The prevention of offending behaviour by people with intellectual disabilities: a case for specialist childhood and adolescent early intervention
| Published date | 21 August 2019 |
| DOI | https://doi.org/10.1108/AMHID-03-2019-0008 |
| Pages | 216-227 |
| Date | 21 August 2019 |
| Author | Verity Chester,Harriet Wells,Mark Lovell,Clare Melvin,Samuel Joseph Tromans |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
The prevention of offending behaviour
by people with intellectual disabilities:
a case for specialist childhood and
adolescent early intervention
Verity Chester, Harriet Wells, Mark Lovell, Clare Melvin and Samuel Joseph Tromans
Abstract
Purpose –Elucidating where antisocial or violent behaviour arises within the life course of individuals with
intellectual disability (ID) could improve outcomes within this population, through informing services and
interventions which prevent behaviours reaching a forensic threshold. The paper aims to discuss this issue.
Design/methodology/approach –The Historical Clinical Risk Management-20, Version 3 assessments of
a cohort of 84 inpatients within a forensic ID service were analysed for this study, with a particular emphasis
on items concerned with the age at which antisocial or violence first emerged.
Findings –For most participants, violent or antisocial behaviour was first observed in childhood or
adolescence. The study also highlighted a smaller subgroup, whose problems with violence or antisocial
behaviour were first observed in adulthood.
Originality/value –Thestudy findings suggest thattargeted services in childhoodand adolescence mayhave
a role in reducing the offending behaviour and forensicinvolvement of people with ID. Thishas implications for
the service models provided for children and adolescents with ID with challenging or offending behaviour.
Keywords Learning disability, Youth, Forensic, Secure, HCR-20, Developmental disability
Paper type Research paper
Introduction
In the UK, specialised forensic/secure services exist for individuals with an intellectual disability
(ID) who have committed a criminal offence or exhibited behaviours which reach a forensic
threshold. Such services care for people diverted from imprisonment due to their vulnerability
(Talbot, 2009), and offer a multi-disciplinary model of support within an environment that
emphasises treatment rather than punishment (Hollins, 2000). In recent years, a developing body
of literature has focussed on the sociodemographic, clinical, and forensic characteristics, and
treatment outcomes of this group (Alexander et al., 2011). These studies have highlighted a high
level of clinical complexity and associated forensic risk (Taylor et al., 2017).
Inpatient services for people with ID and mental health or behavioural problems in the UK have
come under scrutiny as a result of an abuse scandal at Winterbourne View hospital, which was
exposed by an investigative report broadcast on the television programme “Panorama”in 2011
(BBC One, 2011). The resulting Transforming Careprogramme committed to a rapid reductionin
the numberof people with ID within inpatientcare, including those in forensicservices (Taylor et al.,
2017). However,the dramatic subsequentreduction in hospital placementsthat was expected did
not happen (Health and Social Care Information Centre, 2013). It is now acknowledged that the
complexity and scaleof the challenge was underestimated, and the scope andquality of data on
inpatients with ID was poor (National Audit Office, 2015). A number of reasons have been
suggested for the failure to reduce hospital placements within the forensic cohort, including
Received 28 March 2019
Revised 20 June 2019
Accepted 24 July 2019
Verity Chester is based at
Department of Psychiatry, St
Johns House, Harleston, UK.
Harriet Wells is based at
Department of Psychology, St
Johns House, Harleston, UK.
Mark Lovell is based at
Department of Psychiatry,
Tees, Esk and Wear Valleys
NHS Foundation Trust,
Durham, UK.
Clare Melvin is based at the
Department of Psychology,
Hertfordshire Partnership
University NHS Foundation
Trust, St Albans, UK and The
Tizard Centre, University of
Kent, Canterbury, UK.
Samuel Joseph Tromans is
based at the Department of
Intellectual Disability Psychiatry,
Leicestershire Partnership NHS
Trust, Leicester, UK and
Department of Health
Sciences, University of
Leicester, Leicester, UK.
PAGE216
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ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
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VOL. 13 NO. 5 2019, pp.216-227, © Emerald Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-03-2019-0008
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