The psycho-social and clinical profile of women referred for psycho-legal evaluation to forensic mental health units in South Africa

Abstract

Background: There is a paucity of research on women offenders in the South African context, particularly those referred for forensic psychiatric observation. Little is known about their life histories, the nature of their offences or the psycho-social contexts that enable, or are antecedents to, women’s criminal offending.Aims: This research study, the largest of its kind in South Africa, examined the psycho-social contexts within which women offenders referred for psychiatric evaluation come to commit offences. The profiles of both offenders and victims, as well as reasons for referral and forensic mental health outcomes, were investigated.Methods: A retrospective record review of 573 cases, spanning a 12-year review period, from six different forensic psychiatric units in South Africa, was conducted.Results: The findings describe a population of women offenders who come from backgrounds of socio-demographic and socio-economic adversity, with relatively high pre-offence incidences of being victims of abuse themselves, with significant levels of mental ill-health and alcohol abuse permeating their life histories. The majority of index offences which led to court-ordered forensic evaluations were for violent offences against the person, with murder being the single most common index offence in the sample. Most victims of violence were known to the accused. There were also relatively high rates of psychotic and mood-spectrum disorders present, with relatively low rates of personality disorders. The majority of women were deemed to be trial competent and criminally responsible in relation to their index offences.Conclusion: It is recommended that more standardised and gender-sensitive forensic mental health assessment approaches, documentation and reporting be employed throughout the country. Future research should compare male and female offending patterns and forensic mental health profiles.

Different needs in patients with schizophrenia spectrum disorders who behave aggressively towards others depend on gender: a latent class analysis approach

“…As for the type of crime, a study comparing male and female homicide offenders with SMI reported a four to one ratio of males to females [ 16 ]. In contradiction, other studies found that women with SMI committed more serious crimes than men, more frequently including arson (27.5% women, 12.4% men) and homicide (28.1% women, 15.1% men; [ 31 ], and were primarily admitted for such crimes [ 32 , 33 ]. Female offenders with SMI were found to engage in more self-harming (women 22–33%, men 8–13%) and to have comorbid personality disorders [ 34 ].…”

“…Several studies found female offender patients with SMI to be more likely to target close family members [ 16 , 31 ], which has not been found in female offenders without SMI. In contrast to non-offending women with SSD [ 5 , 6 ], many female offender patients with SMI did abuse alcohol (34–48%) or illicit drugs (35–44%), suffered from socio-economic adversity [ 32 , 33 ] and had a higher number of forensic and general psychiatric hospitalizations than men [ 34 ]. The few studies explicitly focusing on female offender patients with SMI [ 31 – 34 ] did not distinguish between different mental disorders and often presented descriptive accounts only.…”

A Qualitative Study of Mentally Ill Women Who Commit Filicide in Gauteng, South Africa

“…The demographic profile of the seven participants was in keeping with a recent review of 573 female offenders across six forensic mental health institutions in South Africa by Nagdee et al (17). This study found that the majority of offenders were aged 21–50 years old, which is similar to this study where 86% of the participants fell within this age group.…”

“…Within the South African context, a recent large retrospective study of 573 accused female offenders referred for observation under the Criminal Procedures Act to six forensic mental health institutions showed that there were 175 crimes committed against children, and of those, 66% were biological children. Furthermore, it was found that 52% of these women had disclosed having a prior psychiatric illness, with 30% having committed filicide (17). In another unpublished study done at Sterkfontein Hospital, Gauteng, South Africa, 42% of referred cases of child homicide were found to have a history of psychiatric illness (18).…”

State patients who committed violent crimes and were admitted to Weskoppies Hospital from 2005 to 2014: Profiles and trends

“…It did not look at changes over time, but found that over the 12-year period in review, murder was the most common index offence and that there were high rates of psychotic and mood-spectrum disorders present in their sample. 12 Another study that examined the factors associated with recidivism at Sterkfontein Hospital, South Africa, found that substance use disorder, antisocial personality disorder and having assault as an index offence were associated with a higher risk of recidivism. 13 …”