The use of psychotropic medication for the management of problem behaviours in adults with intellectual disabilities living in Canada
Bibliographic record
Abstract
The paper provides a Canadian perspective on the use of psychotropic medication in the management of problem behaviours in adults with intellectual disabilities in Canada. Psychotropic medication and intellectual disabilities were explored in the context of Canadian health and social services, clinical practices, medical training and factors that have shaped these over the past few decades. Informal physician intellectual disabilities networks and the newly formed Canadian Network of the National Coalition on Dual Diagnosis provided the opportunity to survey the use of psychotropic medication for problem behaviours across the country. Geographic, political, cultural and other influences on the development of health and social services are described, as well as training requirements for physicians. Survey responses were received from all provinces and represented clinicians in mental health multidisciplinary teams, health and social services ministry representatives, agency staff (up to executive director level) and family members of individuals with intellectual disabilities. Psychiatry and family medicine perspectives of the authors from working in Canada and the UK with people with intellectual disabilities presenting with problem behaviours are described. In Canada there are no national, provincial or territorial policies or guidelines on use of psychotropic medication for the management of such behaviours. There are no requirements for physicians prescribing these medications to have training in the care of people with intellectual disabilities. Services for people with intellectual disabilities and behaviour problems in Canada appear to be more crisis-reactive than those in the UK.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".