Sexual assault in South Africa has reached alarming proportions. Mental illness amongst offenders accused of rape is one of the complicating factors.
To describe the sociodemographic, clinical and forensic profile of alleged offenders accused of rape referred to a South African tertiary public psychiatric hospital for forensic evaluation, as well as describe the profile of the reported victims.
Free State Psychiatric Complex (FSPC) Observation Ward, Bloemfontein, South Africa.
This cross-sectional retrospective study compiled a sociodemographic, clinical and forensic profile of offenders accused of rape referred to the FSPC for forensic assessment between 2011 and 2015. The study population comprised 159 alleged offenders. Sociodemographic data, mental status, clinical diagnoses, comorbid substance use and forensic outcomes were collected from clinical files.
All accused offenders were male with a median age of 30 years. About half obtained primary school level education. Unemployment was common (37.3%) with 40% receiving government grants. Most accused offenders were single (78.0%). Clinically, schizophrenia spectrum and other psychotic disorders were the most common diagnoses (30.8%), followed by intellectual disability (16.3%). Almost a third of the accused offenders did not suffer from any mental illness. Alcohol (20.1%) and cannabis use disorders (12.6%) were dominant comorbidities. After a 30-day evaluation period, 53.2% of alleged offenders were found competent to stand trial. The verdict of criminal responsibility was made for 43.7% of this sample.
This study contributes data on sociodemographics, psychiatric morbidities and comorbidities and forensic findings amongst alleged offenders of rape referred for forensic assessment.
The 2018 World Health Organization’s Burden of Disease report indicated that the lifetime prevalence of physical and sexual intimate partner violence and non-partner sexual violence amongst women aged 15 years and older was 30%.
Many studies on the link between mental health and sexual offences, including rape, have been conducted, both locally and globally, reporting various results. At a tertiary public psychiatric hospital in South Africa, Strydom et al.
There is a lacuna of literature regarding general sociodemographic, clinical and forensic characteristics of offenders of rape and sexual crimes in South Africa. Previous studies revealed that offenders of rape referred for forensic evaluation were predominantly single men with an average age of 30 years.
It is against this background that the researchers decided to study the sociodemographic, clinical and forensic profile of alleged offenders accused of rape (as defined by the
This was a cross-sectional retrospective study. The research was conducted at the Free State Psychiatric Complex (FSPC) Observation Ward, Bloemfontein, South Africa.
The study population comprised all alleged offenders accused of rape referred for forensic evaluation between 01 January 2011 and 31 December 2015. There is an estimated 4-month waiting period between court orders for a 30-day observation and the actual admission to the FSPC’s Observation Ward. The researchers employed the consecutive sampling method to include all available study subjects, thus ensuring a better representation of the target population and use of clinical information.
Researchers used the forensic examination register to identify alleged offenders of rape. All clinical records were retrieved from the clinical records cabinet and archives of FSPC. File numbers were recorded on data forms, and case study numbers were assigned for the purpose of recovering files, if necessary. Information on alleged offenders was captured on a data collection form, which included sociodemographic data, mental status, clinical diagnoses and comorbid substance use disorders, victim details and forensic referral sections (Sections 77, 78 and 79). The findings of the multi-professional team on these sections following a 30-day forensic assessment period were also recorded.
The researchers conducted a pilot study on the first 10 clinical records from 2011 in order to investigate the practical feasibility of this study. These clinical records were included in the main study, and the researchers effected the following change to the data collection form: an additional category ‘mental deficiency’, currently known as ‘intellectual disability’ in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition.
Quantitative descriptive data analysis was performed by the Department of Biostatistics, Faculty of Health Sciences, University of the Free State. The results were summarised by frequencies and percentages (categorical variables) and medians and ranges (numerical variables).
The protocol was approved by the Health Sciences Research Ethics Committee, University of the Free State, South Africa [HSREC-S 35/2016]. Written permission to conduct the study was obtained from the Free State Department of Health and the FSPC. As the clinical files were used, no informed consent was required in this study. The researchers handled all the information obtained from clinical files in a confidential manner.
The total number of alleged offenders accused of rape referred for forensic evaluation at FSPC between 01 January 2011 and 31 December 2015 was 159 (out of 674 observati). The sociodemographic characteristics of the alleged offenders of rape are displayed in
Sociodemographic characteristics of offenders accused of rape (
| Variable | % | |
|---|---|---|
| 10–19 | 21 | 13.2 |
| 20–29 | 52 | 32.7 |
| 30–39 | 46 | 28.9 |
| 40–49 | 24 | 15.1 |
| 50–59 | 12 | 7.6 |
| 60–69 | 3 | 1.9 |
| 70–79 | 1 | 0.6 |
| Male | 159 | 100.0 |
| Female | 0 | 0 |
| None | 16 | 10.1 |
| Primary | 75 | 47.2 |
| Secondary | 67 | 42.1 |
| Tertiary | 1 | 0.6 |
| Unemployed | 59 | 37.3 |
| Employed, informal sector | 29 | 18.4 |
| Employed, formal sector | 1 | 0.6 |
| Disability or pensioner | 63 | 39.9 |
| Scholar or student | 6 | 3.8 |
| Single | 124 | 78.0 |
| Divorced | 1 | 0.6 |
| Married | 6 | 3.8 |
| Widowed | 3 | 1.9 |
| Other | 25 | 15.7 |
All the study subjects were males aged 14–76 years with a median age of 30 years. Almost 75% of this sample was younger than 40 years of age. Just under 50% of these accused had obtained only a primary school level of education, whilst < 1% achieved a higher education qualification. Most of the accused were single. There was a notable unemployment rate amongst the offenders accused of rape, and more than 30% were on social welfare or disability grants. The clinical diagnoses are presented in
Clinical diagnoses amongst alleged rape offenders (
| Diagnosis | % | |
|---|---|---|
| No mental illness | 45 | 28.3 |
| Schizophrenia spectrum and other psychotic disorders | 49 | 30.8 |
| Bipolar mood disorder | 4 | 2.5 |
| Substance use disorder | 6 | 3.8 |
| Major neurocognitive disorder | 4 | 2.5 |
| Personality change due to general medical condition | 1 | 0.6 |
| Anti-social personality disorder | 2 | 1.3 |
| Borderline intellectual functioning | 14 | 8.8 |
| Intellectual disability | 26 | 16.3 |
| 8 | 5.0 | |
| No comorbidity | 39 | 24.5 |
| Alcohol use disorder | 32 | 20.1 |
| Cannabis use disorder | 20 | 12.6 |
| Inhalant use disorder | 3 | 1.9 |
| Other single substance use disorder | 4 | 2.5 |
| Multiple substance use disorders | 16 | 10.1 |
, This is applicable to 114 accused offenders, as comorbidity was only recorded if there was a primary clinical diagnosis.
A large portion of the offenders accused of rape were diagnosed with schizophrenia spectrum and other psychotic disorders (30.8%), followed by those who were diagnosed with intellectual disability (16.3%). Furthermore, some of the alleged offenders presented with comorbid clinical diagnoses. These diagnostic comorbidities were mainly current alcohol use disorder (20.1%) and cannabis use disorder (12.6%). It is important to note that some accused offenders had multiple substance use disorders (10.1%). The multi-professional team findings after a 30-day forensic assessment period are depicted in
Criminal responsibility and competency to stand trial (
| Variable | Competent to stand trial |
Not competent to stand trial |
Total |
|||
|---|---|---|---|---|---|---|
| % | % | % | ||||
| Criminally responsible | 63 | 39.9 | 6 | 3.8 | 69 | 43.7 |
| Criminally not responsible | 1 | 0.6 | 54 | 34.2 | 55 | 34.8 |
| Diminished criminal responsibility | 20 | 12.7 | 14 | 8.9 | 34 | 21.5 |
The majority of offenders accused of rape (88.2%) had only one victim, 5.7% had two, 3.8% three and 2.5% had four victims. Victims were mainly female (89.1%) and in the age groups 0–9 years (34.3%) and 10–19 years (32.2%), respectively. The perpetrator was mainly an acquaintance of the victim (47.3%) or a stranger (30.2%). The median age of victims of intellectually disabled offenders accused of rape was lower than the median age of victims violated by mentally ill or mentally healthy offenders accused of rape (9, 12 and 15.5 years, respectively). Intellectually disabled offenders accused of rape had the highest percentage of male victims (17.8%) compared to 7.7% of mentally ill and 10.7% of mentally healthy offenders accused of rape. The group of alleged offenders with intellectual disability also had the highest percentage of perpetrators who mostly violated acquaintances (56.8%).
The results of this study show that all the alleged offenders accused of rape were males. Valença et al.
As far as education is concerned, it was found that almost half (47.2%) of the alleged offenders only completed primary level education. This was followed by those who had received a secondary level education (42.1%). This finding is in contrast with what was noted in the United States of America, in which 81.4% of their study population had obtained secondary or higher levels of education.
This study revealed that 28.3% of the accused were not suffering from any mental disorders. This finding differs from a Brazilian report in which Valença et al.
Alcohol and cannabis were the most used substances amongst our study population as comorbidities. This is not surprising as South Africans were found to use cannabis the most in comparison to other illegal substances, as reported by a 2012 national population-based survey.
Regarding the constructs of competency to stand trial and criminal responsibility, it was found that 53.2% of the alleged offenders in our sample were fit to stand trial and 43.7% criminally responsible for their offences. Du Plessis et al.
A limitation of the study was that some files were incomplete with important data missing, or some documentation was not completed correctly. Documents such as the SAPS dockets, for example, were incomplete with regard to demographic information of alleged offenders of rape at the time of the crime, which resulted in only demographic information being available at the time of observation. Extended time periods from arrest to observation further contributed to the lack of accurate information at the time of committing rape offences.
In this study, only males were found to have committed rape. These male offenders had a median age of 30 years, with ages ranging from 14 to 76 years. Most accused offenders had lower levels of education, placing almost half of the study population at a primary school level. A noteworthy section of the study population was unemployed and received government grants for disability or pension. The majority of offenders accused of rape were single.
Regarding clinical characteristics, schizophrenia spectrum and other psychotic disorders were the most prevalent diagnosis, followed by intellectual disability. Almost a third of the offenders accused of rape did not suffer from any form of mental illness. In addition to primary clinical diagnoses, alcohol and cannabis use disorders were the two most dominant comorbidities reported.
In terms of competency to stand trial, the multi-professional team found more than half of the accused offenders of rape to be competent after a 30-day forensic evaluation period. Most of this study sample were declared criminally responsible. Nearly 40% of offenders were competent to stand trial and criminally responsible for their actions. A third of the accused offenders were found not competent to stand trial and not criminally responsible.
This study provides valuable information on the sociodemographic, clinical and forensic characteristics of offenders accused of rape in the Free State, South Africa. These findings concerning the profile of offenders accused of rape are echoed to a large extent by other local studies conducted at the same study site.
Although this study aims to contribute to international literature, it should be interpreted with care as far as generalisation of results is concerned as only offenders from the Free State, South Africa, were included in this study, consequently limiting the geographical area.
This study supports the link between low socio-economic status and limited education and the crime of rape. If criminal behaviour resulting in rape is to be reformed, it is suggested that prosocial sex behaviour programmes should be focused on at the primary school level in lower socio-economic sectors.
The authors thank Ms H. le Roux from the Free State Psychiatric Complex for assisting with editing of the references, Mrs A. du Preez from the Frik Scott Library, Faculty of Health Sciences, University of the Free State for assistance with literature searches, and Ms T. Mulder, medical editor and writer, Faculty of Health Sciences, University of the Free State for technical and editorial preparation of the manuscript.
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
L.v.Z. was the supervisor of this study, suggested the concept, assisted with the protocol development and interpretation of data and write-up of this study and article. N.L.M. was involved in the conceptualisation of this study in article format and assisted with the writing thereof. L.C., M.V., L.O., F.O. and S.K. wrote the protocol, performed the data collection, interpreted the results and did the initial write-up of this study. G.J. assisted with the planning, performed data analysis and assisted with the interpretation and write-up of the article.
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Due to the sensitive nature of this research and the institutional management of the study site not having agreed to have their data (obtained from confidential clinical records) shared publicly, supporting data is not available.
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any affiliated agency of the authors.