Trauma and adversity in forensic patients with an intellectual disability: a review of risk assessment reports

Abstract

Purpose People with intellectual disabilities are at a significantly higher risk than the general population for experiencing a wide range of adverse and potentially traumatic events. This paper aims to explore the incidence of experiences of lifetime trauma across this population in one Forensic Intellectual Disability Service. Risk management recommendations and psychological risk formulations were also examined for their consideration of traumatic experiences. Design/methodology/approach Risk assessment reports (n = 39) were reviewed for evidence of traumatic experiences and the consideration of trauma in patient risk formulations and risk management treatment recommendations. Findings Trauma was rated as present or partially present in 84.6% (n = 33) of risk assessment reports reviewed. None of the patients had received a post-traumatic stress disorder (PTSD) diagnosis. Recommendations regarding trauma were identified in 39.4% (n = 13) of the risk assessment reports where trauma was rated either “present” or “partially present”. Practical implications Findings suggest a need for diagnostic tools to be used to measure trauma symptoms and potential cases of PTSD to best support needs of patients. Trauma-focused interventions should also be considered. Further investigation is needed to clarify the disparity between the consideration of trauma in formulations and treatment recommendations. Originality/value This study highlights the different traumatic experiences that forensic patients across three settings have been exposed to during their lifetimes.