The findings of a study by researchers at University College London (UCL) show that people with learning disabilities who have not been diagnosed with a mental health condition are being prescribed anti-psychotic drugs used to treat conditions such as schizophrenia.
Anti-psychotic drugs are prescribed to help reduce hallucinations in patients. Patients with learning disabilities – which are diagnosed before adulthood – do not necessarily have a mental health condition, although may exhibit challenging behaviour.
However, there is also no evidence that anti-psychotic drugs would address challenging behaviour, the researchers say.
The team collated prescribing data and patient records from 571 GP surgeries to determine rates of mental health diagnosis and the likelihood that a patient with a learning disability would be prescribed an anti-psychotic drug.
They investigated a total of 33,016 adults with a learning disability between 1999 and 2013 – and looked at whether they had been diagnosed with challenging behavioural conditions and prescribed brain-altering psychotropic drugs. Challenging behaviour might include aggression or agitation, disruptive behaviour, withdrawn personalities, self-harm or sexually inappropriate behaviour.
The researchers found that nearly half of those with learning disabilities who had been prescribed anti-psychotic drugs had a recorded history of challenging behaviour – and 71% of those prescribed the drugs had no history of a mental health condition at all.
In 2013, the patients were followed up by the team, who looked at prescribing for drugs such as antidepressants, anti-anxiety drugs, mood stabilisers and anti-psychotics.
The team also investigated evidence of mental health conditions among patients, such as depression, bi-polar disorder, schizophrenia, anxiety and dementia.
The research suggested that people with learning disabilities and older patients were more likely to be prescribed an anti-psychotic, even if they had no history of a diagnosed mental health condition.
Study author Dr Rory Sheehan form UCL’s Department of Psychiatry said:
“The number of people with intellectual disabilities who have been prescribed anti-psychotics is greatly disproportionate to the number diagnosed with severe mental illness, for which they are indicated.
“People who show problem behaviours – along with older people with intellectual disability, or those with co-existing autism or dementia – are significantly more likely to be given an anti-psychotic drug, despite this being against clinical guidelines and risking possible harm.”
There is ongoing debate over the misuse of anti-psychotic drugs prescribed as a “chemical cosh” in care homes, in cases where elderly or vulnerable people in care are “managed” using inappropriate medications.
Dr Sheehan added:
“Research evidence does not support using anti-psychotics to manage behaviour problems in people with intellectual disabilities.
“Many people with intellectual disability and behaviour disturbance have complex needs – and other interventions, such as looking at the support people receive and their communication needs, should be prioritised.
“Anti-psychotics, or indeed any medications, should not be prescribed lightly –
and are no substitute for comprehensive care.”
The UCL study into anti-psychotic prescribing was funded by the Baily Thomas Charitable Fund and the National Institute for Health Research.
The findings of the research are published in the British Medical Journal.
Duncan Lewis Mental Health Solicitors
Duncan Lewis is the UK’s largest provider of Legal Aid mental health services in the UK and is able to advise mental health patients on their rights under the Mental Health Act, including access to NHS mental health services and detention under the Mental Health Act.
Our specialist mental health solicitors regularly visit hospitals and police stations to advise on mental health law – and in some cases, may also be able to advise the nearest relative or carer of a mental health patient, including advising on mental health services for children and young adults, elderly and vulnerable patients, and mental health patients facing criminal charges.
There are Duncan Lewis offices nationwide – and our mental health department is led by Mental Health Panel Members.
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