Long-term outcome from a medium secure service for people with intellectual disability.
Medium-secure ID units keep reconviction low, yet most ex-clients still show rule-breaking behaviour years later.
01Research in Context
What this study did
Wetterneck et al. (2006) tracked adults with intellectual disability after they left a medium-secure hospital.
The team looked at who was later convicted again and who still showed problem behaviour.
They wanted to know which personal traits predicted trouble after discharge.
What they found
Only 11% were reconvicted, a low rate.
Most clients, 58%, still acted in ways that looked like offending but stayed out of court.
Young age, past theft, and personality disorder raised the risk of new crime.
How this fits with other research
Eugenia Gras et al. (2003) ran a community program and also saw fewer arrests after treatment.
Their re-offence rate dropped from 43% to 25%, higher than the 11% here.
The gap makes sense: secure units keep the highest-risk people longer, so their later crime rate starts lower.
Cashon et al. (2013) watched secure units in Holland and found that 20% of clients caused 80% of aggression inside the ward.
T et al. now show that the same few risk signs—youth and early rule-breaking—predict crime after the gate opens.
Together the papers say: target the high-rate few both during stay and after release.
Why it matters
You can tell funders that secure ID services do cut later crime, but most clients will still need long-term behaviour support.
Add youth, theft history, and personality disorder to your discharge checklist.
Plan extra supervision, skill teaching, and caregiver training for these flags, not just for the court date.
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02At a glance
03Original abstract
BACKGROUND: The purpose of this paper is to describe long-term outcomes for patients discharged over a 12-year period from a medium secure service for people with intellectual disabilities (ID). METHODS: A cohort study using case-notes analysis and a structured interview of current key informants. RESULTS: Eleven per cent of the sample was reconvicted. Fifty-eight per cent of the sample showed offending-like behaviour that did not lead to police contact. Twenty-eight per cent of the sample was currently detained in hospital under the Mental Health Act. The presence of a personality disorder, a history of theft or burglary, and young age increased the risk of reconviction. Contact with the police was less likely in those with schizophrenia. Re-admission to hospital was associated with the presence of offending-like behaviours, rather than any specific diagnosis. CONCLUSION: In terms of reconviction, these results are good compared with those from general forensic services; however, behavioural problems continue for many years and are managed without recourse to the criminal justice system. There is a borderline group whose needs are poorly defined and serviced. Declaration of interests Horizon National Health Service Trust, the managing authority of the service, gave the grant for this study; the corresponding author was working in the service.
Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00806.x