In Times of Need: Psychiatric Emergency Department Presentations in Autistic Adults

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

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Courchesne, V., Frayne, M., Castelino, C., Luk, V., Man, L. L. Y., Lee, C. H. J., Baharikhoob, P., Pace‐Tonna, C., Jachyra, P., Ameis, S. H., Lin, H., Sawyer, A., Zaheer, J., Lunsky, Y., & Lai, M. C. (2026). In Times of Need: Psychiatric Emergency Department Presentations in Autistic Adults. Autism in Adulthood. https://doi.org/10.1177/25739581251415125

Publication date: 22 Jan 2026 Added to AutiHub: 24 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
15
Publication authors identified as autistic
1 / 15 (6.7%)
  1. Valerie Courchesne
  2. Margot Frayne
  3. Chantelle Castelino
  4. Vanessa Luk
  5. Louisa Lok Yee Man
  1. Ching-Hua Julie Lee
  2. Paria Baharikhoob
  3. Carleigh Pace‐Tonna *
  4. Patrick Jachyra
  5. Stephanie H. Ameis
  1. Hsiang‐Yuan Lin
  2. Amanda Sawyer
  3. Juveria Zaheer
  4. Yona Lunsky
  5. Meng-Chuan Lai

Abstract

Background: Autistic individuals exhibit greater vulnerability to mental health challenges than the general population, yet they lack access to adequate mental health care. Barriers to seeking and receiving adequate mental health care, such as minority stress, adverse life events, discrimination, and stigmatization can result in increased reliance on general and psychiatric emergency departments (ED/PsyED) during mental health crises. There is however limited research detailing PsyED use in autistic adults. Methods: This large-scale retrospective chart review analyzed PsyED visits by autistic adults (aged 16 to 63) in an urban psychiatric hospital in Canada from 2018 to 2020. Data were collected from 345 autistic patients who had 1027 PsyED visits during this 3-year period. Demographic information, psychiatric and neurodevelopmental diagnoses, and reasons for PsyED visits were characterized. Predictors of reasons for visiting PsyED were examined using mixed-effects logistic regressions. Differences between single-time and recurrent visitors were explored. Results: Autistic patients were mostly white (56.2%), Canadian citizens (79.1%), heterosexual (50.7%), and assigned male at birth (72.2%). Many were of low socioeconomic status, with one-third earning less than 15,000 Canadian dollars yearly. Most (84.3%) had at least one co-occurring mental health condition, with 54.8% having two or more. Rates of attention-deficit/hyperactivity disorder and intellectual disability were both around 20%. Most frequent reasons for visits included suicidality (42.9%), aggression (24.6%), and mood symptoms (16.1%). Reasons for visiting PsyED were associated with specific mental health and neurodevelopmental diagnoses. Recurrent visitors (40.3%) did not differ in sociodemographic characteristics from single-time visitors, but had more complex clinical presentations. Conclusion: Mental health needs of autistic adults were high and complex in the PsyED setting, particularly those needing recurrent emergency visits. Addressing service gaps and barriers to ongoing mental health support is essential to enhance the continuity of care.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:01.

Cited references
91
With a DOI
85
Without a DOI, from raw bibliography text
6
7 / 91 (7.7%) cited references include at least one author identified as autistic.
References with data to complete
4 / 91 (4.4%)
References with detected author names
87 / 91 (95.6%)
Without detected author names
4
Without a structured title
4
Without a stable identifier
6
References with raw author names still to review
4
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
496
From DOI or external metadata
496
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
4
133 / 496 (26.8%) names are linked to an author already present in AutiHub. 363 / 496 (73.2%) names are not yet linked.
Names linked to a person identified as autistic
18 / 496 (3.6%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 18 / 133 (13.5%). Distinct people identified as autistic: 17 / 462 (3.7%).
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