The Development of the Care and Treatment of Offenders Initiative

The origins of this venture are over five years old. At the first international Conference for Mentally Ill offenders in 1999 a number of professionals from Forensic Learning Disability services attended. One of them explained to me that Learning Disability services caring for offenders struggled to find an appropriate platform to share their work and to network with colleagues. It seemed that services that cared for people with a learning disability who had committed an offence, or were seen as a danger to the general public, fell between many stools. On the one hand the mainstream learning disability services were reluctant to embrace them or inadequately catered for their needs and likewise mainstream forensic services regarded the learning disability population as a diminishing minority problem and the bulk of research and teaching investment went elsewhere.

When I researched the educational provision for Forensic learning Disability in 1999 another organisation had advertised a range of national events and it seemed that the conference gap identified might be filled. However, the following year I was encouraged to reconsider planning a conference as the need had not been met and the other events had not proved successful.

The University initially built a partnership with: the Royal College of Nursing; Calderstones NHS Trust, Hertfordshire Partnership Trust, Northgate and Prudhoe NHS Trust, and Nottinghamshire Healthcare NHS Trust to plan and organise a three day international conference to be held at the University of Central Lancashire in September 2001.

This three day international conference exclusively focussed on the Care and Treatment of Offenders with a Learning Disability and provided an opportunity to hear presentations from eminent researchers as well as smaller scale research and innovations in concurrent presentations.

Since this initial conference a number of achievements have been realised including:

• 4 Preston conferences and 1 All Ireland conference held since 2001
• Over 750 delegates from 11 countries in attendance (Truly Multi-disciplinary)
• A bringing together of knowledge and expertise from Europe, North America and Australasia
• 3 books published of proceedings with third planned
• Established partnerships between organisations
• The development of a website with all previous proceedings and key-note presentations freely available

The work over the last five years have raised a number of problems and from a personal perspective these have included:

• Current government policy fails to address Forensic Learning Disability issues in any meaningful way;
• There continue to be a range of people with learning disabilities who require a structured living environment somewhere between in-patient and community care that are not being provided for;
• There continues to be poor understanding of Learning Disability in the Criminal Justice Systems
• Services continue to be fragmented in many parts of the UK and overseas
• The Health service is not clear what its role is in relation to Learning Disability generally
• Training has not caught up with practice

The issues that this raises include:

• The availability of effective screening in the criminal justice system to detect learning disability
• The fact that many people with a learning disability caught up in the criminal justice system often have had no previous contact with services
• Some people with a learning disability in involved with the criminal justice system have learned how to disguise their problems (sometimes referred to as a Cloaking Device)
• When considering diverting people from the criminal justice system the question is often asked diversion to what (i.e. can we effectively treat)?
• Some people suggest that a natural consequences of an ordinary life model is that some people with a Learning Disability should simply serve their sentence(s).
• There are clearly not enough adapted treatment programmes to work with this specialist group
• The forensic health literature clearly demonstrates that the levels of recidivism of offenders with a Learning Disability are much higher than the general population or for those people with a mental illness
• There is a clear lack of expertise generally in working with this specialist group
• Stronger ties need to be developed with schools for early detection and intervention
• There is a strong need for professionalism, leadership, and advocacy in particular
• This group of people often present with multiple health problems both physical and psychiatric with particular complications of substance abuse
• The recent Multi Agency Public Protection Arrangements (MAPPA) concerning sex-offenders need careful consideration for this group
• Reliable and valid risk assessment needs a particular focus
• A need for the dove-tailing of the Mental Health Bill and the Mental Incapacity Bill

Key Challenges Include:

• The training of Prison Service and other Criminal Justice system staff
• Early identification of problems
• Pre-School Teams
• Transition Teams
• Criteria for Social Support
• Specialist Support Teams
• A range of in-patient and residential schemes
• Pre-offender programmes

Services will need to consider the key aims of their services and demonstrate how any strategy can contribute to:

• Lowering the re-offender rates
• Reducing the number of prisoners
• Reducing the number of first time offenders
• Reducing the number of victims

This website forms a contribution to the development of a knowledge base and the dissemination of good practice. It can only truly succeed however with the active participation of contributors following the principle of the free and active sharing of their knowledge and expertise.

Dr Colin Dale
April 2005