South east London STOMP clinic patient story: Naomi
What is STOMP?
STOMP stands for stopping over‑medication of people with a learning disability, autism or both.
The STOMP service helps ensure people take only the medicines they need. In south east London (SEL), around one in four people with a learning disability are prescribed mental health medication without a recorded diagnosis. To help address this, the SEL STOMP Clinic was established. The clinic provides specialist services tailored to individual needs and reviews their medication, ensuring treatment is appropriate, safe and effective.
This patient story tracks Naomi’s* journey with the STOMP service in south east London. Naomi does not speak, so her mother, Toni*, shares Naomi’s story with help with Ellen* from her care home and Harriet from the STOMP team.
*pseudonyms replace names in this patient story to protect privacy. Thank you to everyone involved for sharing this patient story.
Background
Naomi is in her mid-forties and lives in a very small residential home for people with learning disabilities. She has lived there for nearly ten years.
Naomi is generally very active and enjoys being with people. Her mother, Toni, describes Naomi as
“…always up and busy, she doesn’t really sit around. [She] loves going for walks and the park… [She] likes texture [and] likes to touch things all around [her], such as fabrics.”
Naomi does not speak so communicating how she feels can be difficult.
Naomi’s profile
Name: Naomi (*pseudonym)
Age: Mid-forties
Location: South east London
Prescription: Citalopram
Work with the STOMP team
In 2025, the STOMP Clinic team began working with Naomi’s GP practice and identified that she would benefit from a review with their support. As a result, Harriet from the STOMP Clinic team began to work with Naomi, her mother, and the care home team to slowly reduce Naomi’s antidepressant medication.
Naomi has been prescribed Citalopram, an antidepressant medication, a long time ago. Naomi did not have a mental health diagnosis but is very vocal when she is in pain or not feeling well. Toni believes the medicine was prescribed at a time when Naomi had painful constipation and period pains and could shout to communicate how she was feeling. There was no discussion with Toni at the time, and it was not discussed in reviews with social services.
Toni has the sense that many residents at Naomi’s previous care home were prescribed the medication to keep them calm, so Naomi’s shouting could have been the reason for the prescription being given. Whilst Naomi didn’t have any obvious side effects from the medication, Toni was supportive of a reduction, especially if it would reduce the number of medications Naomi had to take.
“There was really good communication I thought. Lots of discussions about how it was going. And with the staff as well, supporting the staff… it was all about Naomi’s interests and information.” – Toni
Key changes
- Holistic approach: Harriet worked in partnership with Naomi, her mother and care home team to develop a holistic approach. This included learning about Naomi’s interests, considering how to improve her overall health, including long-term conditions, and providing ongoing open communication to Toni. Toni was always kept in the loop about what was happening, and if she raised any concerns she felt they were taken very seriously.
- Medication reduction: Harriet supported Naomi with a phased reduction of Citalopram through a holistic, person-centred approach, considering Naomi’s complete health needs, including long-term conditions.
- Risk management: During the reduction period, Naomi stopped eating and had to go into hospital. Although this periodically happened, Harriet worked with the care home team to ensure that Naomi’s care needs were met, including one-to-one support that could not be provided by the hospital staff. Harriet also visited Naomi regularly in the hospital, arranged a discharge meeting and established a risk management plan if Naomi stopped eating.
- Sleep hygiene support: Naomi experienced severe insomnia when she stopped taking Citalopram, which led to shouting and disturbing other residents. Naomi was provided with sleep hygiene support, including baths; listening to music; going for walks to help increase activity; herbal teas before bed; and making her room dark enough to support good sleep.
- Positive behaviour support plan: Rhianna, Lead Behaviour and Wellbeing Practitioner at STOMP, worked with Ellen from the care home team to identify the patterns of Naomi’s sleep and shouting. They were able to identify what responses helped calm her down, and what she was doing before, during and after these periods. From here, a positive behaviour support plan was created to help the care home team understand triggers and suggested responses. Ellen remembers Harriet saying: “don’t worry, this is a phase she is passing through, and within two weeks she calmed down and everything was normalised.”
“I think it would have been very easy to say right let’s give her something. But Harriet spoke to the staff about things they could do to help her with her sleep… She also identified that Naomi wasn’t getting enough activities. She liaised with the social worker about getting activities set up.” – Toni
Impact of STOMP
Whilst Toni has always been very involved in Naomi’s care, she now feels more confident advocating for Naomi’s needs. This includes speaking to the care home manager to ensure that allocated one-to-one time can be used for activities that Naomi enjoys, such as going for a walk, or taking buses and trains. She is also preparing to speak to the care home manager to ensure further activities are put in place with social services, such as weekly day centre visits.
The care home staff also felt very supported by the STOMP team, through clear instructions and regular check-ins. Ellen describes how they learnt a great deal from the STOMP team, reflecting: “[Harriet] would make sure we are all doing the same thing… the right thing at the right time for the person.”
This is also helping how they support other residents, as Ellen explains: “I think it’s good for staff to see and have a bit of training about we don’t need to go for the pills. We can do other things to support people with high support needs, more holistic approach.”
Naomi has now finished taking Citalopram. Her other health needs are also being better managed by staff, and with more regular follow-ups. Toni shares: “She’s really happy. She obviously was not depressed, she didn’t need the medication. It’s just nice to see her happy and not on pills.”
Get in touch
For more information about the project “helping people with a learning disability, who have behaviours that challenge, to avoid harm from psychotropic medicines”, get in touch via email.
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