Twenty‐one South Asian adolescents and adults with intellectual disabilities were interviewed regarding eight areas of their lives: accommodation, individual support, day services, service support, social and recreational activities, friendships and relationships, ethnic and racial identity, and racism and stigma. All interviews were coded for user satisfaction with these aspects of their lives, and content‐analysed to draw out relevant themes. From the interviews, it is clear that South Asian adolescents and adults have a strong and positive sense of their ethnic and racial identity, and that they are generally satisfied with their home and family circumstances. However, people with intellectual disabilities from South Asian communities experience pervasive racism and stigma throughout all areas of their lives. Consequences of this double discrimination include a lack of culturally appropriate services, limited friendships and closer relationships, and a lack of meaningful leisure activities. Implications of these findings for services are discussed.

No abstract

Self-reported stressors, coping strategies and stress-related outcomes were explored among 68 direct-care staff working in two networks of small staffed houses for people with learning disabilities. The two networks tended to have lower rates of staff turnover, and staff tended to be older, more qualified and more likely to have dependants, than staff in UK community services reported in previous studies. Staff in Network 2 rated several stressors as more stressful and reported themselves as experiencing greater general distress and work-related stress, than staff in Network 1. Multiple regressions revealed that: (1) stressors relating to the emotional impact of the work, violent service user behaviour and the use of a wishful thinking coping strategy were associated with perceived work stress; (2) stressors relating to the conflict of work with personal or family demands, and the use of a wishful thinking coping strategy, were associated with symptoms of general distress; (3) perceived work stress, together with uncertainty concerning job tasks and limited opportunities for personal advancement, were perceived to have a high impact on work 0952-9608/95/04/0252-208 10.00/0 MENTAL HANDICAP RESEARCH 0 1995 BILD Publications Vol. 8, No. 4, 1995 and personal or family demands and violent service user behaviour, were perceived to have a high impact on staff social life; (5) general distress, together with stressors relating to conflicts between work and personal or family demands and perceived deficiencies in other staff, were perceived to have a high impact on staff personal relationships. The organisational implications of these findings are discussed. CorrespondenceCorrespondence should be sent to Chris Hatton.

The prescription of psychotropic drugs to people with intellectual disabilities was examined in 357 people with intellectual disabilities served by 57 GPs. The results of the survey indicated that (1) 21% of adults with intellectual disabilities were receiving neuroleptic medication, 10% were receiving anxiolyticshypnotics and 10% anti-depressants; (2) the likelihood of an adult being prescribed neuroleptic medication was associated with a number of factors including whether they had challenging behaviour, whether they had a recorded mental health problem; whether they had been resettled from long-stay hospital and whether they were under review by a consultant psychiatrist; (3) the likelihood of an adult being prescribed anti-depressant medication was associated whether they were under review by a consultant psychiatrist and whether they had a recorded mental health problem; (4) the likelihood of an adult being prescribed anxiolyticlhypnoticmedication was associated with a different set of factors including whether they had significant support needs, whether they had epilepsy and whether they were under review by a consultant psychiatrist; (5) nearly one-half of people with intellectual disabilities who are receiving neuroleptic medication and just over one-third of people with intellectual disabilities who are receiving anti-depressant medication are not under the review of a consultant psychiatrist; (6) the factors predicting prescribing practices of the GPs in such cases were broadly consistent with the factors predicting overall prescribing practices.

Aspects of the use of psychoactive medication were assessed among 118 adults with intellectual disabilities who had been resettled from long-stay hospitals into two local dispersed housing services. The resulting data indicated that (1) 69% of people were receiving psychoactive medication primarily for the control of challenging behaviour;(2) only 8% had psychiatric diagnoses; (3) polypharmacy was frequent and (4) medication was continued over long periods sometimes without review. The prescribing practices of general practitioners tended to follow those inherited from the long-stay hospitals. The findings are compared with recent policy statements conceming the use of anti-psychotic medication and the need for multidisciplinary medication audit, and contrasted with evidence for the greater efficacy of non-pharmacological alternatives.