Medication for Challenging Behaviour and People with Learning Disabilities
This report is about how many people with learning disabilities are getting medicine for challenging behaviour and mental health problems. Challenging behaviour Doctors sometimes give people with learning disabilities medicine to try and stop challenging behaviour. Challenging behaviour means hurting yourself, hurting others, or behaving in a way that makes it difficult for you to be in the community. There are lots of reasons for challenging behaviour. People can be challenging because they are unhappy and are trying to tell people. They may not feel well, or be frightened. It is important to find out why people are challenging, and do something about it. 2
Mental health problems Doctors often give medicines to people with mental health problems. There are different mental health problems. People with mental health problems can have challenging behaviour. Depression Some people are unhappy a lot of the time for no reason. This is called depression. Doctors treat people who have depression with medicine called antidepressants. Psychosis Some people have strange ideas that don t make sense or hear people talking when there is no-one there. This is called psychosis. Doctors treat people with psychosis with medicine called antipsychotics. Treating challenging behaviour and mental health problems When people with learning disabilities have challenging behaviour, carers often ask doctors to help. 3
Doctors look for reasons why people have challenging behaviour. There may be things that can be changed to help people, but, sometimes it can be difficult to change things like where someone lives. It can also be difficult to find out why people have challenging behaviour. Doctors check if people have depression or psychosis. This can be difficult, as people with learning disabilities may not be able to say how they feel. Doctors often give people antipsychotics or antidepressants to see if this will stop the challenging behaviour. This may help at first, as medicine can make people less anxious. It can also makes people tired. If people have psychosis or depression these medicines can be really helpful. 4
But, if people don t have depression or psychosis, there is no evidence that the medicines help stop challenging behaviour. This study We asked how many people with learning disability are taking antipsychotics and antidepressants at any time. We compared this to the number who have psychosis and the number who have depression. We did this by looking at doctors records. What we found Think of 100 adults with learning disabilities. Doctors are prescribing antipsychotics for 17of those people. 5
Doctors are prescribing antidepressants for 17 of those people. 7 people are being prescribed both. Only 4 of those 100 adults with learning disabilities have psychosis. Fewer than 7 people have a depression. 16 are taking one or other drug and don t have either a psychosis or depression. Our conclusions Many people with learning disabilities are being given antipsychotics or antidepressants who should not be having them. 6
About Public Health England Public Health England exists to protect and improve the nation's health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Public Health England Wellington House 133-155 Waterloo Road London SE1 8UG Tel: 020 7654 8000 www.gov.uk/phe Twitter: @PHE_uk Facebook: www.facebook.com/publichealthengland Prepared by: Gyles Glover, Public Health England Rachael Williams, Clinical Practice Research Datalink With David Branford, Ray Avery, Umesh Chauhan, Matthew Hoghton, Sarah Bernard For queries relating to this document, please contact: Gyles.Glover@phe.gov.uk Crown copyright 2015 You may re-use this information (excluding logos) free of charge in any format or medium, under the terms of the Open Government Licence v3.0. To view this licence, visit OGL or email psi@nationalarchives.gsi.gov.uk. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. Published July 2015 PHE publications gateway number: 2015200 7