Clinical, Demographic, and Criminal Behavior Characteristics of Patients With Intellectual Disabilities in a Canadian Forensic Program

Ipsita Ray,Kristina Shatokhina,Benoit H. Mulsant,Anupam Thakur,Roland M. Jones,Alexander I. F. Simpson

doi:10.3389/fpsyt.2019.00760

Ipsita Ray, Kristina Shatokhina + Show 4 more

Open Access

https://doi.org/10.3389/fpsyt.2019.00760

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Abstract

Background: People with intellectual disability (ID) and forensic issues constitute a challenging clinical group that has been understudied in forensic settings. Methods: We assessed the characteristics of patients with ID under the authority of the Ontario Review Board (ORB) in a large forensic program of a tertiary psychiatric hospital (excluding those with a cognitive disorder) and compared their characteristics with those of a non-ID control group. Results: Among 510 adult ORB patients, 47 had an ID diagnosis. ID patients were of younger age at index offense, with a lower level of education, and were less likely to have been married or employed, more likely to have committed a sexual offense, more likely to have a diagnosis of paraphilia, less likely to be “not criminally responsible,” and more likely to be “unfit to stand trial.” They were also more likely to have committed their index offenses against care professionals and be treated in a secure unit. Conclusion: Our findings have major implications for clinicians, clinical leaders, and policymakers about the specific needs of patients with ID presenting with forensic issues and differing needs in terms of treatment and risk management.

Highlights

People with concurrent intellectual disability (ID) and forensic issues constitute a challenging clinical group in inpatient psychiatric settings and in the community
The findings from this study suggest that there is a small but significant number of patients with ID assessed and treated in the forensic mental health system
These findings and their implications deserve some comments

Summary

Introduction

People with concurrent intellectual disability (ID) and forensic issues constitute a challenging clinical group in inpatient psychiatric settings and in the community. The majority of forensic ID research is from the United Kingdom, where specialized ID forensic mental health services are well established, including forensic inpatient settings, community samples, and juvenile populations (15, 18). In these varying settings, the prevalence of reported ID has varied widely. In both prison and hospital studies, those with ID were typically younger than those without ID (3, 6, 14), and their most common offenses were violent or sexual offenses or arson (6, 19) Those with ID had higher rates of self-harm and attempted suicide (4), higher rates of aggression. People with intellectual disability (ID) and forensic issues constitute a challenging clinical group that has been understudied in forensic settings

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