Referrals into services for offenders with intellectual disabilities:Variables predicting community or secure provision

摘要

Background There is a need for research to promote an understanding among servicedevelopers on why people with intellectual disabilities (ID) are referred to offenderservices in order for them to receive appropriate assessment and treatment. Previousstudies investigating referrals into forensic ID services have concentrated on referralsources and administrative variables such as legal status. Aims To construct a predictive model for choice of service referral based on a com-prehensive range of information about the clientele. Method We conducted a case record study of 336 people referred to community ser-vices and 141 to secure provision. We gathered information on referral source, demo-graphics, diagnosis, index behaviour, prior problem behaviours and history of abuse.Results Comparisons revealed 19 candidate variables which were then entered intomultivariate logistic regression. The resulting model retained six variables: communityliving at time of referral, physical aggression, being charged, referral from tertiary healthcare, diverse problem behaviour and IQ < 50, which correctly predicted the referralpathway for 85.7% of cases. Conclusions An index act of physical aggression and a history of diversity of problembehaviours as predictors against the likelihood of community service referral suggestthat professionals have similar concerns about people with ID as they do about theirmore average offending peers; however, the more severe levels of ID mitigated in favourof community referral, regardless. Offenders with ID tend to be referred within levelsof service rather than between them, for example, form tertiary services into genericcommunity services.