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Created: Mar 23, 2023 08:00 AM
• Seb Henagulph is a consultant psychiatrist in private practice in Bermuda. He has extensive experience in treating all mental health issues
“A little knowledge is a dangerous thing”— Alexander Pope (paraphrased)
Violent acts towards children, particularly those of a sexual nature, are a highly emotive and psychologically damaging aspect of modern societies.
Recent headlines in The Royal Gazettehave been dominated by those who have taken on the task of protecting the children. I fully support the services they provide in service of prevention.
However, when it comes to the assessment, treatment and management of offenders, I would urge some caution with the solutions offered.
The danger with these solutions is both financial — they tend to prove very expensive to the public purse — and, my main concern, is that they can actually increase the risk of reoffending rather than prevent it.
We all know Bermuda is a small place. This has the effect of both magnifying these emotive issues and, owing to our limited population size, highlighting the challenges we face in attempting to reduce reoffending in those convicted of offences before the courts. While it is my understanding we do have suitably qualified individuals assessing the risk of offenders in both prison and court services, far more challenging is provision of effective treatment and management that leads to a reduced risk of reoffending.
Psychological treatment, often vaunted as a solution for an individual’s offending behaviours, has been shown to have limited impact, even in specialist offender units — in the United States, Britain and continental Europe.
A typical response to this is to advocate for incapacitating offenders by either keeping them locked in institutions for as long as possible — preferably abroad — or heavily monitoring their day-to-day movements in public. Failing this, a desire to publicly expose their offending and personal details “to protect others” is suggested. I will provide some numbers below to illustrate how these solutions can backfire.
The vast majority of those convicted of sexual offences commit only one offence in their lifetime. Even in an individual judged “high risk” by a rating instrument such as the Static-99R, reoffending rates are between 22.8 per cent and 37.2 per cent over five years. If we kept all high-risk offenders locked up, the vast majority — between 63 and 77 out of every 100 high-risk offenders — would never reoffend anyway. So for every three high-risk offenders you keep locked up, you prevent one offence over five years. We as a society have to decide if this is a wise, long-term approach.
Further complicating matters is that those who commit sexual offences do so for a variety of reasons. Basic types of sexual offender can be separated into 1, “indiscriminate offenders” (property and violent, including sexual offences); 2, “selective sexual offenders” (only sexual offences); and 3, “selective child sex offenders” (offend only against children). Of this last group, there is an approximately 50:50 split between those who have a developmental sexual attraction to children (paedophilia/hebephilia) and those who offend against children for other reasons.
There were arrests for 45 sexual offences and 23 offences against children — unknown proportion that were sexual — recorded by the police in 2020. Were we to imprison all of these offenders for lengthy periods, we would very quickly run out of room to place them and it would prove rather expensive. I estimate that the existing cost of imprisoning someone in Bermuda is about $130,000 per year. For the 68 individuals above, that would come to nearly $9 million per year; and that is just one year of offences. This is money that would be better spent on prevention services.
Other solutions that have been invoked include “sending them abroad”. While I believe there are provisions for the Department of Corrections to transfer high-risk inmates to British prisons, this also is not without great cost. In Britain, while relatively cheaper at £48,409 (about $58,500) per prisoner, this also quickly becomes an expensive proposition with numbers of people for extended periods. Furthermore, these costs increase over time — the UK cost has gone up by £13,000 over five years.
Even in large, well-resourced jurisdictions, providing effective treatment is a challenge. As noted above, this is partly because of the wide variety of motivations for sexual offending. Obviously, this issue is even more acute in Bermuda with our limited people and resources.
So what can we do? Professional thinking in this area is that risk management is the best approach to take. This requires individual assessment and multidisciplinary working. The formation of the local High-Risk Offender Group was a step in this direction, although it is under-resourced and tasked with monitoring and managing a wide variety of high-risk offenders, not just sexual ones.
As to public notification, I have previously indicated in this paper that there is a lack of evidence that this approach has any positive impact — and more likely negative. Professional opinion in this area is that focusing on managing an individual’s risk and responsivity factors is the most effective way of reducing risk of reoffending. Factors such as substance use, unemployment, homelessness and social ostracising all increase the risk of reoffending. Public notification makes all these factors more likely.
There was previously a programme called Circles of Support and Accountability in Bermuda, based on a North American model. It appears to have been last mentioned in 2015. This approach has proved to be quite effective in reducing sexual reoffending. It is unclear what became of this programme, but I would suggest it be funded and restarted.
Ideally, prevention will be the most impactful intervention in the long run and so the services providing this should be further supported. There is some evidence that teenage girls should be the focus of our prevention efforts, as they are responsible for producing the next generation. If these girls are living in emotionally unstable, trauma-inducing, poverty-stricken and substance-using environments, then this is passed on to the next generation as an interaction between genes and environment — so-called “epigenetics”.
Support for services providing intervention in this population is paramount to make Bermuda a safer place to live for all.
• Seb Henagulph is a consultant psychiatrist in private practice in Bermuda. He has extensive experience in treating all mental health issues
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