A retrospective record review of individuals charged with sexual offences against minors, referred for forensic psychiatric observation
BACKGROUND: Sexual offences against children have been an escalating problem in South Africa. Several international studies have found links between mental illness and sexual offenders. However, very little has been published on forensic psychiatric observation populations charged with sexual offences. South African studies have neither reported on mental illness and sexual offences against children, nor on forensic psychiatric observation of individuals charged with sexual offences against children. AIMS: To determine the demographic and clinical characteristics, and outcomes of the observation process, in a population charged with sexual offences against minors, referred for forensic psychiatric observation. OBJECTIVES: To measure the number of individuals admitted to a forensic psychiatric unit for observation, for any charge of a sexual offence against a minor, over a three year period; to determine their demographic profiles; to determine the number assessed to be fit to stand trial and criminally responsible, and the number not fit to stand trial and/or not criminally responsible; to determine if associations exist between the reasons for referral and outcomes in terms of fitness and responsibility; and to ascertain whether mental disorders were present in these individuals. METHODS: This study took the form of a retrospective record review at Sterkfontein Hospital from January 2007 to December 2009. It included all individuals charged with a sexual offence against a minor. Data was collected from the Criminal Procedure Act reports and clinical files. RESULTS: Rape was the commonest charge. More than half the sample was found fit to stand trial and criminally responsible. However, a high number of psychiatric diagnoses were made, of which substance-related disorders and intellectual impairment represented the majority of diagnoses. CONCLUSIONS: Among individuals referred for forensic psychiatric observation, charged with sexual offences against minors, rape was the commonest charge. Most of these individuals were found fit to stand trial and/or criminally responsible. However, a significant number were diagnosed with mental disorders. It is recommended that they receive special rehabilitation and psycho-education into their psychiatric conditions and the consequences thereof.
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, 2014