The burden for clinical services of persons with an intellectual disability or mental disorder convicted of criminal offences: A birth cohort study of 14,605 persons followed to age 64

Abstract

Background

Intellectual disability (ID), schizophrenia spectrum disorder (SSD), bipolar disorder (BD), substance use disorder (SUD), and other mental disorders (OMDs) are associated with increased risks of criminality relative to sex-matched individuals without these conditions (NOIDMD). To resource psychiatric, addiction, and social services so as to provide effective treatments, further information is needed about the size of sub-groups convicted of crimes, recidivism, timing of offending, antecedents, and correlates. Stigma of persons with mental disorders could potentially be dramatically reduced if violence was prevented.

Methods

A birth cohort of 14,605 persons was followed to age 64 using data from Swedish national health, criminal, and social registers.

Results

Percentages of group members convicted of violence differed significantly: males NOIDMD, 7.3%, ID 29.2%, SSD 38.6%, BD 30.7%; SUD 44.0%, and OMD 19.3%; females NOIDMD 0.8%, ID 7.7%, SSD 11.2%, BD 2.4%, SD 17.0%, and OMD 2.1%. Violent recidivism was high. Most violent offenders in the diagnostic groups were also convicted of non-violent crimes. Prior to first diagnosis, convictions (violent or non-violent) had been acquired by over 90% of the male offenders and two-thirds of the female offenders. Physical victimization, adult comorbid SUD, childhood conduct problems, and adolescent substance misuse were each associated with increased risks of offending.

Conclusion

Sub-groups of cohort members with ID or mental disorders were convicted of violent and non-violent crimes to age 64 suggesting the need for treatment of primary disorders and for antisocial/aggressive behavior. Many patients engaging in violence could be identified at first contact with clinical services.

Keywords:

• Mental disorders
• intellectual disability
• criminal convictions

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The SBC Multigen contains sensitive personal data that cannot be shared. The analyses in this study have been carried out within a research project that has received ethical permission to access the data. To get to know more about the SBC Multigen and how to get access to the data, visit: https://www.su.se/stockholm-birth-cohort-multigenerational-study/contact

Additional information

Funding

This study was funded by The Swedish Research Council, Grant No. 2018-01452, and FORTE, Grant No. 2016-07148. ML acknowledges financial support from the Canadian Institutes of Health Research in the form of Vanier Canada Graduate Scholarships.

Notes on contributors

Sheilagh Hodgins

Sheilagh Hodgins published results of the association of mental disorders in 1992, and crime in the 1953 Stockholm birth cohort. Since then, she has replicated the results in other cohorts, and studied the development of antisocial/aggressive behaviour by persons with mental disorders, and effective treatments and management strategies.

Fredrik Sivertsson

Fredrik Sivertsson is associate senior lecturer at the Department of Criminology, Stockholm University. His main research interests concern continuity and change of crime over the life course as well as the development of juvenile crime during the 21st century in Sweden.

Amber Beckley

Amber Beckley is Senior Lecturer in Criminology at Örebro University. Her research focuses on how developmental factors influence criminal offending and victimization across the life-course.

Mimosa Luigi

Mimosa Luigi, MSc, is an MD/PhD candidate at McGill University and the Institut national de psychiatrie légale Philippe-Pinel, Canada. Supported by a Vanier Canada Scholarship, her doctoral research focuses on optimizing clinical practices and assessment methods for the prevention of violence and restrictive measures on inpatient forensic units.

Christoffer Carlsson

Christoffer Carlsson is Associate Professor at The Department of Criminology, Stockholm University. His research interests include developmental- and life-course criminology, criminal networks, and violent extremism.