Re-examining the relationship between intellectual disability and receipt of inpatient psychiatry and complex continuing care services in Ontario, Canada

Objectives: Over the last few decades, new residential, vocational, recreational, and educational opportunities for persons with intellectual disabilities (ID) in Ontario (Canada) have allowed them to integrate into mainstream society. However, persons with ID continue to struggle to fit into the healthcare system. In particular, previous work reported that persons with ID tended to receive more interventions that focused on behaviour management, and less related to community skills and reintegration. The current study determines whether the presence of an ID diagnosis continues to predict service use.Methods: Analyses are based on anonymized population-level data collected as part of regular clinical practice in inpatient psychiatry (171495 assessments, 3.9% have an ID) and complex continuing care (CCC) hospitals (112021 assessments, 1.32% have an ID) in Ontario. Multivariate logistic regression models were used to test the relationship between ID and services, controlling for select confounders.Results: The results showed that persons with and without ID in inpatient psychiatry and CCC continue to have differential odds of receiving various healthcare services, in spite of needs recognized through the assessment. Overall, interventions that target behaviours rather than improvement of skills are received by persons with ID in both settings.Conclusion: Persons with ID continue to experience inequities in the Ontario healthcare system.