The Royal's Sexual Behaviours Clinic
"Are Any Sex Crimes Necessary?”
Crime Prevention Ottawa
J. Paul Fedoroff, M.D.
Director SBC
Director Forensic Research IMHR
Chair, Division of Forensic Psychiatry
University of Ottawa
27/02/12
I get it – the old caffeinated-cop,
decaffeinated –cop routine
2
COSTS OF CHILD ABUSE IN
CANADA/Year (Juristat)
Acknowledgements
• The University of Ottawa (U of O)
• The Institute of Mental Health Research (IMHR)
• The Royal Ottawa Health Care Group (ROHCG)
• The Integrated Forensic Program (IFP)
• The Sexual Behaviours Clinic (SBC)
• The SBC’s Patients, Their Families, and Children
At the turn of the (last)
century…
• A disease with no known cause
• Associated with vampires
• Widespread but mainly in cities
• Possible cause: masturbation
Robert Koch, 1905
The Royal Ottawa 1909
Treatment
Some things have changed
Some things stay the same
Sex crime rates are dropping
For Children
And treatment seems to work
(Cortoni & Nunes, 2008)
Recidivism
National SOP (347)
Control (137)
Sexual
1.1 %
4.4%
Violent/Sexual
2.0%
17.8%
Any
6.8%
36.5 %
Hanson & Harris, 2004
• Reviewed 95 studies involving
31,216 sex offenders
• Average community time: 5-6 years
• Any recidivism: 36.9%
• Sexual recidivism: 13.7 %
Program Outcome
Marshall, Marshall, Malcolm, Serran & Fernandez, 2005
Treated*
(N = 534)
Expected**
Sexual
3.2%
16.8%
General
13.6%
40.0%
Re-offence
*Mean follow-up = 5.4 years
**Based on Static-99 and L.S.I
COST-BENEFIT ANALYSIS OF TREATING SEXUAL
OFFENDERS IN THE PROGRAM
Treated
Per year
Actual Failures
per year
60
2
Expected failures
Reduction in
per year
number of victims
per year
10
Cost per re-offender
$ 200,000
Cost to treat 60 sexual offenders for a year
$205,000
8
Overall Program
(Financial) Impact
Savings per year
Savings (8 x $200,000)
Less costs
TOTAL SAVINGS
$1,600,000
$ 205,000
$1,395,000
COSA (N=47)
Control (N=47)
Sexual Recidivism
2.13 % (1)
12.77% (6)
Violent Recidivism
8.51 % (4)
31.91 % (15)
General Recidivism
10.64 % (5)
38.30 % (18)
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Here is what the SBC does now
1.
2.
3.
4.
We see anyone, from anywhere, without delay.
We do complete assessments.
We start treatment immediately.
We insist harm to children stops immediately (we
do not “taper”).
5. We lead by example.
•
•
•
•
•
•
•
•
We lead by example.
We are lawful.
We are honest.
We are respectful.
We do not work alone.
We deliver what we promise.
We are optimistic and insist on success.
We do not do anything without consent.
We admit we can be wrong and fix mistakes.
Good cop- Bad Cop
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So that’s it?
!
A single victim is at least two too many.
A single offense affects:
The victim
The victim’s family
The offender’s family
The community
With the right treatment things
changed…
Do you like kids too much?
Police line-up
24
J. Paul Fedoroff, M.D.
Director, Sexual Behaviours Clinic
Paul.Fedoroff@rohcg.on.ca
613-722-6521
Thank You/Merci
HelpNow@me.com
Mental health and well-being for all • La santé mentale et le mieux-être pour chacun
Questions/Comments