Guest blog from a Clinical Nurse Specialist, CAMHS
The ‘Family Intensive Support Service’ is a team within the Child and Adolescent Mental Health Service, working with children and young people who have a moderate to severe learning disability, challenging behaviour and very often a mental health disorder such as anxiety or OCD. Some of the children and young people these teams work with will have been prescribed Anti-psychotic medication. Anti-psychotic medication is a drug that can come with a lot of side effects such as weight gain, nausea and headaches and can also lower the threshold for seizure activity, and should be considered as a last resort when prescribing.
Auditing the use of Anti-psychotic medication in children and young people is an important part of the teams work.
A recent audit analysing over one years’ worth of data identified how many young people had been prescribed this type of medication, and, in the same time period how many had stopped taking the drug.
Some families who have taken the decision to use anti-psychotic medication to treat their children have never looked back and think of it as ‘getting back their child’. Others thought their children’s condition had deteriorated with medication and felt deflated when it had not worked.
Those parents who do give their children the prescribed drugs, and see a difference are often reluctant to reduce the dose or stop the medication completely fearing their child’s condition will become challenging and unmanageable. Often parents have experienced physical and verbal aggression at the hands of their children and get very little help with managing this type of behaviour.
Our audit showed that out of the 30 children on the caseload between July 2013 and July 2014, only three stopped taking anti-psychotic medication, one was due to it not being effective and the two others were due to changes in environment leading to less challenging behaviour and no longer needing anti-psychotic medication.
When parents have to make the decision whether to medicate their children or indeed reduce/stop medication, they are often faced with pressure from other outside agencies. School and social care agencies sometimes want to be able to ‘manage’ children whilst they are at school or respite. This often leaves parents with a dilemma, they may perceive that their child might be better off reducing or stopping medication but be frightened to take that step. Parents need not only increased support in managing challenging behaviour but independent support and advice in being the final decision makers on whether their child is medicated or not.