Mental health assessment of under trial sexual assault accused in Bengaluru central jail – A cross section study

 

 

Abstract               The study has been carried out to assess the mental health status of the under trail sexual assault accused in Bengaluru central jail, Karnataka. It is a cross sectional descriptive study. With their consent, the mental health assessment was done using M.I.N.I Plus questionnaire. Later with the help of M.I.N.I Plus SPSS software data was tabulated, analyzed and expressed in terms of number of cases and percentage. Prior permission from concerned jail authority was taken. In our study, 68% of offenders were suffering from general anxiety disorder, 56% offenders are alcohol dependent, 59% offenders have social phobia, 12% offenders suffer from post-traumatic stress disorder, 9% offenders were smokers, 2% offenders suffer from depression, 1% offenders suffer from mania and 1% suffers from psychosis.

Key Word: sexual assault accuse.

 

INTRODUCTION

Sexual violence in general terms is often misunderstood even amongst forensic psychiatrist. This means that other mental health professionals probably also struggle with the concept. The reasons for this are complex; however it is a field that is clinically challenging and often does not receive the interests it deserves from the various professionals in the field of psychiatry, psychology, forensic experts and other mental health professionals. It is clearly a very important area ideally suited for psychological, demographical, social and forensic medicine research.¹ In recent decades intense scrutiny has been focussed on the adjudication and treatment of sexual offenders.² Dignity of woman is a part of her non-perishable and immortal self. Any kind of liberal approach in any case of rape is not acceptable to any extent. The problem of rape become still more complicated due to highly unequal society where woman are of low status and are often segregated and disadvantaged. In many occasions we come across with sexual violence more commonly like in Juvenile delinquency, Family problems, Poor living arrangements, Substance misuse, Organised delusions, Thought disorder, Command hallucinations.¹ In 1936, Dr.James Pritchard coined the term Moral Insanity. It refers to those individuals who appeared to lack any well-formed conscience although otherwise seeming perfectly normal.² Holmstorm’s and burgess (1980) suggested four meanings for sexual aggressive behaviour: The assertion of power and control, The expression of anger and hatred, Camaraderie in group of rape and Sexual experience per second.¹ The psychopathy check list-revised (PCL-R; Hare, 1991), partially robust predictor of future violent behaviour. In addition to general criminal behaviour, it has also been effective in predicting future sexual violence (Hanson 1998, Hanson and Bussire 1998, Prenkley et al. 1997).¹ Similarly, many tools are available for assessment of mental status like,¹

1. The Minnesota Multiphasic Personality Inventory -2(MMPI-2) developed by Hathaway and McKinley , 1989
2. The Rust Inventory of Schizotypal Cognitions(RISC)
3. The Multiphasic Sex Inventory (MSI) developed by Nicholls and Molindor
4. The Hyper Masculinity Scale(HIS) developed by Mosher and Sirkim
5. The Rape Myth Acceptance Scale (RMAS) developed by Burt , 1980
6. Attitudes to woman scale (AWS) developed by Spencer , et al,1973
7. MINIPLUS Statistical scale³

 

MATERIALS AND METHOD

The main objective of our study is to assess the mental health status of alleged accused in sexual assault cases and to correlate the substance abuse with sexual offences. All the alleged accused in a sexual offence’s cases brought by investing officer for examination in the Department of Forensic Medicine and Toxicology, Bangalore Medical college and Research Institute, Bengaluru are included in the study. Subjects who have not given valid consent are excluded from the study. Data will be collected from all subjects through personal interviews and relevant data entered in Performa which compromises of M.I.N.I Plus ³ tool to make mental status assessment. Later each performa will be analysed by the Psychiatrist and data will be tabulated; statically analysis will be done using appropriate tests with M.I.N.I Plus SPSS statistical package.

RESULTS

Table 1: Age Wise Distribution of Sexual Offenders

In our study, 63% of offenders were in the age group of 19-29 yearrs, 21 % were in the age group of 30-39years, 11% were from40-49 years and 5% were from 50-59 years. The above table shows that a active and generative age group between 19-39 years are the offenders.

 

Table 2: Psychiatric Disorders Among Sexual Offenders

In our study, we observed that each individual is suffering from more than one form of psychiatric disorders. We mean to say that, 68% of offenders suffer from general anxiety disorder, 59% of offenders have social phobia, 56% of offenders are victims of alcohol dependency, 38% of under trail accused have anti social personality disorders, 31% of people have suicidal tendency, 12% of offenders suffer from post-traumatic stress disorder, 9% of offenders have smoking dependency, 2% of offenders have depression, 1% of offenders suffer from mania and 1% suffer from psychosis.

 

DISCUSSION

As per National crime records bureau, a total of 3,09,546 incidents of crime against women were reported in 2013, in which Andhra pradesh (10.6%), Uttar pradesh (10.5%), West bengal (9.6%), Rajasthan (9%), Maharashtra (8%) and Madhya pradesh (12.9%) hold their shares.⁴ Some mental health professionals contended that , when applied to sexual offenders , the term mental abnormality should simply refer to one of the paraphilia’s outlined in Diagnostic and Statistical Manual of mental disorder (DSM-IV).² Personality disorder among sexual offender is most accurately described as neither a mental illness nor a mental disorder but rather as a pattern of aberrant behaviour.⁵ The term "sexual predator" is often considered distinct from “sex offenders". For example, many U.S. states make legal distinctions between these categories, defining a "sexual offender" as a person who has committed a sexual offense. The term "sexual predator" is often used to refer to a person who habitually seeks out sexual situations that are deemed exploitative.² Chiswick in 1983 observed that, majority of those who commit sexual offences are in fact suffering from a mental disorder. It is not surprising that current public opinion that individuals with mental illness are primarily responsible for sexual offences.¹ In a study by Gibbson and Robertson in 1983 concluded that17 out of 358 offenders suffer from mental illness.¹ Similarly, Murray, et al in 1992 concluded that32 out of106 offenders are suffering mental illness.¹ Motiuk and Belcourt in 1996 observed that, mental illness is the primary reason for sexual offences. Craissati and Hodes in 1992 suggested that out of 11 offenders 10 offenders are suffering from mental illness.¹ Andrew j et al suggests serious mental illness among offenders and need hospitalisation to prevent recidivism. Jayid Sarkar in 2013 suggests majority of sexual of offenders suffer from mental disorders like psychoses and paraphilias. Longstorm et al. suggested that personality disorders, alcohol and drug abuse are prevalent among sexual offenders.²Bonta et al in 1998 suggested that mental ill might be understood in context of criminological theory in addition to psychopathological framework.¹ Flor-Henry (1987) suggested that sexual deviations are overwhelmingly a consequence of the male pattern of cerebral organisations. Various studies has shown that sexual sadism and violence is associated with brain damage most commonly in anterior temporal lobe region of the brain. Higher serum levels of testosterone were found to be associated with higher likelihood of sexual violence¹ An etiological explanation by Welsn (1987) suggested that the sexual deviations or aggression results from the male struggle for access to young healthy females and that the difficulty stem from the problems which unsuccessful males have in managing their sexual drive.¹ Henn et al , 1976 examined the records of 239 individuals charged with sexual offence and found that major mental illness was very rare among both those who had been charged with rape and those who had offended against children. Kavoussi et al. 1998 observed that, conduct disorder is commonly diagnosed in adolescent’s sexual offender group than mental illness.¹ In 1993, Monagahan concluded that juvenile delinquency, family problems, substance abuse and lower economic status was responsible for sexual violence. The behaviourist seem to believe that there is in particular character do present in their sexual deviation, the behaviour itself is a disorder.¹ Fazel in 2005, concluded that there are 3 times the risk of mental disorder and 30 times more risk of alcohol and drug abuse in sexual offenders.⁶

 

CONCLUSION

Many authors observed different reasons behind sexual offences like mental illness, behavioural disorder, alcohol and drug abuse, lower economic status, high testosterone level, temporal region injury etc. Among these most of them observed some kind of mental illness among sexual offenders. Many undetected mental health problems are looked into society as curse and devoid individuals and families of normal facilities which is leading cause of alcoholism, drug abuse and recidivism which in turn leads individual to indulge in greater crimes and poor interpersonal relationship and this becomes vicious cycle. Even after so many studies, still there is no solid evidence or reason which makes certain individual involved in sexual offences and recidivism. So more combined effort by forensic expert, psychiatrist and psychologist is required in this aspect to throw light on mindset of a particular person involved in sexual offences.

 

REFERENCES

• Nambi S. Forensic aspects of sexual offences. Text book of forensic Psychiatry.1^st ed. India (Haryana): Jaypee Brothers Publishers; 2014.p.97-107.
• Goldstein AM, Weiner IB. Evaluation of sexual predators. Handbook of Psychology. New Jersey: John Wiley and Sons; 2003.p.463-470.
• M.I.N.I Plus 5.0.0 [internet] 2015. Available from http://www.mdpu.ca/documents/mini.pd accessed on 02nd November 2016.
• Crime in India 2013 [internet]. Available from http://ncrb.gov.in accessed on 4^th November 2016.
• Harris GT,Rice ME, Quinsey VL. Appraisal and management of risk in sexual aggressors. Implications for criminal justice policy. Psychology, public policy and law.1998.4.p73-115.
• Fazel S, Lubbe S. Prevalence and characteristics of mental disorders in jails and prisons. Curr Opin Psychiatry. 2005; 18: 550–554.