Receipt of psychotropic medication by people with intellectual disability in residential settings.
UK homes give antipsychotics for behavior, not psychosis, and later studies show this pattern persists while harm piles up.
01Research in Context
What this study did
Rose et al. (2000) asked staff in UK residential homes about every resident with intellectual disability.
They noted who took antipsychotics, antidepressants, or sleeping pills.
Then they looked at why each drug was given: challenging behavior or mental-health symptoms.
What they found
Homes gave antipsychotics for behavior problems, not for psychosis.
Sleeping pills also tracked with behavior.
Antidepressants were the only drugs tied to mood signs, not to behavior.
How this fits with other research
de Kuijper et al. (2010) asked the same question in the Netherlands and got the same answer: one in three residents took antipsychotics, mostly for behavior.
Boswell et al. (2023) later used whole-country records and still saw high antipsychotic use, so the early snapshot still holds.
Scheifes et al. (2016) and de Kuijper et al. (2013) added a warning: long-term use brings stiff muscles, weight gain, and lower quality of life.
Put together, the picture is clear: behavior drives the prescription, but the pills carry real medical cost.
Why it matters
If you support adults with ID, check the reason for every antipsychotic. Ask the doctor: "Is this for psychosis or for behavior?" If it is for behavior, request a behavior plan review and consider a slow taper. Your question can cut harm without losing control.
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02At a glance
03Original abstract
Previous studies have reported that the rate of prescription of antipsychotic medication for people with intellectual disability is far in excess of the expected prevalence of psychoses for this population. Recent research identifying factors which predict the use of psychotropic medication suggests that challenging behaviour may play a key role in determining the receipt of antipsychotic medication. The present study reports the prevalence of psychoactive medication receipt for 500 people with intellectual disability living in different forms of residential provision in the UK. Variables which predict the receipt of psychotropic medication are also identified. The results show differences between forms of residential provision in rates of medication receipt. Analyses of predictors of psychotropic medication receipt suggest that, whilst the receipt of antidepressants is predicted by symptoms of mental ill health, the receipt of both antipsychotics and hypnotics/anxiolytics is predicted by variables related to challenging behaviour.
Journal of intellectual disability research : JIDR, 2000 · doi:10.1046/j.1365-2788.2000.00307.x