Editorial

Adrian Darakai (Deakin University), Andrew Day (James Cook University) and Joe Graffam (Deakin University) consider public attitudes towards the employment of ex-offenders with a disability. This is one of the only studies that has examined public attitudes towards this group.

Ex-prisoners often face significant challenges in their efforts to find meaningful and stable work, undermining their chances of successful reintegration back into the community. These problems are likely to be compounded for those who have an intellectual disability, given evidence that the disabled generally experience high levels of discrimination when applying for and maintaining jobs. This study determines whether members of the public hold different attitudes and expectations towards the employment of ex-offenders who have an intellectual disability. Participants were presented with vignettes, and then completed a short survey designed to measure their attitudes and expectations towards the employment of ex-offenders. Whilst presence of a mild intellectual disability did not significantly affect community attitudes towards ex-offender employment, it did change expectations about employment outcomes.

The authors suggest that it appears that ex-offenders are perceived as a homogenous group of people, despite actual and substantial differences existing within this population.

Grace Trundle, Leam Craig and Ian Stringer from Forensic Psychology Practice in Sutton Coldfield in the UK present a case study on differentiating between pathological demand avoidance (PDA) and antisocial personality disorder (ASPD).

This study seeks to explore the differing clinical features of PDA and ASPD presented in the form of a single case study. The study highlights to practitioners in forensic settings the potential of misdiagnosis and conceptual confusions between the two conditions when working with offenders with personality disorders. The clinical similarities and differences between PDA and ASPD are delineated. These differences and similarities are evaluated and applied to offender management including intervention options.

The authors note that there are considerable similarities between ASPD and PDA making the two conditions difficult to separate. Both diagnostic criteria identify childhood behavioural problems, aggression, destructiveness, conduct disorder, manipulation and non-compliance as indicative of the disorder. Misdiagnosis of PDA as ASPD reduces the efficiency of treatment programmes.

The implications of these findings could prove useful in the successful risk management of offenders with PDA. Given the similar behavioural characteristics between PDA and ASPD, the prevalence of PDA among offenders may be higher than observed.

Paula Johnson (Mersey Care NHS Foundation Trust), David J.W. Evans (Lancaster University) and Zulaikha Khan (Mersey Care NHS Foundation Trust) consider whether an example of Seclusion Room Contactless Monitoring Technology is able to accurately detect the presence of life in a ward seclusion room ensuring patient well-being, without interference from background “living noise” (e.g. voices) or “electronic noise” (e.g. other systems).

They assessed the system’s ability to monitor movement caused by human respiration through its ability to discriminate false positives (i.e. presence of an inanimate object ± movement or noise, in the absence of a person in the seclusion room) and false negatives (i.e. failure to detect a human presence) in a ward setting.

The team suggest that their findings demonstrate that this example of technology is able to monitor movement caused by human respiration and can accurately and reliably detect the presence of life in seclusion rooms, in the ward setting, without interference from background noise (living and electronic).

Sarah Ashworth and Paul Mooney from Partnerships in Care together with Krista Jansen and Lydia Bullock from the University of Nottingham present a paper titled “Mind Matters: a psychoeducation programme for individuals with intellectual disabilities and co-morbid diagnoses of mental disorder”.

The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings.

“Mind Matters” is a group-based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period.

The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme, in addition to the apparent increased social skills and motivation to engage with future psychological intervention.

The authors believe that this approach benefitted both the group members and staff, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities.

This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.

Shaunagh Macdonal and Jane Clarbour from the University of York together with Clare Whitton and Kelly Rayner from Tees, Esk and Wear Valley NHS Foundation Trust consider the challenges of workings with sexual offenders who have autism in secure services.

Previous literature has reported that working with sexual offenders can impact staff negatively. In addition, working with individuals with intellectual disability also appears to be challenging. There are benefits stated of working with sexual offenders and this research seeks to highlight the challenges and positive experiences of staff members working with sexual offenders who have autism.

A semi-structured interview was conducted to explore the challenges and benefits of working with this population. Eight participants were interviewed who work on the autism specialist ward at a forensic secure hospital in the UK. The findings show the specific challenges of working with a population that has not been previously studied.

The authors suggest there are a number of specific challenges this staff group face, and steps that can be taken at the personal and organisational level to mediate these. Recommendations are made for how staff are supported in their work from recruitment and induction onwards. This model provides a framework that can be adopted by organisations to ensure that the likelihood of their staff experiencing negative feelings is reduced and also suggests future avenues of research.