Community integration is preferred by people with intellectual and developmental disabilities (IDD); it is also associated with better outcomes, including for people with higher support needs. In fact, community integration is a social determinant of health – community integration positively impact people’s health, while social isolation, exclusion, and segregation worsen people’s health.
While less is known about the impact on people with IDD, research about other populations shows community integration can also reduce emergency department use. For these reasons, the aim of this study by CQL | The Council on Quality and Leadership was to examine the relationship between community integration, higher support needs, and emergency department use. To do so, we analyzed Personal Outcome Measures® data from 251 people with IDD.
In our study, people with comprehensive behavior support needs visited the emergency department more often than people without comprehensive behavior support needs. But, when people with comprehensive behavior support needs participated in the life of the community they had 78% fewer emergency department visits compared to when they did not participate in the life of the community (see figure).
Community Participation and Emergency Department Use of People with Behavior Support Needs
“Having a lack of experiences and opportunities, as well as facing isolation, can lead people with IDD to participate in ‘challenging’ behavior. Perhaps, as a result of participating in the life of the community, people with comprehensive behavior support needs are more fulfilled and have fewer unmet needs as a result. It may also be that these people with IDD were defined as having behavior support needs because of behavior that was exacerbated or caused by segregation and/or isolation in the first place… A strong community infrastructure is needed to ensure all people with IDD, regardless of support needs, can experience, and, as a result, benefit from, community integration” (Friedman, 2021, pp. 8-9).