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The purpose of this paper is to explore the place of medication in the management of challenging behaviour in people with intellectual disability by considering it in the context of the whole system around the person and by considering the challenges of implementing best practice guidance.

The paper identify factors that are barriers to implementing appropriate best clinical practice guidelines (such as “Challenging behaviour: a unified approach”) in relation to medication intervention. The paper explores current policy and recommendations on how to improve services for people with intellectual disability and challenging behaviour and make suggestions about how to ensure better compliance with existing guidelines and improve service delivery.

Better integration of services, access to specialist interventions including applied behavioural analysis and understanding communication are all essential to reducing the use of medication, as is the need for reactive, personalised and skilled social care provision.

The paper will help professionals and those involved in the provision of service to people with challenging behaviour to focus on areas of improvement and ensure that available resources are maximised to deliver the best outcome for them.

The purpose of this article is to explore the current evidence base in understanding the relationship between mental health and challenging behaviour in people with intellectual disabilities.

The article discusses how challenging behaviour is associated with psychiatric disorders. Common aetiological factors between challenging behaviour and psychiatric disorders and diagnostic issues are considered. The article ends with a review of the assessment and management of challenging behaviour within the context of mental health.

Several studies have highlighted common aetiological factors that are responsible for challenging behaviour and psychiatric disorders in people with intellectual disabilities, and although there is an overlap in the symptoms, both are thought to be different phenomena. Treatment of the psychiatric disorder should ameliorate the challenging behaviour, although a functional analysis of the behaviour may still be required in order to understand the purpose of the behaviour. There is evidence for a range of different treatment approaches.

The article will assist professionals working with people with intellectual disabilities to understand the complex relationship between mental health and challenging behaviour. It also gives guidance on principles of management of people with complex mental health and behavioural needs.