Susan Hayes

Mental illness and intellectual disability in Magistrates Courts in New South Wales, Australia

BACKGROUND Little is known about the prevalence of intellectual disability (ID) and/or cognitive impairment (CI) among accused persons in the Magistrates (Local) Courts, the personal, health and mental health characteristics of this cohort, and their service provision needs in the community. The study aimed to determine the prevalence of dual diagnoses of ID and/or CI and psychiatric disorder in a sample of accused persons appearing before four Magistrates Courts. Accused persons with ID and/or CI may not be identified in the Magistrates Court as having a disability and therefore may be unable to access the legal safeguards which exist for their protection within the criminal justice system and/or may fail to receive appropriate community health and welfare services. METHOD The sample was drawn from accused persons aged over 18 years appearing before four Magistrates Courts in metropolitan and urban areas of a large city. Participants were assessed using the Kaufman Brief Intelligence Test, Second Edition (KBIT-2), Vineland Adaptive Behavior Scales, Second Edition (VABS2) and the Psychiatric Assessment Schedules for Adults with Developmental Disabilities Checklist. RESULTS On the KBIT-2, 10% of participants achieved a standard score (SS) below 70 (mild ID range) and a further 20% were in the 70-79 (borderline) range. The VABS2 results indicated that 12% of participants had SS below 70 and a further 9% were in the 70-79 (borderline) range. The prevalence of mental illness in the group with intellectual deficits was 46%, compared with a prevalence of 36% for those without intellectual deficits. CONCLUSIONS People with ID and/or CI were found to be over-represented in the Magistrates Court. Furthermore, results highlight the unmet mental health needs of this cohort in the criminal justice system. The results of the study have implications for the planning of services and diversionary options to facilitate better management of defendants with ID and/or CI with mental health needs.

Trends and challenges in forensic research on offenders with intellectual disability

Abstract Background The Journal of Intellectual & Developmental Disability has a well‐respected history of establishing the parameters and contributing to developments in the field of offenders with intellectual disability (ID). Method The field has seen a number of developments over the past 15 years, and this paper identifies several trends that have emerged in the research during this period, including work on prevalence of ID in prison populations, development of risk assessment, consideration of staff issues, developing the psychometrics of offence‐specific assessments, evaluating treatment methods, and testing the underlying theoretical frameworks which attempt to account for offending. Results and Conclusions We refer to a number of studies which have advanced these developments in the field and draw the readers attention to the way in which papers in this special issue contribute to and further develop each of these research trends.

Medical training and English language proficiency

Summary. Concern is often expressed about the English language proficiency (ELP) of students engaged in professional training. This report assesses the ELP of the 1990 and 1991 intakes into medicine at the University of Sydney. A quick screening test and individual in‐depth tests were used in a two‐stage design. Admission to the course is highly competitive and most students are selected from the top 0.75% of Higher School Certificate results but 15% and 19% of the year cohorts were found to be below average in ELP. English proficiency was found to be consistently correlated with first‐ and second‐year university results. Initiatives taken to support students with language disadvantages and to ensure that graduates will be able to communicate effectively with patients are outlined.

Children's memory of events: effects of stress, age, time delay and location of interview

To examine the ability of children aged between 4 and 12 years to recall a stressful event (venipuncture) compared with a non-stressful event (demonstration of venipuncture), recall was tested after 6-8 weeks. Half also had recall tested after 2-7 days. Testing took place where the stressful event occurred (n=122) or at a neutral location (n=127). Children who experienced the stressful event were less likely to give inaccurate responses in free recall or to acquiesce to suggestive misleading questions. Apart from incorrect responses in free recall, correct responses increased and incorrect responses decreased with increasing age. Recall after 2-7 days was superior to recall after 6-8 weeks. Those who had an early and a late interview had better recall at the late interview than those who had a late interview only. The location of interview showed no effects on recall.

Prevalence of intellectual disability in local courts

Research has established that people with intellectual disabilities are overrepresented amongst samples of suspects being interviewed by police, and in prison populations in many Western jurisdictions. This study examined the prevalence of intellectual disability at a different stage of the criminal justice system, amongst cohorts of persons accused of criminal offences and appearing before local courts in New South Wales. Volunteer participants were obtained from six courts in both rural and urban areas. Participants were screened using the Matrices section of the Kaufman Brief Intelligence Test which is a non-verbal, untimed test of fluid intelligence, and the Mini-Mental State Examination (MSE); in addition, demographic data were obtained. People with intellectual disabilities, especially Aboriginal people living in rural areas, were found to be overrepresented in local court appearances. Moreover, a significant proportion of the sample was below the cut-off score on the MSE indicating the need for fur...

Recent Research on Offenders with Learning Disabilities

People with learning disabilities are typically over‐represented in Western criminal justice systems. They are vulnerable during police questioning, and may not comprehend their right to silence; they may confess, or acquiesce to the police version of events. They may have a long history of challenging behaviour which has never been appropriately addressed until the behaviour brings them into contact with the criminal justice system. It is important for service providers to have a working knowledge of the criminal justice system, and a clear idea of their role in relation to the client, especially during police interviews.

Career motivations of male and female medical students.

Australian medical students (N = 645) were asked at the beginning of their training to rank the importance of a list of motivations relevant to their choice of medicine as a career. Both male and female students ranked the desire to help others as the most important motivation, closely followed by the scientific nature and the intellectual challenge of the profession of medicine. Both genders rated considerations of status and prestige as of low importance. These findings are similar to surveys from other countries chat have reported altruism and intellectual challenge as prime motivations for both genders.

Diagnosing intellectual disability in a forensic sample: Gender and age effects on the relationship between cognitive and adaptive functioning

Abstract Background The relationship between adaptive behaviour and cognitive functioning in offenders with intellectual disabilities is not well researched. This study aims to examine gender and age effects on the relationship between these two areas of functioning. Method The Vineland Adaptive Behavior Scales (VABS) and the Kaufman Brief Intelligence Test (K‐BIT) were administered to 202 volunteer participants accused or convicted of crimes, 9% being of Australian indigenous background. The sample included males and females, juveniles and adults. Results Significant correlations were found between all subtests and domains on each instrument; for males under 18 years, correlations were lower, and significant correlations were absent between K‐BIT Vocabulary and VABS subdomains and composite standard score for this group. Conclusions Generally there is convergence between assessment of adaptive behaviour and cognitive skills, across age ranges and for both genders. Caution is needed in interpreting test results for young male offenders with possible intellectual disability; repeat assessments are advisable for this group.

People with an Intellectual Disability in the Australian Criminal Justice System

Intellectual disability (ID) is not accurately identified early enough in the criminal justice system. The extent to which each jurisdiction addresses the needs of persons with ID is inconsistent. Magistrate Court diversion programmes aiming to identify defendants with ID needs vary throughout Australia. This article argues the need for a national approach for the diversion of persons with ID from the criminal justice system. This will be important for persons with and without coexisting mental illness and will affirm international developments protecting the rights of persons with ID (including those in the criminal justice system) to improved and accessible health care.

Health of women ex‐prisoners

In an attempt to assist understanding of the specific health problems of women prisoners, the research reported here described the health of a volunteer group of female ex‐prisoners (N = 30), comparing them with a group of women from similar life circumstances who had not been imprisoned (N = 30), and with data from an Australian community study. The following instruments were administered: a structured interview; General Health Questionnaire (30 item) (GHQ‐30) Medical Outcomes Study. Short Form‐36 items (SF‐36) Kaufman Brief Intelligence Test (K‐BIT). Physical and mental health effects specifically related to imprisonment were examined. Both ex‐prisoners and non‐prisoners had poor mental and physical health compared‐with Australian women generally. This poor level of health functioning was probably related to the method of recruitment of the sample, reflecting the fact that women from poor socioeconomic levels who are receiving help from welfare agencies tend to be in poor health. The ex‐prisoners functi...