Clinical, Demographic, and Criminal Behavior Characteristics of Patients With Intellectual Disabilities in a Canadian Forensic Program

Background: People with intellectual disability (ID) and forensic issues constitute a challenging clinical group that has been understudied in forensic settings. Methods: We assessed the characteristics of patients with ID under the authority of the Ontario Review Board (ORB) in a large forensic program of a tertiary psychiatric hospital (excluding those with a cognitive disorder) and compared their characteristics with those of a non-ID control group. Results: Among 510 adult ORB patients, 47 had an ID diagnosis. ID patients were of younger age at index offense, with a lower level of education, and were less likely to have been married or employed, more likely to have committed a sexual offense, more likely to have a diagnosis of paraphilia, less likely to be not criminally responsible, and more likely to be unfit to stand trial. They were also more likely to have committed their index offenses against care professionals and be treated in a secure unit. Conclusion: Our findings have major implications for clinicians, clinical leaders, and policymakers about the specific needs of patients with ID presenting with forensic issues and differing needs in terms of treatment and risk management.