Historic collaboration to address inappropriate use of psychotropic medicines

Did you know that some Australians are STILL chemically restrained to control their behaviour?

As a result of this, National Disability Insurance Scheme (NDIS) Minister Senator Linda Reynolds has launched a landmark Joint Statement on the Inappropriate Use of Psychotropic Medicines by the NDIS Quality and Safeguards Commission, Aged Care Quality & Safety Commission (ACQSC) and Australian Commission On Safety and Quality In Health Care ACSQHC).

“There is absolutely no place in a modern and humane country for the inappropriate use of psychotropic medications to chemically restrain people,” Senator Reynolds said when launching the collaboration.

“Shockingly we know that this occurs far too frequently across our health, aged and disability care systems."

“Psychotropic medications should always be used as a “last resort” not a “first in line” approach to managing behaviours of concerns."

“This collaboration follows extensive work by the Morrison Government over recent years to establish a quality and safeguards framework for the disability sector and to better understand and collect data on the use of restrictive practices.

Implementing this statement will require long-term collaboration between government and regulators working in partnership with all sectors to address these shared issues.”

In a statement issued at the launch of the campaign, Senator Reynolds said the three Commissions released the joint statement to better address the inappropriate use of psychotropic medicines such as mood stabilizers and sedatives in people with disability and older people as a form of restrictive practice, and committed to collaborative action to reduce it.

“The use of psychotropic medicines can be appropriate for treating, or enabling the treatment of a diagnosed mental disorder or a physical illness or physical condition,” she said in her statement."

“However, using psychotropic medicines to influence or control the behaviour of people who exhibit behaviours of concern, is a restrictive practice and is subject to regulatory oversight."

“Reducing and minimising the use of restrictive practices, except where absolutely necessary, remains a key focus for the NDIS.” 

Senator Reynolds the landmark joint statement would ensure NDIS participant’s rights to choice and control are protected, improve their quality of life and lead to more positive health and wellbeing outcomes for all Australians with disability.

“This critical collaboration by the three commissions follows extensive work by the Morrison Government over recent years to establish a quality and safeguards framework for the disability sector and to better understand and collect data on the use of restrictive practices,” she said.

The Royal Commission into Aged Care Quality and Safety identified an over-reliance on chemical restraint as a priority concern in aged care, the Australian Seniors News (ASN) reported.

Health, aged care and disability support providers are all required by law to ensure that restrictive practices are only used as a last resort, and in the least restrictive form.

Healthcare practitioners and aged care providers also require informed consent for the prescription and use of psychotropic medicines, including when used as a restrictive practice, ASN said.

The ACQSC, the NDIS Quality and Safeguards Commission (NDIS Commission) and the ACSQHC recognise that there is:

• Evidence that psychotropic medicines are being overprescribed and overused, in particular with older people and people with disability;
• Little evidence that psychotropic medicines are effective for managing behaviours of concern;
• Evidence that psychotropic medicines contribute to risks of harm to older people and people with disability, including by contributing to risk of falls, weight gain, hypertension and diabetes, by adversely affecting the person’s ability to swallow, and by increasing the risk for aspiration pneumonia and other respiratory complications;
• Evidence that psychotropic medicines can diminish the wellbeing and quality of life of older people and people with disability.

According to the ASN, all three Commissions have agreed to work together to reduce the inappropriate use of psychotropic medicines through:

• Raising awareness of the risks associated with inappropriate use of psychotropic medicines amongst healthcare, aged care and disability workforces;
• Supporting improvements to the availability and quality of behaviour support planning, and preventative and de-escalation strategies;
• Strengthening understanding and capacity for appropriate informed consent, prescribing, dispensing, administration and cessation of psychotropic medicines.

By working together with other key individuals and organisations within the health, aged care and disability sectors, to reduce inappropriate use of psychotropic medicines, the commissons aim to improve the quality and safety of health, aged care and disability supports for all Australians, the statement read.

Senior Australians and Aged Care Services Minister Richard Colbeck said the work of the ACQSC, NDIS Commission and ACSQHC on the use of psychotropic medicines would help to strengthen action already taken by the Government in this area to ensure senior Australians receive the care they expect and deserve.

The ACQSC has developed a series of resources to support the aged care sector since new requirements were introduced regarding the use of restrictive practices in aged care in July and September 2021.

“The resources developed by the ACQSC are important to help providers to understand their obligation to ensure that restraints, including psychotropic medications, are only used as a last resort.” Mr. Colbeck said.

Health and Aged Care Minister Greg Hunt, said psychotropics had a place in health care but they should only be used according to accepted medical practice, with the health and wellbeing of people in aged or disability care settings being our paramount consideration.

“The collaboration to reduce inappropriate use of psychotropic medicines across the three sectors where people with disability and older people receive care, is ground-breaking. It can provide a real opportunity and impetus for the type of systemic change highlighted by both the Disability Royal Commission and the Aged Care Royal Commission,” Mr. Hunt said.

The ACSQHC is committed to high quality and safe health care for all Australians, this includes improving outcomes in the health care of older people and people with disability through appropriate prescribing, dispensing and administration of psychotropic medicines.

It aims to do this by gathering intelligence on the inappropriate use of antipsychotics through the Australian Atlas of Healthcare Variation series, and analysing that information to provide national clinical guidance across the health sector.

Further information can be found in a joint statement on the ACQSC, NDIS Commission and ACSQHC’s respective websites.