Patients with Autism Spectrum or Intellectual Disability in the Psychiatric Emergency Department: Findings from a 10-year Retrospective Review.

Abstract

Purpose: There is a dearth of information about patients with autism spectrum disorder (ASD) or intellectual disability (ID) who seek emergency psychiatric care. Given this backdrop, this retrospective study aims to explore clinical, demographic, and disposition-related information about this patient population over a 10-year period.

Methods: This study includes individuals with ASD or ID (n = 1461) and had presented to a psychiatric emergency department between 2012 and 2021. Data were extracted using a structured chart review methodology, and included demographic, clinical and visit information. Bivariate and multivariate logistic regressions were estimated to explore associations between key variables and dispositions of interest.

Results: Sample was predominantly White (77.21%), adolescent (mean age ± SD = 15.5 ± 4.3) and male (72.76%). The most common reason for their presentation was aggression towards others (36.39%). 28.27% of patients were psychiatrically hospitalized but 30% of those who needed hospitalization were discharged due to lack of inpatient bed availability.

Conclusion: This study adds to the limited literature about individuals with ASD or ID seeking emergency care. The results indicate a highly acute patient population with aggression, suicidal thoughts, and self-injurious behaviors who are frequently prescribed psychotropic medications and face barriers to accessing higher levels of care.