Psychiatry RAISR4D

Pragmatic Reasonable Accommodation in Everyday Medicine for People With Intellectual Disabilities: A Qualitative Study of Non-Psychiatric Physicians in Japan

04/07/2026

AI Summary

Medication management tailored to patients' understanding, preferences and home support
Relationship-centred communication to elicit symptoms, confirm comprehension and reduce misunderstandings
Flexible care processes including time, environment and team roles, with clear documentation and coordination to mitigate risks

J Appl Res Intellect Disabil. 2026 Jul;39(4):e70276. doi: 10.1111/jar.70276.

ABSTRACT

BACKGROUND: In Japan, providing reasonable accommodation for people with intellectual disabilities became mandatory on 1 April 2024, but evidence from non-psychiatric hospital care is limited.

METHOD: We conducted semi-structured interviews with nine hospital-based non-psychiatric physicians in Japan (October 2023-March 2024) and analysed data using inductive thematic analysis.

RESULTS: Physicians described accommodations in (1) medication management tailored to understanding, preferences, and home support; (2) relationship-centred communication to elicit symptoms and confirm comprehension; and (3) flexible care processes, including time, environment, and team roles. They mitigated risks through witnessed explanations, clear documentation, and proactive coordination with nurses and family members.

CONCLUSIONS: Practical, workflow-embedded accommodations are common in non-psychiatric settings and could be strengthened by structured communication supports and systematic information sharing.

PMID:42400349 | DOI:10.1111/jar.70276

Document this CPD