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People with learning disabilities in a low secure in-patient unit: comparison of offenders and non-offenders

  • Suzie Reed (a1), Ailsa Russell (a2), Kiriakos Xenitidis (a2) and Declan G. M. Murphy (a2)

People with learning disability who exhibit challenging behaviour are frequently segregated from services and local teams are often reluctant to receive them back into their care. This situation is worse in those whose challenging behaviour includes a forensic history, but the difference between those labelled as challenging and those treated as offenders is not clear, and there is a lack of evidence about treatment effectiveness.


To test between-group differences in aggression and treatment outcome in people with learning disability and challenging behaviour, with and without a forensic history.


Clinical records of 86 former in-patients (45 offenders and 41 non-offenders) of a specialist unit were compared on measures of behavioural disturbance and placement outcome.


People in the offenders group were significantly less likely to be aggressive to others and to use weapons, but significantly more likely to harm themselves compared with the non-offenders group. Both groups had a significant reduction in their challenging behaviour during admission, and there was no significant difference in treatment outcome.


The negative reputation of people with learning disabilities who offend needs to be reconsidered.

Corresponding author
Suzie Reed, Research Nurse, Institute of Psychiatry, The David Goldberg Centre for Health Services Research, Section of Psychiatric Nursing, Box PO30, De Crespigny Park, London SE5 8AF, UK. E-mail:
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Declaration of interest

The authors are or have been part of the clinical team at the specialist unit evaluated.

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People with learning disabilities in a low secure in-patient unit: comparison of offenders and non-offenders

  • Suzie Reed (a1), Ailsa Russell (a2), Kiriakos Xenitidis (a2) and Declan G. M. Murphy (a2)
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Confusion aroung inconsistency in the results

Thomas Marshall, LD Psychiatrist
17 December 2004

Dear Sir/Madam,

I found this study fascinating, as it demonstrates the apparently random nature of a forensic label in our patients. It is clearly not to dowith risk. I am confused by some of the results. The whole gist of the argument is that the offender group are less violent than their non-offender counterparts.However, it is stated that in the offenders group the challenging behaviour diminishes from 0.79 incidents per week to 0.36 and that for thenon-offender group from 0.23 to 0.11. This is challenging behaviour generally, but this suggests the offender group exhibit greater challenging behaviour throughout their stay than the non-offender group. Table 2 states the opposite.I would be interested to see how this inconsistency can be explained. ... More

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