RESIDENT: Neurodevelopment Disorders in the Criminal Justice and Forensic Mental Health Systems

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Presenting Author(s): Dr. Jeremiah Bolstad

Co-Author(s): Maryana Kravtsenyuk

Date and time: 23 Mar 2019 from 13:30 to 13:50

Location: Bluebell  Floor Map


  1. Review the current literature on the costs of mental illness in the criminal justice system;
  2. Review the current literature on adults with developmental disabilities and fetal alcohol spectrum disorder in forensic psychiatric populations; and
  3. Discuss the obstacles to community reintegration of this complex population and current gaps in the literature.

Literature References

  1. Jabobs, P., Moffatt, J., Dewa, C. S., Nguyen, T., Zhang, T., & Lesage, A. (2016). Mental health services costs within the Alberta criminal
    justice system. International Journal of Law and Psychiatry, 47, 102-108.
  2. Duke, L. H., Furtado, V, Guo, B., Vollm, B. A. (2018). Long-stay in forensic-psychiatric care in the UK. Social Psychiatry and Psychiatric
    Epidemiology, 53(3), 313-321
  3. Hogue, T., et al. (2006). A comparison of offenders with intellectual disability across three levels of security. Criminal Behaviour and
    Mental Health,16(1), 13-28
  4. Lin, E., Barbaree, H., Selick, A., Ham, E., Wilton, A. S., & Lunsky, Y. (2017). Intellectual and developmental disabilities and Ontario’s
    forensic inpatient system: A population-based cohort study. Psychology, Crime & Law,23(9), 914-926 Reed, S., Russell, A.,
  5. Xenitidis, K., & Murphy, D. G. (2004). People with learning disabilities in a low secure in-patient unit: Comparison of offenders and nonoffenders.
    British Journal of Psychiatry,185(06), 499-504 Stinson, J. D., & Robbins, S. B. (2014). Characteristics of People With
    Intellectual Disabilities in a Secure U.S. Forensic Hospital. Journal of Mental Health Research in Intellectual Disabilities,7(4), 337-358
  6. Vijayalakshmy, P., Hishinuma, E. S., Kavanagh, B., Makini, G. K., Jr., Goebert, D., & Fernandes, D. (1998). Admissions, Length of
    Stay, and Discharge Barriers at the Hawaii State Hospital. Hawaii Medical Journal,57, 561-566
  7. Paluka, A. M., Raina, P., Lui, S-K., & Lunksy. (2012). The clinical profiles of forensic inpatients with intellectual disabilities in a
    specialized unit. Journal of Learning Disabilities and Offending Behaviour,3(4), 219-227
  8. Smetanin, P., Stiff, D., Briante, C., Adair, C.E., Ahmad, S. & Khan, M. The Life and Economic Impact of Major Mental Illnesses in
    Canada: 2011 to 2041. Risk Analytica, on behalf of the Mental Health Commission of Canada.


Mental illness represents a significant economic burden in Canada, estimated at $51 billion per year. Persons with mental illness have a
greater likelihood of interacting with the justice system. Treatment costs for mental illnesses represent 13% of public expenditures in the
criminal justice system in Alberta. People with developmental disabilities including fetal alcohol spectrum disorder (FASD) are known
to be overrepresented in both the criminal justice system and in forensic psychiatric hospitals. Community reintegration is one of the
most challenging tasks for the forensic psychiatrists working with this cohort of patients. A lack of specific forensically informed services
support for these individuals prevents their reintegration back into the community and leads to increased lengths of stay in forensic

Current literature in this area focuses on youth, with scarce data in the adult forensic population and their complex mental health needs.
This presentation will review the existing literature on the costs and prevalence of FASD, developmental disorders and intellectual
disability among adult forensic psychiatric inpatients. A proposed study to further define the prevalence and treatment needs of patients
with developmental disabilities and FASD in forensic psychiatric hospital in Alberta will be discussed.

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