The use of anti-psychotic and other psychotropic medication in a specialist community service for adults with learning disabilities

Purpose: The aim was to examine the extent to which, in the five integrated community teams for adults with learning disabilities (CTLDs) in an English county-wide service, the use of psychotropic medication for service users was based on the presence of an appropriate mental health condition or epilepsy.

Design/methodology/approach: Adult participants were recruited following referral to one of the CTLDs for assessment, treatment and/or support of a possible mental health and/or behavioural need. Data were collected about (i) participant characteristics; and (ii) psychotropic medication 9-12 months after recruitment.

Findings: While a total of 42 (78%) of the 54 participants were apparently prescribed regular or prn (as required) psychotropic medication, only 24 (57%) of these individuals had a recorded past or current mental health condition or epilepsy for which such medicine could be appropriate.

Research limitations/implications: There were several limitations: the sample size was small; its representativeness was uncertain; and data collection was compromised by barriers to explicit knowledge exchange within and across the learning disability service.

Practical implications: While recent guidance about the use of psychotropic medication is welcome, minimising inappropriate use requires more comprehensive person-centred interventions (including crisis management plans), underpinned by imaginative, but feasible, data collection methods and integrated formulations. Investment is needed in developments that support multi-disciplinary and inter-agency working to promote ‘good practice’ by CTLDs in responding to referrals for possible mental health and/or behavioural needs.

Originality/value: Complementing recent large studies of primary care (GP) records, this is the first examination of the use of psychotropic medication by service users in English CTLDs.