Stakeholder Views on Hospitalisation of Adults With Intellectual Disabilities in New Zealand

Abstract

Background: Community stakeholders play a crucial role in supporting the wellbeing of people with intellectual disabilities, including during hospitalisation. This study explored community stakeholder perceptions of the barriers to safe and equitable hospital care for adults with intellectual disabilities in Aotearoa New Zealand. Method: Semi-structured interviews (n = 9) and anonymous online surveys (n = 38) were analysed using reflexive thematic analysis within an interpretive description framework. Results: Four themes were generated: experiencing the hospital as unsafe due to structural and interpersonal discrimination; communication breakdowns that undermine care and amplify distress; distress misread as behavioural issues; and stakeholders becoming the default safety net. Across themes, discrimination emerged as the underlying mechanism shaping patient safety, communication practices, behavioural interpretations, and reliance on stakeholder vigilance. Conclusion: These findings highlight the need for systems-level change, including improved training on working with people with intellectual disabilities, enhanced communication practices, and strengthened continuity of care to support equitable hospital experiences.