1. Clinical Forum – Learning Disabilities Managing access to social media with intellectually disabled offenders Dr Amanda McKenzie Principal Clinical Psychologist T: 01224 557142 E: amanda.mckenzie@nhs.netamanda.mckenzie@nhs.net

2. NHSG Forensic LD Service Integrated Model – core team IP Unit – Fern CSU 5 CLDTs Virtual Team 2 Referral sources: Intra-team vs. Legal

3. Case Vignette – Mr A Clinical Profile: 42 y.o. male Looks much younger Mild LD (Borderline non-verbal abilities) Memory problems – esp. Working Memory Expressive vs. Receptive Communication Compensatory strategies Seen by Generic & Forensic LD Psychiatry – no MI, no PD. Criteria for use of civil legislation not met Lives with parents – family supportive Had been in regular employment till index offence

4. Case Vignette – Mr A Referred 2007 – Solicitor 5 Charges: 1.BoP – sexual comments/graffiti 2.BoP – sexual comments to minors 3.Public Indecency 4.Contravention of Sec.127(1) (A) of the Communications Act 2003 5.Lewd, Indecent & Libidinous Practices & Behaviour

5. Case Vignette – Mr A Convicted of charges 1-4 PO – 2 years Joint offence focused work with CJSW & CP RSO – 2 years Schedule 1 Offender – 2 years MAPPA Level 2 – 2 years

6. Case Vignette – Mr A Additional Charge: Failure to comply with notification requirements of Part II of the Sexual Offences Act 2003 Found Not Guilty due to LD/low reading age

7. Case Vignette – Mr A 2008 – charged with offences under Sec.127(1) (A) of the Communications Act 2003 PF’s Release

8. Case Vignette – Mr A Referred 2011 – SCS Charges: 1.Public Indecency 2.Public Indecency

9. Case Vignette – Mr A Convicted of 2 charges CPO – 2 years CSOGP/JSOP – CP & CJSW, modified CBT, 2:1 180 hours unpaid work RSO – 5 years MAPPA Level 2 – 5 years

10. Case Vignette – Mr A CP Ax/Risk Formulation: o Deviance – SSKAT & QACSO o Poor socio-sexual and problem solving skills o Age Discrimination o Denial o Minimisation o Lack of Insight o External LOC o Lack of Victim Empathy o Poor Impulse Control

11. Case Vignette – Mr A CP Ax/Risk Formulation: o Lack of generalisation of remedial relapse prevention strategies o Intense sexual pre-occupation & inability to delay gratification – high levels of sexual arousal o Inappropriate sexual fantasies – non-consensual o ? Escalation from non-contact to contact o Unable to attend Young Sex Offenders’ Group

12. Case Vignette – Mr A Concerns of risk of harm arose during 2011 Ax – disclosure to Police + Ongoing MAPPA concerns re: diversity, escalation, chronicity & severity: o Offence Paralleling Behaviours (OPBs) o Grooming of female adolescents o Relationships with women with children – LAC concerns

13. Case Vignette – Mr A o Access to pornography – Internet/Film & TV/Magazines o Ongoing inappropriate use of smart- phone – MMS/SMS o Pre-occupation with sex o Increase in masturbation & fantasy o Ongoing inappropriate use of social media – Bebo/Facebook etc o Ongoing use of dating sites – Online/Newspapers/Teletext

14. Case Vignette – Mr A o Use of binoculars in public places frequented by families/young women – “plane spotting” o Walking the dog in parks (linked to MO) o Mobility – bicycle; driving lessons o Phoning sex chat lines – banned from landline by parents due to bills o Frequently changes mobile numbers/e-mail addresses – police believe has forensic knowledge o Has young nieces/nephews – parents do not allow unsupervised access

15. Case Vignette – Mr A o Disclosure to Psychiatrist of homosexual assault in past, not charged o Disclosure of homosexual fantasies and previous same sex encounters – but also homophobic beliefs o Disclosure of sexual feelings towards young female CJSW o Escalation in alcohol consumption o Continues to seek employment inconsistent with RSO status

16. Case Vignette – Mr A Current Management: Complies within statutory framework – MAPPA/RSO Risk Ax – RM2000, LS/CMI, HCR-20 = high risk of recidivism Application for a Sexual Offences Prevention Order (SOPO): 1.Prohibit all contact with minors 2.Monitor Mr A in public places 3.Prohibit purchase and use of mobile/internet and other media 4.Prohibit access to designated children's’ areas

17. Case Vignette – Mr A Referral to SW: 1.Lack of meaningful activities and structure 2.Appropriate supported employment 3.Move towards supported specialist accommodation

18. Case Vignette – Mr A Ongoing CSOGP/JSOP with input from CP – progress is slow! Reinforcement from CFLDN Long Term need for External Supervision & Controls Consideration to ECPA/ MARS if not subject to MAPPA Once external controls in place – CP will do individual Access to Media Policy based on risk formulation