Setting the scene
Case Vignette 1
Dr Swaraj Alkanti
ST5 Psychiatry of Intellectual Disabilities
The State Hospital
Mr Smith
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34 year old man
Borderline learning disability with an IQ of 71
(verbal IQ - 65, performance IQ - 82)
? Asperger’s Syndrome
Index Offence - 1995 – Raped a 15 year old
girl – Displays very little remorse
Made subject to a CORO and admitted to
TSH
Background
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Past psychiatric history
Past medical history
Family history
Early childhood
Relationships
Employment
Drug and alcohol history
Forensic history
Discharge from TSH
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Discharged to local low secure unit in 2004
He was transferred to an open ward within
the same hospital in June 2006
Early 2007 - Unescorted 15 min time out in
the hospital grounds
Social networking
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Allowed access to mobile phone
ISB group – Met Y – introduced Mr Smith to wider
group
Towards the end of 2008, staff became
aware/suspicious of inappropriate use of mobile
phone
Access to the mobile phone reduced for an hour a
day – Y offered him a spare handset
Mid 2009 - Y bought a brand new phone with
camera and internet for Mr Smith
Influence of technology
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Full access to the internet and various social
networking sites like Bebo, Guys & Bi’s etc
Feb’ 2010 – grounds access was suspended
Described feelings of “anger and hatred
towards everyone” and that he “just felt like I
had to do something to get my freedom back”
Thoughts about escaping from the hospital
Escape plan
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Y managed to bring in a screwdriver secretly
and left it in the toilet for Mr Smith
April 2010 – Staff found many of the
prohibited items in his possession
But not the screwdriver and the new mobile
phone which he hid amongst his clothes in
the drawer
Made up his mind to escape that very night
Subverting security
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Escaped through his window by removing the restrictor bar,
which was held in place by only 2 screws
Planned to travel on a bicycle, using the “back roads” and
eventually cross the border to England
Planned to visit/establish relationship with a male in England he
had “met” through a website
Believed that the CORO would no longer apply once out of
Scotland
Discovered to be missing by the staff, the following morning at
the breakfast time.
He was located and apprehended by the Police the same day
and returned to the ward
Readmission to TSH
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He was readmitted to TSH (in absence of Scottish
med secure facility) in view of:
- His past forensic history
- The serious nature of the incident involving
subverting security
- His associations with (at least) two other known
sex offenders and
- His confession to making detailed plans over a
number of months to effect an escape
Thank you