Reliability and validity of the Static-99R in sex offenders with intellectual disabilities

Purpose Risk assessment studies involving recidivism in sex offenders with intellectual disabilities (SOIDs) continue to be scarce, limited and producing mixed results. This study aims (to test the ability ...) to test the ability of one such instrument (the Static-99R) to predict intramural sexual and violent incidents involving members of this group. Design/methodology/approach The Static-99R was prospectively scored for 38 SOIDs. Occurrences of any violent or sexual incident and/or illegal sexual behaviour were recorded during a minimum period of six months. Predictive accuracy was analysed using several performance indicators. Findings The Static-99R significantly predicted sexual incidents (area under the curve = 0.70) but failed to predict violent and illegal sexual incidents. Regarding illegal sexual incidents, the instrument was better at detecting low-risk individuals than high-risk offenders. Originality/value Risk assessment studies, both in offenders with and without an intellectual disability (ID), rarely use multiple accuracy estimates. The current study used both discrimination and calibration indicators to evaluate the ability of the Static-99R to detect low- and high-risk offenders.

Supporting justice-involved people with extreme complex needs in the Australian community: a third sector practice perspective

Purpose This qualitative research aims to explore staff perspectives on working effectively with people with intellectual disability who are in contact with the criminal justice system. Design/methodology/approach Taking a case study approach, staff working for a third sector community organisation were interviewed about the components of effective work with their customers. The staff supported people engaged in the Community Justice Program. Findings Staff consistently described relationship building as the most important part of their work. There were three components to relationship building: the process of relationship building, the elements of a high-quality staff–customer relationship and the staff skills needed to develop a good relationship. Originality/value This paper makes two contributions to the literature. First, it focuses our attention on a third sector organisation supporting people in contact with the justice system as opposed to a formal criminal justice agency. Second, the paper seeks to understand the processes and skills staff deploy to build a high-quality relationship with criminal justice-involved people with intellectual disability.

Trauma and institutional risk in a secure developmental disorder service: does the SAVRY inflate risk in adolescents exposed to ACEs?

Purpose Adverse childhood experiences (ACEs) are highly prevalent in people with developmental disorders who engage in offending behaviour. Many violence-based risk assessment tools include items pertaining to ACEs, and may inflate risk scores in trauma-exposed groups. This paper aims to explore the relationships between ACEs, risk assessment scores, incidents of risk and restrictive practices, in adolescents with developmental disorders in a forensic inpatient setting. Design/methodology/approach Secondary analysis was conducted on clinical data for 34 adolescents detained to a developmental disorder service. Data were extracted for Structured Assessment of Violence Risk in Youth (SAVRY) risk scores and risk behaviours and restrictive practices, as measures of observed risk. Findings Participants exposed to more ACEs had higher SAVRY risk scores (p < 0.001, two-tailed), with elevations specifically on the historical subscale (p < 0.001, two-tailed). Neither ACEs nor risk scores were associated with the frequency of risk behaviours. Nevertheless, participants exposed to four or more ACEs were secluded more frequently (p = 0.015, two-tailed), indicating a potential association between trauma and risk severity. Those with more complex developmental disorders experienced fewer ACEs (p = 0.02, two-tailed) and engaged in self-harm behaviours less frequently (p = 0.04, two-tailed). Research limitations/implications The inclusion of ACEs in risk assessment tools may lead to the inadvertent stigmatization of trauma-exposed individuals. Further investigation is necessary to offer clarity on the impact of early adversity on risk assessment accuracy and levels of institutional risk, and the role of developmental disorders in this relationship. Originality/value To the best of the authors’ knowledge, this study is the first to explore the relative associations between ACEs, risk assessment scores and observed institutional risk and does so in a highly marginalized population.

Reflections on systemic barriers for ethnic minorities in accessing community-based forensic services for people with intellectual disabilities and autism

Purpose Community-based forensic support services (CBFSSs) were commissioned nationally by National Health Service (NHS) England in 2017 in response to “Building the Right Support” (NHS England, 2015). CBFSSs provide multidisciplinary support to adults with intellectual disabilities and/or autism who are in (or at risk of) contact with the criminal justice system and those transitioning from inpatient secure care. This paper aims to highlight potential systemic barriers to accessing community forensic services for people from an ethnic minority background. in one CBFSSs in Northern England. Design/methodology/approach This paper provides preliminary reflections on potential systemic barriers within the criminal justice system and health-care services that have implications for service users from ethnic minority backgrounds accessing CBFSSs. Findings There is a paucity of data, policy and literature that focuses on people with intellectual disabilities and autism with forensic needs from ethnic minority backgrounds. This lack of data obstructs further reforms to meet the needs of this population. Originality/value CBFSSs are commissioned across England. While some regional variation is to be expected, services should be aware of the systemic barriers people from ethnic minority backgrounds within their region face. These barriers should be considered and addressed when evaluating service efficacy and delivery. Recommendations are made to review and address issues of under-representation of ethnic minorities within CBFSSs.

“Let’s Talk About: Sex”: development, pilot and evaluation of a positive sexual-health education group for individuals within secure ID settings

Purpose There is a dearth of positive, proactive, sexual-health education programmes available for individuals with intellectual disabilities (IDs). This paper aims to provide an overview of the development, pilot and evaluation of a programme aimed at increasing awareness of the intricacies and risks of sexual health, intercourse and relationships. This programme covers relevant topics in a non-judgemental, informative and supportive approach. Design/methodology/approach A pre-post comparison within-group design was used (N = 14). The programme was run separately across three in-patient ID secure services within the UK and lasted for 16 weeks. The measure used to explore change was the sexual attitudes and knowledge questionnaire (SAK; Heighway and Webster, 2007). Findings Scores indicated improvement across all sub-factors as measured by the SAK, although no results reached statistical significance using Wilcoxon signed rank tests. Qualitative feedback indicated the benefits of this programme in relation to participants’ increased knowledge and confidence. Results have been discussed in terms of both the statistical analysis and clinical implication. Originality/value Results have been discussed in terms of statistical analysis and clinical implications with the aim of clinicians considering the programme’s application and utility within various clinical contexts. Additionally, gaining insight into the process of programme development and refinement, including future directions.

Online self-radicalisation: a case study of cognitive vulnerabilities for radicalization to extremism and single actor terrorism

Purpose Understanding the psychological risk factors in radicalisation and terrorism is typically limited by both a lack of access to individuals who carry out the acts and those who are willing to engage in research on the matter. The purpose of this study is to describe the process of self-radicalisation of an otherwise law-abiding individual who engaged in single-actor terrorism activities. Design/methodology/approach A single case study, based on clinical interviews and psychometric testing, of an individual with autism who engaged in multiple acts of terrorism through online activity. The case is presented within existing frameworks of radicalisation, and describes how it developed along the steps described in the path to intended violence. Findings A number of variables are identified as contributing towards the individual’s vulnerability to radicalisation, such as deficits in higher order cognition, psychopathology, autism spectrum disorder traits, personal interests, social isolation and life stressors. Originality/value Unique to this study is how the process of radicalisation and the possibility to carry out the individual’s attacks was made possible only through the use of internet technology.

The use of appropriate adults for persons with mental disabilities in investigation interviews in Singapore

Purpose This research study aims to explore the trends in the use of appropriate adults (AAs) for persons with mental disabilities (PMDs) during law enforcement investigation interviews in Singapore and examine the profile of PMDs who were supported by AAs through the investigation process. AAs play a vital role in facilitating communication and providing emotional support to PMDs during investigation interviews. Design/methodology/approach A descriptive analysis was conducted on data collected from 2016 to 2019. Findings The findings of the study indicate a growing demand for AA services to support PMDs with some variations across different geographical regions. Approximately three-quarters of all completed interviews supported PMDs who were suspects/accused. Interviewees who received AA support were largely Chinese, male, in their adolescent or early adulthood years and had an intellectual disability. More than half of the interviews supported by AAs involved offences that were sexual in nature or property related. Originality/value These results reflect a growing awareness of the role and importance of AAs for PMDs and have practical implications on service delivery and development. This paper’s findings on the profile of PMDs supported by AAs also set the groundwork for further research to investigate how PMDs interface with the criminal justice system.

Men with intellectual disabilities and sexual offending histories: an exploration of their experiences of living within a secure hospital setting

Purpose There is a national drive to transform services for individuals with intellectual disabilities (ID), to provide care within the community rather than hospital settings. However, there are limited community provisions for those with more complex care needs such as sexual offending. There has been limited research focussing on this client group’s experiences of inpatient services and the treatment they have received from their own perspective. This study aims to explore their experiences of living in a secure service focussing on treatment for sex offences. Design/methodology/approach In total, 10 men with ID and sexual offending histories took part in an interview designed to explore their experiences of living within a secure hospital setting. The data were analysed using thematic analysis. Findings Three key themes relating to the participants’ experiences within the hospital were identified. These were, namely, “hospital environment”, “personal journey through secure services” and “closeness to home”. Practical implications Men’s experiences at a secure hospital were generally positive in terms of a supportive staff approach. Difficulties existed around the hospital organisation affecting the support they received. Originality/value Some participants experienced a struggle to become more independent and move to less restrictive environments due to their perceived risk levels. Some participants found being away from home to be hard and longed to be closer to their families. Around half of the participants did not want to live near their hometown due to family difficulties, negative peer influences or fears of consequences for their sexual offending. Implications for community service planning are considered.

Forensic intellectual disability services: differences in staff perspectives in the Danish and Norwegian systems

Purpose Persons with intellectual disabilities (ID) who offend are treated differently depending on the national jurisdiction. Norway and Denmark are two such examples. The differences in care models may also have an impact on staff perspectives. This paper aims to study the differences between Norwegian and Danish staff members within secure forensic ID services. Design/methodology/approach A cross-sectional study involving Norwegian (n = 145) and Danish staff (n = 279) in secure forensic learning disabilities services was conducted. The response rates were 50% in Denmark (n = 147) and 69% in Norway (n = 98), respectively. An electronic survey covering five sets of topics (demographic characteristics, working conditions, workplace culture, work motivation and work resilience) was used. The findings was statistically analysed using SPSS. Findings This study confirmed that staff in the two neighbouring countries have common conceptions of their employment. Danish staff were more exposed to violent incidents (t = 4.1(237); p < 0.001). There was greater concern with workplace safety in Denmark (t = 5.2(237); p < 0.001) compared to more team-based and rigid working conditions in Norway (t = −2.6(237); p < 0.01). Originality/value These differences are discussed in relation to some important national differences in a professional culture, educational systems, service organisation and legal issues that possibly add realistic explanations to the findings.

Clinical and criminal profile of internet offenders with ASD

Purpose Autism-specific characteristics have been associated with internet criminal activities. Internet and non-internet offenders differ on a series of demographic, psychological and offending variables. However, the clinical and criminal presentation of individuals with autism spectrum disorder (ASD) in forensic secure care settings has been underexplored. This paper aims to explore the profiles of internet offenders with ASD admitted to a secure psychiatric unit. Design/methodology/approach This study provides the results of a service evaluation of individuals with ASD. The demographic, clinical and criminal characteristics of a small sample of internet offenders with ASD admitted to secure care are described and discussed. Findings Internet offenders present in secure care with high rates of comorbid disorders, histories of violence and traumatic experiences, mood disorders and difficulties with relationships. Of the 24 internet offenders discussed, 18 of them committed an offence of a sexual nature involving children. Originality/value This paper highlights the potential risks for individuals with ASD in using the internet and the possible difficulties associated with detecting this because of rapid advancements in technology.