Psychotropic and Anticonvulsant Medication: Individuals With Intellectual and Developmental Disabilities Who Transitioned to the Community From an Institution

Abstract

Influenced by Georgia's settlement agreement with the United States Department of Justice relating to the enforcement of the Americans with Disabilities Act, an increasing number of individuals with intellectual and developmental disabilities (IDD) are transitioning from institutions to community living. In this study we evaluate the pattern of medication use among individuals who recently transitioned to the community (IRTC), comparing results to the IDD population already residing in the community (comparison group). Average use and prevalence rates were trended over time, between January 1, 2010, and December 31. 2012. Findings indicate a significant increase in medication use in the IRTC and comparison group, with a greater and faster increase in the IRTC population. We suggest the transition process should be examined and revised, ensuring adequate preparation time and training for each person and relevant staff, particularly on medications and challenging behaviors. Several demographic trends were also significant and are discussed.

Utilizing health records to characterize obesity, comorbidities, and health-care services in one human service agency in the United States

“…Underreporting and underidentification of proper diagnoses have been previously noted in this population (McCarron et al, 2014; Tsiouris et al, 2013), but these results suggest a significant reversal. Similar to other researchers who have noted the broad use of psychotropic drugs for behavioral control without an associated psychiatric diagnosis (Kelly and Su, 2015; Singh and Matson 2009; Tsiouris et al, 2013), we also noted that five of six reviewed records were receiving psychotropic medications in spite of the absence of any mental health diagnosis.…”

“…This obesity epidemic and its ramifications have been widely recognized. Organizations like the American Medical Association and Healthy People 2020 have advocated for prevention programs and health weight loss interventions to address the high obesity prevalence (Frellick, 2013; Healthy People, 2014), unfortunately persons with intellectual disability experience disparities in health care and are often not included in general health screening and health promotion programs (Kelly and Su, 2015; McCarron et al, 2014 , 2011).…”

Typology of Community Living Transitions for People with Intellectual Disabilities: Are Current Experience in Rehabilitation Centers Tied to the Best Practices?

“…The steps of the transition, when performed, are done abruptly, offering little time for educators to prepare the person with ID to become involved in their own transition. Thus, the conditions which favor the emergence of self‐determination are not implemented (Griffiths et al, ; Kelly & Su, ; Shogren & Wehmeyer, ). When educators feel a sense of emergency, it becomes difficult for them to keep the person with ID at the center of the transition process; as such they are likely to be swept away from the transition process.…”

“…The typology highlights various experiences that put into question the real place of self‐determination that is made for people with ID in the transition process. More specifically, it serves as a reminder of the importance of placing the person with ID at the center of the community living transition process and to provide a clinical and administrative framework which promotes the emergence of self‐determination and the involvement of individuals with ID in their own transition (Griffiths et al, ; Kelly & Su, ; Owen et al, ; Shogren & Wehmeyer, ; Silberman et al, ; Wehmeyer et al, ). Hopefully, by becoming aware of this typology, rehabilitation centers will identify strategies for transitions that maximize involvement and collaborative planning with the person with ID and his family, and minimize the feeling of powerlessness among educators and individuals with ID.…”

Adverse Side Effects of Psychotropic Medication and Challenging Behavior: Pilot Work Assessing Impact

“…Deb and colleagues (2015) reported that approximately 41% of their sample was prescribed two or more psychotropic medications off label. Kelly and Su (2015) found that the percentage of individuals with IDD prescribed with psychotropic medications increased to 44% from 21% after transitioning to community residential settings from institutions in the state of Georgia, and the average number of medications prescribed per individual raised to 1.84 from 0.68. These studies illustrate how conventional psychotropic medication use has become in treating challenging behavior among populations with IDD.…”