for people with intellectual disabilities (ID), and the link between particular life events and hospital use. METHODS: Informants provided data on 746 adults with ID who had experienced at least one 'crisis'. Informants completed a checklist of recent life events from the Psychiatric Assessment for Adults with Developmental Disabilities Checklist (PAS ADD checklist) and also indicated whether the crisis resulted in a visit to the hospital emergency department. RESULTS: Individuals experiencing life events in the past year were more likely to visit the emergency department in response to crisis than those who did not experience any life events. Individuals experiencing a move of house or residence, serious problem with family, friend or caregiver, problems with police or other authority, unemployed for more than 1 month, recent trauma/abuse, or a drug or alcohol problem were more likely to visit the emergency department. CONCLUSIONS: Six specific life events were found to be associated with use of emergency departments in response to crisis. We suggest intervention efforts be targeted towards people who experience life events, particularly these events, as they may be a risk factor for hospital visits.
Journal of intellectual disability research : JIDR, 2011 · doi:10.1111/j.1365-2788.2011.01417.x