Examining Longitudinal Patterns of Psychotropic Medication Use by Individuals with Intellectual Disabilities Relocating from Institutions to Community Settings

Abstract

For 133 years, institutionalization was the primary model of care provided for individuals with intellectual disabilities in Ontario. By March 31, 2009, the last remaining institution in Ontario was closed. Given that individuals with intellectual disabilities are more likely to develop health and mental health comorbidities than the general population, investigating outcomes after relocation is critical for ensuring safe and successful transitions to community settings. This study examined changes in psychotropic medication usage following deinstitutionalization as well as changes over time in the community. Various proxy measures were collected on demographic variables (e.g., age, sex, etc.), adaptive functioning, challenging behaviour, psychotropic medication usage, health status, and mental health status. A multilevel model was used to investigate within and between-person changes in psychotropic medication usage longitudinally across three points in time. Variables, including adaptive functioning, challenging behaviour, and health and mental health status, were investigated as potential predictors of psychotropic medication usage. Health variables and mental health status positively predicted psychotropic medication. Cognitive performance and health instability from the facility to the community had a negative influence on the total number of psychotropic medications. Challenging behaviour did not predict psychotropic medication usage in this study, possibly due to the measure used. Further examination of these results may be used to inform policy and practice for individuals with intellectual disabilities in Ontario.