Report - Public hearing 6 - Psychotropic medication, behaviour support and behaviours of concern

Report of Public hearing 6: Psychotropic medication, behaviour support and behaviours of concern

Introduction

The Disability Royal Commission held Public hearing 6 in September 2020 in Sydney and Brisbane.

The hearing looked at the ways people with cognitive disability are treated when they show ‘behaviours of concern’. The hearing focused on psychotropic medication as a way to control behaviours of concern.

We have written a report about this hearing. It’s on our website. The report will help us develop recommendations to make a better, safer better place for people with disability. This Auslan video is a summary of this report.

At the hearing we heard from 30 witnesses. This included:

• people with disability
• family members
• advocates
• carers
• doctors
• practitioners
• academics
• government representatives.

People with disability talked about their experiences of psychotropic drugs and the impact it had on their lives.

One woman, Paula McGowan, talked about her son Oliver, and how he died at 18. Oliver had autism, mild intellectual disability and epilepsy. He was a natural leader and high achiever. In 2016, Oliver went to hospital due to seizures. He developed pneumonia and was given antipsychotic drugs even though his parents said not to. Oliver reacted to the drugs and died.

Key findings

The report highlights key findings that came out of the hearing. Some of these are:

• Psychotropic medication is over-prescribed to people with cognitive disability.
• There is a power imbalance between people with cognitive disability and service providers, doctors and even family members. This can lead to psychotropic medication being used without the person with cognitive disability understanding what is happening, or giving consent.
• People with cognitive disability may experience more side effects of psychotropic medication than people without disability. Side effects can be:
  • nausea
  • headaches
  • weight gain
  • death
  The negative effects of psychotropic drugs can cause people with cognitive disability to show more and more different behaviours of concern.
• Laws and policies about the use of psychotropic medication are complex and different in every state.
• The health and disability sectors need to collaborate to fix the over-use and misuse of psychotropic drugs on people with cognitive disability.
• In the short term, sometimes psychotropic drugs may help address behaviour, for example they can calm people down. But psychotropic drugs are unlikely to fix the cause of the behaviour.
• ‘Positive behaviour support’ reduces the incidences of behaviours of concern. Positive behaviour support can also lead to psychotropic drugs being used less often.
• There needs to be accessible information and guidance on things like:
  • managing behaviours of concern
  • positive behaviour support
  • side effects of psychotropic medication
• There is a lack of services, especially in rural and remote areas. This means high quality behavioural support is not available to all people with cognitive disability.

More information

You can read the full report on our website. Go to the ‘Publications’ section.