The Care Quality Commission, Public Health England and NHS Improving Quality have recently published reports commissioned by NHS England into the prescribing of psychotic drugs to people with learning disabilities. The research found that there is an alarming rate of over-prescribing of these drugs to people with learning difficulties: the report authored by Public Health England, estimates that up to 35,000 adults with a learning disability are being prescribed an antipsychotic, an antidepressant or both without appropriate clinical justification.
The research concluded that:
- There is a much higher rate of prescribing of medicines associated with mental illness amongst people with learning disabilities than the general population, often more than one medicine in the same class, and in the majority of cases with no clear justification
- Medicines are often used for long periods without adequate review
- There is poor communication with parents and carers, and between different healthcare providers
Dominic Slowie, NHS England’s National Clinical Director for Learning Disabilities admitted that this is an historic problem and the research was needed to find out the scale of the problem so that action could be taken.
This is something that we feel strongly about at The Richardson Partnership for Care, and we regularly review the medication that our service users take with the aim of reducing it over the longer term wherever possible. Our focus is on behavioural therapy and all staff are trained in managing actual or potential aggression using the least restrictive techniques.
This is what the uncle of one of our service users with learning disabilities said about his care:
“Over a period of ten years, my nephew has presented with very challenging behaviour. Having his time with the Richardson Partnership for Care, his behaviour has improved as a result of excellent care. This consists of reducing the ‘chemical cost’ of drug therapy with a range of behaviour modification and genuine and dedicated care, which we greatly appreciate.”
Our team of psychologists support our service users to help them to manage their behaviour and maintain their mental health. We have found that personalised care and the right level of clinical psychology provision has enabled individuals with even the most challenging behaviour to make good progress and reduce their medication.
One of the techniques used by our psychologists to help modify behaviours is Applied Behaviour Analysis (ABA). Support staff complete specialised recording forms, which are collated and analysed by the psychologists. The results help us to understand the relationship between specific behaviours and the environment. This means that things that may negatively affect behaviour can be more positively adapted, as part of a learning process.
In addition, each service user has their own health passport to give them ownership of their medical information and clarity regarding the medication that they are taking.