European Psychiatry - Volume 33 - March 2016

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S38 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55
Patients with an intellectual disability (ID) have a disorder with
onset during the developmental period that includes both intel-
lectual and adaptive functioning deficits in conceptual, social,
and practical domains (according to the DSM-5). These deficits
in adaptive functioning result in failure to meet developmental
and sociocultural standards for personal independence and social
responsibility. Without ongoing support, the adaptive deficits limit
functioning in one or more activities of daily life. Therefore, it is
not surprising that these patients cross physical/sexual boundaries
quite often. Above that, a proportion of all sex offenders have an
intellectual disability.
The treatment of these sex offenders with an ID has to focus on
protective factors, next to risk factors in order to decrease the risk
of recidivism. Due to the chronicity of their disorder, quality of life
is an important issue in these patients.
In this paper, we want to address some ethical controversies:
– hormonal treatment in patients with ID who are sex offenders;
– the right to have a ‘normal’ sexual life in these ID offenders,
and the Dutch experience of the Stichting Alternatieve Relatiebe-
middeling (SAR, that can be translated as foundation of alternative
relationship mediation).
The SAR is an alternative dating service, giving information about
the sexuality of physically or mentally disabled people and orga-
nizing sexual encounters for them.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S62
Assessment of people with intellectual
disability for the court: What does a
psychiatrist need to know?
R. Latham
East London NHS Foundation Trust, London, United Kingdom
This presentation will focus on the importance of psychiatrists
understanding that they operate at an interface between two very
different disciplines; medicine and law. There will be consideration
of what and why psychiatrists need to understand the law, the way
it operates and the likely implications of their opinions. There will
be consideration of an example from England and Wales to illus-
trate the way inwhich psychiatry and lawmight interpret the same
information. The aim is that psychiatrists will be better equipped
to face the challenges the law presents.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S63
Use of risk assessment tools for people
with intellectual disability: The latest
evidence
C. Morrissey ∗
1 University of Nottingham, School of Medicine, Nottingham, United
Kingdom
2 Lincolnshire Partnership NHS Trust, Clinical and Forensic
Psychology, Lincoln, United Kingdom
∗ Correspondence.
A relatively high proportion of people detained in forensic psychi-
atric hospitals have intellectual disabilities (up to 3000 people in
the UK; Royal College of Psychiatrists, 2013), and people with intel-
lectual disability are significantly over-represented among those
psychiatric patients with long lengths of hospital stay (CQC, 2013;
Vollm, 2015). Peoplewithmild to borderline intellectual disabilities
are also prevalent in the UK prison system.
Although the relationship between intelligence and offending is
complex, lower intelligence is a known actuarial risk factor for
offending behaviour. Studies, which have investigated the predic-
tion of re-offending risk in populations with intellectual disability,
have nevertheless found lower rates of recorded re-offending com-
pared to those in mainstream forensic populations (e.g. Gray et al.,
2010). The relatively high rate of ‘offending-like’ behaviour, which
is not processed through the criminal justice system in people
with intellectual disability makes risk prediction a more complex
exercise with this group of people. It also makes outcomes mea-
surement more difficult.
This paper will give an overview of the current research evidence
and clinical practice in the field of risk assessment, risk manage-
ment and outcome measurement with offenders with intellectual
disability. It will summarise the findings of a recent NIHR funded
systematic review by the author, which pertains to this area, and
will point to future developments in the field.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S64
Prisoners with intellectual disability:
How to adapt interventions and the
environment
V. Tort Herrando (Coordinador)
Unitat Polivalent de Psiquiatria Quatre, Camins, Parc Sanitari Sant
Joan de Deu, Sant BoI de Llobregat, Barcelona, Spain
There is an increasing interest in the Spanish prison to give the
appropriate care when they are in prison. This situation has a spe-
cial meaning in inmates with learning disabilities, as they are a
vulnerable group inside prison. They are vulnerable in different
areas as they have a high prevalence dual diagnosis (both with
mental illness and drug misuse), they could suffer from abuse from
other inmates, difficulties to understand prison regulations, etc. The
prevalence of intellectual disability (ID) in the prison setting has
been poorly evaluated. In Spain, despite various approximations or
estimates regarding people with intellectual disabilities no reliable
data is available.
In our presentation, we will give an overview of the care of this
group of patients, presenting some data from an epidemiological
study in Spain. The rate of learning disabilities was of 3.77% of the
study population has an IQ below 70, and 7, 3% has borderline IQ
rate. We also describe a new setting in one of wards of a prison of
Barcelona where has a model of therapeutic community for treat-
ing offenders with intellectual disabilities. This resource open two
years ago and is run between prison services and an organization
“Accepta” (specialized in people with learning disability and penal
law problems). This is an effort from the prison services to adapt
to the needs of inmates and deliver a better service with a good
post-release follow-up.
And finally, we present some data about learning disability in pen-
itentiary psychiatric settings (the prevalence as a main diagnose is
around 10%).
Disclosure of interest The author has not supplied his declaration
of competing interest.