The Health and Care of People with Learning Disabilities dataset - how many people are taking mental health medications?

Note: if you want to skip the graphs, go straight to the conclusions for a quick summary...

For over 30 years, it's been clear that huge numbers of people with learning disabilities in England (and in other places too) are prescribed (told by their doctor to take) what are sometimes called 'psychotropic' drugs - drugs that are prescribed to change something about a person's mental state. Typically, these are drugs prescribed for reasons of 'mental health', although they might also be prescribed to change a person's behaviour. Recent research led by Sue Caton at Manchester Metropolitan University with co-researchers with learning disabilities has shown that people with learning disabilities are often not involved in decisions about what mental health medications they're taking (this link goes to a toolkit produced by the project that might help people get more involved in these decisions).

In England, NHS England and other organisations have been running the STOMP programme since 2016. STOMP stands for 'Stopping over medication of people with a learning disability, autism or both'. More recently STAMP ('Supporting Treatment and Appropriate Medication in Paediatrics) has been added by NHS England. Part of the aim of both these programmes is to reduce the number of people with learning disabilities and autistic people who are prescribed these drugs.

This blogpost will summarise some recent information about the percentages of people with learning disabilities being prescribed a range of mental health drugs. 

This blogpost will be the first of a series going into a lot of detail using information from the 'Health and Care of People with Learning Disabilities' dataset, compiled by NHS England. Every year (going April to March), this takes information from GP information systems in England to produce statistics about the health and health treatment of people registered with a GP as a person with learning disabilities, often comparing them to the health and healthcare of people without learning disabilities. It's a brilliant source of information that isn't used as much as it should be. The interactive information tool is quite hard to get your head around but it does make it quite flexible - for many things you can look at how things are by age, sex, region and even more locally than that, and for most things you can look back over at least the last five years. The most recent information available covers April 2024 to March 2025, with updates usually released every year in December.

There are a few reasons that I want to go into mind-numbing detail this time around (it's not ONLY that I like graphs). First, I'm not going to be doing these blogposts for ever, so I want to make the ones I do as full of information as possible for completeness. Second, I want to show what these kinds of datasets can do, in the hope that people will keep using them. Third, a recent 'consultation' has said that this is the last year that this dataset in this format will be produced. It will be replaced by something that might have more information and will cover all GP practices (a very welcome development), but will not have any way of directly comparing people with learning disabilities to people without learning disabilities (which is such a useful feature of the dataset as it stands).

Before we start, there are a few cautions to bear in mind about this dataset. The biggest one is that the information only covers about 6 in 10 people registered with a GP (54.6%) - not all the companies that own the electronic information systems used by GPs allow their data to be used (!). So coverage across different parts of the country is really patchy. The second caution is that there are likely to be many people with learning disabilities who are not registered as such with their GP. A third caution is that the extent to which this dataset includes people with learning disabilities in inpatient units really isn't clear. Finally, it's really important to remember that all this information is based on what health systems and GPs record, which is likely to have its own biases, particularly when it comes to people with learning disabilities.

'Severe mental illness' and antipsychotics

Antipsychotics are a set of drugs that are supposed to be prescribed for people with mental health issues with labels such as psychosis, which in GP-record world (along with some other mental health issues) are classed as 'severe mental illness'.

In 2024/25, 7.6% of people with learning disabilities were diagnosed with a 'severe mental illness', compared to 1.0% of people without learning disabilities. A clutch of research projects have shown that mental health issues such as psychosis might be more common amongst people with learning disabilities, but nowhere near to the extent that GPs are diagnosing severe mental illness, with the suspicion that some people with learning disabilities are getting this label to justify them being prescribed antipsychotic drugs for reasons essentially of attempted behavioural control. These percentages haven't changed much from 2017/18 (7.6% of people with learning disabilities; 0.9% of people without learning disabilities).

In terms of sex (the term used in the dataset), more girls/women (8.0% in 2024/25) than boys/men (7.4% in 2024/25) with learning disabilities had a severe mental illness diagnosis, while there was no difference amongst people without learning disabilities. 

In terms of age bands, substantially more people with learning disabilities are diagnosed with severe mental illness from an early age (e.g. 10% or more from the age of 35-44 onwards) than people without learning disabilities, peaking at 16.3% of people with learning disabilities aged 65-74.

Antipsychotics. Overall, in 2024/25 13.8% of people with learning disabilities were being prescribed antipsychotics, compared to 0.9% of people without learning disabilities. For people with learning disabilities, this was a reduction from 15.5% of people being prescribed antipsychotics in 2017/18 (there was no change over time for people without learning disabilities). 

Fewer girls/women with learning disabilities were being prescribed antipsychotics (12.9% in 2024/25) than boys/men with learning disabilities (14.3% in 2024/25). 

In terms of age bands, the percentage of people with learning disabilities prescribed antipsychotics increases sharply from the age of 10 - from the ages of 25-34 years onwards, more than 10% of all people with learning disabilities in 2024/25 were being prescribed antipsychotics, peaking at 23.5% of people aged 65-74.

From 2020/21 onwards, the Health and Care dataset has added information on people being prescribed antipsychotics when they don't have a diagnosis of severe mental illness or palliative care needs. In 2024/25, 8.2% of people with learning disabilities (6.9% of girls/women; 9.1% of boys/men) without a severe mental illness diagnosis were still getting prescribed antipsychotics, compared to 0.4% of people without learning disabilities or a severe mental illness diagnosis. The percentage of people with learning disabilities prescribed antipsychotics in the absence of a diagnosis of severe mental illness has reduced over time, from 9.3% of people in 2020/21 to 8.2% in 2024/25.

These prescriptions in the absence of a severe mental illness diagnosis also rise steeply for people with learning disabilities from an early age - 10% of adults with learning disabilities without a diagnosis of severe mental illness are prescribed antipsychotics by the age of 25-34.

Taking into account differences in the populations of people with and without learning disabilities in things like age and sex, in 2024/25 being prescribed antipsychotics was 14 times more common among people with learning disabilities than you would expect from general population prescribing rates; for those without a diagnosis of severe mental illness this rose to being 18 times more common.

Depression and anti-depressants

The Health and Care dataset has very similar information about GP diagnosis of depression and the prescribing of anti-depressants.

Overall, the percentage of people with and without learning disabilities diagnosed with depression has increased over time, for people with learning disabilities (15.9% in 2024/25, up from 14.6% in 2020/21) and for people without learning disabilities (14.7% in 2021/22, up from 13.6% in 2020/21). Rates of diagnosed depression overall are higher for people with learning disabilities.

Amongst people with learning disabilities, girls/women were more likely to be diagnosed with depression (20.0% in 2024/25) than boys/men (13.2% in 2024/25). In terms of age bands, from the ages of 25-34 years onwards, more than 15% of people with learning disabilities had a diagnosis of depression, peaking at 25.5% of people aged 55-64.

Anti-depressants. Overall, in 2024/25, 22.4% of people with learning disabilities were being prescribed anti-depressants, compared to 11% of people without learning disabilities. Girls/women with learning disabilities were more likely to be prescribed anti-depressants (27.2% in 2024/25, compared to 14.6% of girls/women without learning disabilities) than boys/men with learning disabilities (19.4% in 2024/25, compared to 7.5% of boys/men without learning disabilities). 

In terms of age bands, from the ages of 18-24 years onwards, more than 15% of people with learning disabilities were being prescribed anti-depressants, peaking at 34% of people aged 55-64.

The Health and Care dataset has also been reporting on people being prescribed anti-depressants when they don't have a diagnosis of depression. In 2024/25, 12.4% of people with learning disabilities without a diagnosis of depression were being prescribed anti-depressants, compared to 4.4% of people without learning disabilities or a diagnosis of depression. For both groups, this had increased slightly since 2020/21 (11.6% of people with learning disabilities without a diagnosis of depression; 4.3% of people without learning disabilities or a diagnosis of depression). Again, this was more common for women with learning disabilities without a diagnosis of depression (13.7% in 2024/25) than men (11.5%). 

In terms of age bands, from the ages of 18-24 years onwards, more than 10% of people with learning disabilities but with no diagnosis of depression were being prescribed anti-depressants, peaking at 17.3% of people aged 65-74.

Taking into account differences in the populations of people with and without learning disabilities in things like age and sex, in 2024/25 being prescribed antidepressants was twice as common among people with learning disabilities than you would expect from general population prescribing rates; for those without a diagnosis of depression this rose to being 3 times more common.

Benzodiazepenes

Benzodiazepenes are a type of 'sedative' - they slow down the body and mind and are prescribed for acute anxiety or sleep problems, and it is recommended that they are not prescribed for more than four weeks at a time. The percentage of people with and without learning disabilities being prescribed benzodiazepenes is decreasing over time. In 2024/15, 6.1% of people with learning disabilities were being prescribed benzodiazepenes (down from 7.6% in 2017/18) compared to 1.4% of people without learning disabilities in 2024/25 (down from 2.4% in 2017/18). 

Amongst people with learning disabilities, in 2024/25 similar percentages of women with learning disabilities (6.4%) and men with learning disabilities (6%) were being prescribed benzodiazepenes.

In terms of age bands, more than 5% of people with learning disabilities from the age of 25 onwards were being prescribed benzodiazepenes.

Taking into account differences in the populations of people with and without learning disabilities in things like age and sex, in 2024/25 being prescribed benzodiazepenes was 5 times as common among people with learning disabilities than you would expect from general population prescribing rates. 

Conclusions

Many more people with learning disabilities than other people continue to be prescribed mental health medications, often without a relevant mental health diagnosis. Nearly 1 in 4 of all people with learning disabilities registered with GPs are on antidepressants, and 1 in 7 people with learning disabilities are on antipsychotics. 

While STOMP and STAMP initiatives might be having some impact on reducing the number of people being prescribed antipsychotics and benzodiazepenes, the increasing numbers of people being prescribed antidepressants is threatening to cancel out any of these gains.

People with learning disabilities, compared to people without learning disabilities, are particularly likely to be prescribed mental health medications in the absence of a matching mental health diagnosis. This isn't news, but it doesn't stop it being a scandal.

There are also some big gender differences amongst people with learning disabilities, with little sign of these gaps closing over time. Women with learning disabilities are more likely to be prescribed antidepressants and than men with learning disabilities,  and it's the other way round for antipsychotics.

Significant numbers of people with learning disabilities are being prescribed these drugs at much earlier ages than people without learning disabilities (often in relatively early adulthood) for potentially longer periods of time. This is really worrying, given what we know about the side effects of many of these drugs over time, their addictive properties, and their potential impact on how they make people feel.

From the Health and Care dataset. we don't know how many people with learning disabilities are being prescribed more than one mental health drug, although a research project in Jersey suggested that almost a quarter (23%) of people with learning disabilities were being prescribed two or more mental health drugs. 

We also don't know any more how many people with learning disabilities in inpatient units are being prescribed these types of medications.