Top tip 2: Learn about best practice in supporting people whose behaviour challenges

Understand relevant approaches for supporting people, and the guidelines and restrictions on the use of psychotropic medication.

The Challenging Behaviour Foundation’s Pathway Resource is a clear and well-presented resource, which you can use with people with a learning disability, autism or both, their loved ones and professionals to help address over-medication. The NICE guidance document ‘Challenging behaviour and learning disabilities: prevention and interventions’ (see inset box) gives recommendations on the care of people with learning disabilities, autism or both whose behaviour challenges, including the use of medications. The guidance is that psychotropic medication should only be used for challenging behaviour if:

  • Psychological or other interventions alone do not reduce the challenging behaviour within an agreed time, OR 
  • Treatment for any mental or physical health problem has not led to a reduction in the behaviour, OR
  • The risk to the person or others is severe (for example because of harming others or self-injury).

The guidance also makes it clear that when providing support and interventions for people with a learning disability and behaviour that challenges, independent advocacy must be offered to the person and to their family members or carers, as described in the Care Act, Mental Capacity Act and Mental Health Act. Positive Behavioural Support (PBS) is one approach that supports many people with learning disabilities whose behaviour challenges. It can reduce or prevent the perceived need for medication. Advocates should have at least a general understanding of PBS so that they can explore the extent to which it may help.