Abstract
Introduction: Internationally, people with intellectual disability (ID) who appear in court on criminal charges are commonly sentenced to either compulsory hospital care and treatment, or prison. In New Zealand (NZ), people with ID who are charged with a criminal offence receive a sentence of compulsory treatment and rehabilitation under the Intellectual Disability Compulsory Care and Rehabilitation Act 2003 (IDCCRA). The IDCCRA, was designed as an alternative to prison or being placed under the Mental Health Act (MHA) 1992 (Ministry of Health (MOH, 2004). There is limited research regarding the IDCCRA, and none concerning the demographic profile of people who are detained under this legislation.
Aim: This study identified and explored the demographic profile of people admitted to a secure inpatient facility under the IDCCRA between 1 June 2004 and 31 December 2020.
Methodology: A retrospective file audit was undertaken to ascertain a demographic profile of each person who experienced admission(s) to a secure hospital-based service under the IDCCRA. The template data extraction tool (Appendix A) was utilised to identify and capture the relevant demographic data required for this research. This included age, gender, ethnicity, index offence, date of admission, whether this is their first or only admission, length of stay, whether the person was under legislation when discharged and date of discharge. This was entered manually by the writer into Microsoft Excel and a univariate descriptive analysis was employed.
Results: Thirty-one care recipients were identified, the data showed two significant findings - the percentage of Māori care recipients (35 percent), has increased over time and was three times greater than the percentage of Māori in the regional area (Statistics NZ, 2020). Also, that the numbers of people under 25 years old being admitted to secure units is increasing. This age group had the largest number of current care recipients (48.2 percent).
Discussion: The findings of this study support recent research that ethnicity and age of care recipients have changed considerably over time. Compared to the general population, Māori continue to be over-represented in the judicial system which is congruent with international research concerning indigenous populations. This study recommends collaboration, participation, and inclusion of indigenous people to ensure autonomy and barriers to health service are addressed. Increasing the capacity of the Māori workforce and providing ongoing professional development for all health professionals to improve the knowledge, skills, attitudes, and delivery of culturally responsive care is crucial.
The findings also demonstrated the numbers of care recipients under the age of 25 years is increasing over time which has been reiterated in recent Ombudsman reports. This research recommends focusing on early identification of disability to reduce the increasing numbers of young people with ID encountering the criminal justice system. Improved training and education for staff and services alongside efficient communication and collaboration with both the individual and their family are necessary to work towards the goal of reducing the likelihood of offending behaviours and/or re-offending. The results generated through this research represent an important contribution to the small but emerging literature on matters relating to care recipients subject to NZ's unique IDCCRA.