A Hospital-Based Treatment Programme for Male Mentally Handicapped Offenders

Abstract

The paper describes a special hospital-based treatment programme for male mentally handicapped offenders, comprising a package of practical and personal skills training coupled with a socialisation programme based on token-economy strategies within a controlled and structured environment. Twenty patients admitted to the programme and followed up after discharge for an average of 3.3 years were studied in detail. All had committed serious or persistent offences and showed a high level of psychosocial pathology. A good or fair response to the treatment programme was made by 85%, and 65% were judged well adjusted or reasonably well adjusted at last follow-up contact. A good outcome was associated with more than two years' in-patient care, a good response to the treatment programme and stable residential placement, regular occupation and regular supervision and support in the community. Offenders against the person (sex and assault) had a better prognosis than and showed other interesting differences from property offenders (property and arson).

Forensic psychiatry for people with learning disability

“…In special hospital patients, Murrey et al (1992) found that 'mentally handicapped offender victims were primarily males and females under the age of 16', with a higher frequency of offences against boys. Day (1994), in his sample of 47 referrals, however, taking into account all incidents and not just convictions, found that 'two-thirds of hetero sexual victims were adults, unlike other studies where the majority of victims are under 16 years of age', but all bar one homosexual incidents were with children under 16.…”

“…However, there have been recent studies of specific groups: adult clinic referrals (Day, 1994),adolescent clinic referrals (Gilbyetal, 1989),special hospital patients (Murrey et al, 1992), and criminal defendants (Hawk et al, 1993).Using more than 4000routinely filed returns by assessing psychiatrists in Virginia, Hawk et al (1993)found that 'the rate of sex offence charges was nearly twice as high among mentally retarded defendants as among defendants who were not retarded'. Moreover, these individuals constituted 'more than one-fourth of mentally retarded defendants evaluated' and '13% of all sex offenders in the sample'.…”

“…The most striking finding was that, although one third had engaged in some offending behaviour during the follow-up period, only one person was reconvicted (cf. Day (1988), 55% reconvicted). High levels of community support were available after discharge and those from special hospital, prison, those who were mentally ill or who had a low IQ were found to do particu larly well.…”

“…As demonstrated by the reports cited below, however, this is the direction in which secure learning disability services are developing. Day (1988) reported an in-patient treatment programme for male offender patients based in an eight bed unit. The treatment package comprised skills training, a token-economy incentive scheme, counselling and supportive psychotherapy, and medication.…”

A survey of patients from five health districts receiving special care in the private sector

“…These patients required admission to a specialised unit for the mentally impaired where staff had exper tise in dealing with patients posing criminal and deviant behaviour, as described by Day (1988). They were mildly mentally handicapped and had psycho pathic traits, sexual perversions, and exhibited crimi nal behaviour in the community.…”