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11
Non-dischargeable Mentally Disordered Offenders in a German
Hospital Order Institution
Paper presented to the 3rd Annual IAFMHS Conference, April 9th – 11th,
2003, Miami
Sabine Eucker & Dieter Jöckel, Forensic Psychiatric Hospital Haina, D-35114 Haina
15
Non-dischargeable Mentally Disordered Offenders 1
• increasing interest in expert discussion• limited to high risk personality disordered
offenders• headline „untreatable insane offenders“• developments:
- Germany: placement in correctional system?
- Great Britain: DSPDs
- Netherlands, Germany: long stay units
17
Non-dischargeable Mentally Disordered Offenders in the Haina
Forensic Psychiatric Hospital 1
definition: hospital inmates who are not expected to be discharged to the community in theforeseeable future
18
Non-dischargeable Mentally Disordered Offenders in the Haina
Forensic Psychiatric Hospital 2
• October 2000: 102 „non-dischargeable“ inmates
29% of all inmates
• October 2002: 1 „non-dischargeable“ inmate was discharged to the community
19
Compiled Data
• personal data
• criminal data
• diagnostic data
• risk assessment data
• clinical judgment data
110
Sample (N=102)
• mean age: 43 years (23 - 79)
• women: 8%
• mean treatment term: 6,6 years (0-33)
• longstay wards: 25%
111
Level of Security (N =102)
• pass: 57 %
a) with accompany: 29 %
b) without accompany: 28 %
• totally under lock and key: 43 %
112
Index Offenses and Main Diagnoses (N = 102)
Offenses
• sex offenses 34%• assault 19%• murder 11%• attempted murder 10%• arson 10%• robbery 8%• other 5%
Main Diagnoses
• no mmD 50% a) PD 30% b) paraphilia 20%• schizophrenia etc. 30% (only paranoid)• organic mental d. 12%• mental retardation 6%
113
Significant Differences Between Non-dischargeable and
Dischargeable Inmates (N=343)
Non-dischargeable inmates:• older• more sexual offenses• more personality disorders• more paraphilia• more mental defiency (IQ < 85)
114
No Significant Differences Between Non-Dischargeable and Dischargeable Inmates (N=343)
• substance abuse
• APD (DSM-III-R)
• acute psychotic symptoms
117
Factor Analysis (N=102)
• all variables which occur more often than 4 times
• main axis analysis• exclusion of variables with a low selfvalue• selfvalue criterion, scree test: 3 – 9 factors• varimax rotation• best interpretation: 5 – factor –solution• s2: 54%
118
5-Factor-Solution (N=102)
1. Antisocial lifestyle
(s2: 21%)
• PCL- SV 7-10
• H-Score (HCR-20)
• APD (DSM-III-R)
• substance abuse
• prior convictions
• robbery
2. Placement in hospital
order institutions
(s2: 12%)• diminished
responsibility• placement in prison
possible• no schizophrenia• personality disorder• admission questionable
119
5-Factor-Solution (N=102)
3. Sexual violence ( s2: 8%)
• sex offence• paraphilia• mental defiency
(IQ<85)• no organic mental
disorder• no attempted murder
4. Low motivation for treatment (s2: 7%)
• no motivation• from first day on non-
discharge ability obvious
• no arson
120
5-Factor-Solution (N=102)
5. Psychotic violence
(s2: 6%)
• first hospital order
• chronic psychotic
• assault
• no murder
121
Conclusions
1. Non-dischargeable insane offenders are scarcely noticed by forensic research.
2. The proportion of non-dischargeable insane offenders seems to be striking high.
3. The research of non-dischargeable insane offenders should not be reserved to the „DSPs“.
4. Up to 35% cannot be identified by common risk markers.
5. The term „non-dischargeable“ seems to be more appropriate than „non-treatable“.