Background: Psychopharmacotherapy for adults with disorders of intellectual development (ID) is subject to criticism, particularly with regard to the treatment of individuals living in residential accommodation. The aim of the present study was to assess the quality of the psychotropic medication and to identify factors that may affect adherence to existing guidelines for prescribing these drugs to adults with ID. Moreover, suggestions for the improvement of psychotropic medication were to be gathered. Methods: We interviewed staff of residential accommodation for adults with ID using an anonymous online survey based on a self-developed questionnaire. Results: Study participants (n = 350) assessed the quality of psychopharmacotherapy differentially and in part very critically. An improvement of psychotropic prescription was indicated through the adjustment of specific parameters. In addition, the following suggestions for improvement of psychopharmacotherapy were mentioned: Closing of existing gaps in care, improvement of knowledge, stronger patient-centeredness and inclusion of the environment, guarantee of comprehensive diagnostics and regular controls as well as critical handling of psychopharmaceuticals and the use of alternatives or supplements to psychopharmaceuticals. Conclusion: Psychopharmacotherapy of adults with ID living in residential accommodations might be improved by establishing case conferences during outreach visits. However, comprehensive structural changes are needed to close the gaps in care identified by the study participants.