Qualitative exploration of psychotropic medication to manage challenging behaviour in adults with intellectual disability: views of family members
| DOI | https://doi.org/10.1108/AMHID-06-2017-0027 |
| Date | 05 September 2017 |
| Pages | 207-218 |
| Published date | 05 September 2017 |
| Author | Nicole Edwards,Julie King,Hanna Watling,Sara Amy Hair |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Qualitative exploration of psychotropic
medication to manage challenging
behaviour in adults with intellectual
disability: views of family members
Nicole Edwards, Julie King, Hanna Watling and Sara Amy Hair
Abstract
Purpose –The purpose of this paper is to produce the views of parents and siblings of adults with intellectual
or developmental disability (ID/DD) around the use of psychotropic medication to manage challenging
behaviour (CB) where there is no co-existing mental illness.
Design/methodology/approach –Seven family members of six adults with ID/DD were interviewed using
semi-structured interviews, over the telephone or face-to-face. The interviews were transcribed, coded and
thematically analysed.
Findings –This paper identified that if used appropriately, psychotropic medication to manage CB may be of
benefit to some people with ID/DD; but there is a need to ensure the medication is prescribed for the benefits
of people with ID/DD rather than those around them. Drawing on the knowledge of family may allow for the
use of alternative strategies and the reduction of medication to manage CB. There is the need for improved
communication with family members, inclusive decision making, and access to information regarding the
philosophy and legislation regarding medication used to manage CB in adults with ID/DD.
Originality/value –This paper presents views of a small cohort of family members of people with ID/DD
in Queensland, Australia. Findings can be used to improve approaches taken by service providers in
their interactions with people with ID/DD prescribed psychotropic medication to manage CB, and their
family members.
Keywords Australia, Psychotropic, Human rights, Intellectual disability, Medication, Chemical restraint
Paper type Research paper
Introduction
Challenging behaviour (CB), including aggression, destruction, inappropriate sexual behaviour,
and self-injury presents in approximately 7-15 per cent of people with intellectual or
developmental d isability (ID/DD) (Emerson et al., 2001; Webber et al. , 2008).These behaviours
pose serious risk of ha rm to self and others an d negatively affect q uality of life (Davis and
Gavidia-Payne, 2009; Holden and Gitlesen, 2006). Psychotropic medications, inclusive of
antipsychotics , mood stabilisers, antian xiety and antiepileptic me dications are often prescri bed
to people with ID/D D to manage CB in the absence of psyc hiatric diagnosis; estimat es indicate
that the prescription rate is 2-4 times higher than the rate of diagnosed mental illness in this
population (Glover et al., 2015; Tsiouris et al., 2013). Despite common use of medication for
the management of CB, the literature is inconclusive regarding effectiveness in reducing CB
(Brylewski an d Duggan, 2004; Deb and Unwin, 2007) or ha s failed to demonstrate reductio ns
that exceed that of placebo treatments (Ahmed et al., 2000; Tyrer et al., 2008). Psychotropic
medication has als o been linked to a number of s ide effects and its use t o manage CB has
been identified a s a threat to the human r ights of people wit h ID/DD (Australian L aw Reform
Commission, 2014).
Received 27 June 2017
Revised 5 October 2017
Accepted 10 October 2017
The authors acknowledge funding
from the QUT School of Public
Health and Social Work,
Queensland Government OPG and
Office of the Public Advocate.
Nicole Edwards is a Senior
Lecturer and Julie King is a
Lecturer, both at the School of
Public Health and Social Work,
Queensland University of
Technology, Queensland,
Australia.
Hanna Watling is based at the
School of Psychology and
Counselling, Queensland
University of Technology,
Queensland, Australia.
Sara Amy Hair is a Research
Officer at the School of Public
Health and Social Work,
Queensland University of
Technology, Queensland,
Australia.
DOI 10.1108/AMHID-06-2017-0027 VOL. 11 NO. 5/6 2017, pp.207-218, © Emerald Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE207
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