Learning Disability Today
Supporting professionals working in learning disability and autism services

Time to put an end to the chemical cosh for people with learning disabilities

Dan Parton cutResearch by Public Health England has found that more than 30,000 people with learning disabilities are being prescribed antipsychotic or antidepressant medication – or both – without appropriate clinical justification. This practice has to be stamped out – and quickly.

The figures in the research are shocking. That such a number of people are subject to medication regimes that are not clinically justified – meaning they don’t need it – is unacceptable. That this has been allowed to happen for a significant amount of time, seemingly without challenge, is also reprehensible.

Research, commissioned by NHS England and delivered in three reports from the Care Quality Commission, Public Health England and NHS Improving Quality, also found that there is a much higher rate of prescribing of medicines associated with mental illness among 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.

In addition, medicines are often used for long periods without adequate review, and there is poor communication with parents and carers, and between different healthcare providers. Worryingly, this inappropriate use of medication is not just in residential units but also in the community.

While antipsychotic and antidepressant drugs can be useful for some people with learning disabilities – as they can in the general population – they are not appropriate for everyone. They should only be used as part of a multi-professional treatment plan, with the benefits, length of treatment and any side effects clearly stated. This is clearly not always the case currently.

If other groups in society were subject to such drugging there would be outcry. This practice has long been a problem in older people’s care too, especially those in residential care, but there have been moves to address it – and there have been repeated newspaper splashes on those affected. It should be no different for people with learning disabilities.

This practice simply has to be stopped. Prescribing such drugs with no appropriate clinical reasoning can never be justified. Making people with learning disabilities into little more than drowsy zombies means they can never fulfil their potential. Just because they may have a mental illness or behaviour that challenges, for example, that is no reason to just pump them full of drugs.

Instead, other treatments and therapies should be used that don’t require medication, such as positive behaviour support. While this may be more complicated to do – or perhaps cost more – that is no reason not to do it. This is people’s lives we are talking about: they have just the same rights as everyone else to live a good life and not be stuck on drugs that do nothing for them.

NHS England has pledged ‘rapid and sustained action’ to address this scandal. Firstly, representatives of professional and patient groups will attend an urgent summit tomorrow [July 17], at which an action plan and a delivery board will be established to drive the necessary changes.

So far, the words are positive. But we’ve seen positive words before and then little happen afterwards to address a problem – think of the response to the Winterbourne View scandal over the past 4 years. This has to be backed up with action. A ‘call to arms’ may be in the offing but it needs more than that and it has to come from the top. As we have seen, without sufficient incentive – carrot or stick – those involved in prescribing these drugs will continue to take the easy option and maintain the status quo. Change is needed and quickly – this chance must not be squandered.

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