A review of individuals charged with common assault and assaults with intent to do grievous bodily harm, referred for forensic psychiatric observation
BACKGROUND: Common assault and assault with intent to do grievous bodily harm comprise the majority of contact crime in South Africa and have been on the rise over the years. Some international studies have demonstrated a link between violent crimes and psychiatric illness. There is, however, a lack of information in our setting regarding this link. AIMS: To determine and compare the demographic and clinical profiles, and the outcomes of the observation process, of individuals charged with the minor offence of common assault and those charged with the serious offence of assault with intent to do grievous bodily harm, referred for forensic observation. OBJECTIVES: To describe the clinical and demographic profiles of individuals admitted for observation, charged with common assault and assault GBH, over a three year period; to determine the number of these individuals assessed to be fit to stand trial and criminally responsible, and the number found not fit to stand trial and/or not criminally responsible; to compare the characteristics and the outcomes of those charged with common assault versus those charged with assault GBH. METHODS: This study was conducted as a retrospective record review at Sterkfontein Hospital from January 2013 to December 2015. It included all individuals charged with common assault or assault GBH. Clinical files and Criminal Procedure Act reports were used to obtain the data. RESULTS: The total sample size was 118, and included 25 individuals charged with common assault and 93 charged with assault GBH. Due to the large discrepancy in numbers, the two groups could not be compared. In cases of common assault 96% of individuals were male, 92% were unemployed, 56% had an incomplete high school education, and 84% were known to the complainant. With respect to assault GBH 90.3% of accused were male, 87.1% were unemployed, 45.2% had an incomplete high school education, and 69.9% were known to the complainant. Females represented the majority of complainants in both groups (64% in common assault and 48.4% in assault GBH). In the case of assault GBH the most common weapon used was a blunt object (45.2%), whereas with common assault, in most cases no weapon was used (56%). For common assault 64% of individuals were found not fit and not responsible, and this was the case for 53.8% of those charged with assault GBH. For both common assault and assault GBH, where a diagnosis was present, psychotic disorders were the most common (60% and 58.1% respectively), followed by substance use disorders (36% and 52.7% respectively). CONCLUSIONS: The study found that almost four times the number of these individuals referred for observation were charged with assault GBH compared to common assault. For both groups, the majority were found not fit and not responsible. It is recommended that when these individuals are referred back as patients they receive pharmacotherapy if indicated, and rehabilitation in the form of occupational therapy, psychotherapy and social interventions. These measures should include intensive psycho-education regarding their psychiatric illness so as to improve adherence to treatment regimens and reduce the risk of recidivism. .
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Psychiatry, Johannesburg, 2019