Disability Forensic Assessment

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Disability Forensic Assessment Treatment
Service
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Australia

• Huge Land mass almost as great as that of the
  continental USA, 32 times greater than that of
  the United Kingdom.
• Population 21.5 Million.
• 8 States and Territories.
• Westminster System of Government 3 levels -
  Commonwealth, State, Local.
• Victoria
• Second Smallest state (in mass).
• 227 600 km2 (about the same area as England,
  Wales and Scotland),
• Population 5.3 million.
• About 36 per cent of Victoria is covered by
  forest.

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VICTORIAS BUSHFIRES - Feb 09

• 210 Deaths
• Over 2000 homes destroyed
• 822 emergency presentations to Hospitals

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Department of Human Services.

• Disability Forensic Assessment
  TreatmentService (DFATS) is a specialist service
  within Disability Services Division of DHS,
• Largest Victorian Government Department,
• Responsible for Health, Mental Health, Senior
  Victorians, Community Services, Housing and
  Disability,
• Funds organisations such as hospitals, aged care
  facilities, ambulance services, and community
  service agencies,
• Operates a range of residential case management
  services for people with ID.

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Population Demographics Intellectual Disability

• Clients registered on the DHS, Disability
  Services, database (2009)
• Total 41,889
• Male 24,866
• Female 17,023
• Victoria Prison population (2009)
• Total number of prisoners 4,223
• Male 3985
• Female 238
• Intellectual Disability 112
• Female ID 2

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Disability Forensic Assessment Treatment
Service (DFATS)

• Established in 1987 in response to challenges
  facing the service system,
• Target group
• people with an intellectual disability,
• involved in the criminal justice system
• have demonstrated dangerous, anti-social
  behaviour.

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DFATS Service Philosophy

• Offenders with an intellectually disability have
  the same right to treatment as their non-disabled
  counterparts,
• They have the ability to learn, understand
  obtain internal control over their offending
  behaviours,
• Treatment is to assist the client to obtain the
  least restrictive lifestyle whilst reducing risk
  to the community,
• Consistent application of treatment across
  environments provides the best opportunity for
  real change,
• Treatment decision making by a
  multidisciplinary team ensures that a whole of
  life approach is taken,
• Reducing the risk of reoffending is enhanced by
  increasing community agency knowledge
  awareness of this group.

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DFATS - Programs

• Three tiers of programs
• Intensive Residential Treatment Program (IRTP),
• Community Program (consisting of individual and
  group session to people with a disability
  residing in the community)
• Prison based programs,
• Consultancy Program (court assessments, aadvice
  and training).

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IRTP

• A highly structured, supervised residential
  program,
• Currently four stages each involving different
  levels of security, supervision, treatment and
  community access (max.5 clients in each stage),
• A legislatively mandated entrance process to
  program,
• A legislatively mandated treatment planning
  process reviewed by the OSP VCAT.
• Programs delivered by Program Support Team
  (clinical and case management) together with
  Residential Support Team.

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IRTP Eligibility

• Clients need be eligible for services under
  Disability Act (2006) most are borderline to
  moderate ID. (Clients need to demonstrate a
  capacity to comprehend Cognitive Behavioural
  Therapy (CBT) treatment concepts)
• 18 years or older
• They must be convicted of a serious offence as
  defined by the Sentencing Act 1991 which
  includes
• Murder/ attempted murder / Manslaughter
• serious assault
• arson
• Serious sexual offences against adults or minors

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IRTP Eligibility

• Must be subject to one of the following orders
• A Residential Treatment Order (Sentencing Act
  1991)
• A Parole Order (Corrections Act 1991)
• A Custodial Supervision Order (Crimes Mental
  Impairment and Unfitness to be Tried Act 1997)
• Prison transfer
• An Extended Supervision Order (Serious Sex
  Offenders Monitoring Act 2005)

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IRTP
IRTP Program Details A range of offence-specific
and related individual and group work, utilising
a cognitive behavioural approach based on a
positive sanctioning model. A life skills and
social skills component designed to increase
clients independence, capacity to engage in
treatment and preparation for community living.
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IRTP Program Numbers

• 16 Clients (Max 20 clients)
• Major Offence Types Rape / sexual offences
  against children n14, abduction n1, Serious
  Assault n1.
• Criminal History Manslaughter, Arson,
  Abduction, Aggravated Burglary with Offensive
  Weapon, Intentionally Cause Serious Injury,
  Recklessly Cause Serious Injury.
• Age Range 21 - 53

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Community Prison Programs

• Delivered by the Program Support Team (clinical
  and case management) for those residing in the
  community, in group homes, prison or youth
  justice services. It includes
• direct specialist services including counselling
  and group work
• community-based groups and individual therapy
  sessions at DFATS premises and in the community
• prison based services at Port Phillip and Loddon
  Prisons
• specialised support services to young forensic
  disability clients in the Youth Custodial System
• Community Dual Disability Clinic providing
  services to people with an intellectual
  disability and mental illness.

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Community Prison Programs Client Profile

• 32 Clients (Individual Group)
• 39 Clients (DDC)
• (aspergers, paranoiac, suicide self harm,
  depression, ADHD)
• 112 Registered Clients in Prison system.
• Male 110, Female 2,
• Remand 34, Sentenced 78,

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Corrections Victoria Disability Framework

• Establishment of a pathway for ID offenders as
  they move through their imprisonment
• Consists of the Joint Treatment Program (JTP) in
  PPP step down independent living units in
  Loddon Prison.
• JTP based upon a therapeutic community.
• Staff from CV, DFATS PPP (GSL) provide a range
  of programs.

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Joint Treatment Program

• 33 Prisoners in unit
• Cognitive functioning- Borderline to moderate ID,
  
• Co morbidity - ID mental health, ID
  substance abuse,
• Age range - 21 to 60 years,
• Offence types Drug related, Sexual offences,
  Violent offences, Property offences,
• Length of sentence 12 months to 20 years.

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Joint Treatment Program Intervention Focus
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DFATS STAFFING

• 6 Psychologist
• 1 Social Worker
• 1 Dual Disability Clinician (DDSO 3a)
• 4 Psycho Educational Trainers
• 4 Case Management Team
• 3 VPS (Prison / YJ liaison)
• 60 DDSO (1-4) Residential Workers

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DFATS Staffing
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Difficulties Dilemmas

• Consistent application of a treatment approach in
  the wider system.
• Public perception of intellectual disability.
• Limited life opportunities for the clients.
• Modification of current treatment approaches.
• Treatment versus security / risk.
• Working within a dramatically changing social
  service system.
• Resource allocation.
• Research comparisons outcomes.