8.4.7 Offenders with Intellectual Disability

8.4.7 Offenders with Intellectual Disability

The Assessment, Management and Treatment of Offenders with Intellectual Disability

Offenders with intellectual disabilities present unique challenges to the criminal justice system. The assessment, management, and treatment of these individuals require a multidisciplinary approach that incorporates both the individual’s disability and the nature of their criminal offence.

The prevalence of offending among individuals with intellectual disabilities (ID) is consistently higher than in the general population. Some research suggests that approximately 30% of people with ID interact with the criminal justice system. In addition to increased arrest rates, individuals with ID have higher prosecution rates due to a greater likelihood of pleading guilty and a reduced tendency to engage in plea bargaining. Evidence also indicates that those with more severe ID are less likely to offend compared to individuals with mild or moderate disabilities.

Offence TypeDescriptionAdditional Information
AggressionMore common in people with IDAggressive behaviour in individuals with ID has a wide range of causes, including aggression related to epileptic seizures and in association with Autism Spectrum Disorder (ASD)
Sexual OffendingHigher rates were reported in people with IDThe reasons behind this are complex and not well understood. It may be due to poor sexual knowledge and attempts to fulfil normal sexual desires. Sexual Offender Treatment Programs (SOTPs) can be adapted for those with ID. Libido suppressants may be used but remain controversial.
ArsonOver-represented among people with IDThe motivations for arson can vary, with some incidents seen as a “cry for help” and others due to a fascination with fire. Cognitive Behavioral Therapy (CBT) programs have been developed in certain forensic units in England specifically for individuals charged with arson.

Assessment:

Assessment of offenders with intellectual disabilities should include a comprehensive evaluation of the individual’s intellectual functioning, adaptive behaviour, and psychiatric comorbidity. The assessment should also include an evaluation of the individual’s social and environmental circumstances and the nature of their offence. A range of standardized measures can be used to assess intellectual functioning, including the Wechsler Adult Intelligence Scale (WAIS) and the Kaufman Assessment Battery for Children (KABC). Assessing adaptive behaviour can be achieved using the Adaptive Behavior Assessment System (ABAS) or the Vineland Adaptive Behavior Scales (VABS). Additionally, psychiatric comorbidity can be assessed using standardized diagnostic interviews such as the Structured Clinical Interview for DSM-5 (SCID-5).

Management:

Managing offenders with intellectual disabilities requires a multidisciplinary approach that incorporates medical, social, and psychological interventions. Individuals with intellectual disabilities may require specialized housing, educational, and vocational services. They may also require specialized support in accessing community resources and services. In addition, offenders with intellectual disabilities require specialized support in navigating the criminal justice system, including legal representation and advocacy.

The National Appropriate Adult Scheme aims to ensure that all vulnerable people have access to a trained person who can ensure that the person’s rights are being respected and make sure they understand when they are being interviewed by the police.

Treatment:

The treatment of offenders with intellectual disabilities requires a person-centred approach that recognizes the individual’s unique needs and circumstances. The treatment should address the individual’s intellectual disability, psychiatric comorbidity, and the nature of their criminal offence. The treatment plan should be developed by a multidisciplinary team and should include a range of interventions such as psychotherapy, behavioural interventions, and pharmacotherapy.

One example of an effective intervention for offenders with an intellectual disability is cognitive-behavioural therapy (CBT). CBT has been found to be effective in reducing reoffending rates in individuals with intellectual disabilities by addressing maladaptive thinking patterns and behaviours that contribute to criminal behaviour. Additionally, pharmacotherapy can be used to treat psychiatric comorbidities such as depression, anxiety, and attention deficit/hyperactivity disorder (ADHD).

Assessment, management, and treatment of offenders with intellectual disabilities require a comprehensive and multidisciplinary approach that recognizes the unique needs and circumstances of each individual. In the UK, there are specialized services that address the needs of offenders with intellectual disabilities, including the Intellectual Disability and Mental Health Inpatient Service (IDMHI) and the Community Forensic Learning Disability Team (CFLDT). These services provide specialized support for individuals with intellectual disabilities who have come into contact with the criminal justice system.

References:

  1. Clare, I. C. H., & Gudjonsson, G. H. (2010). Offenders with intellectual disability. John Wiley & Sons.
  2. Holland, A. J., & Clare, I. C. H. (2013). Handbook of offender assessment and treatment. John Wiley & Sons.
  3. Murphy, G. H., & Clare, I. C. H. (2013). Offenders with intellectual disability. Advances in Psychiatric Treatment, 19(2), 95-103.
  4. Murphy, G. H., Clare, I. C. H., & Young, G. (2010). A systematic review of interventions to reduce the impact of adult offending by people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 23(4), 313-327.