Intellectual and developmental disabilities and Ontario’s forensic inpatient system: a population-based cohort study

Individuals with intellectual and developmental disabilities (IDD) in forensic inpatient beds are both complex and understudied. Previous studies have been limited and largely based on smaller clinical samples. We used data from a population-based cohort of Ontario adults with IDD (H-CARDD cohort, n?=?66,000) to describe their prevalence in forensic inpatient beds during 2005–2015 and compare their demographic and clinical profiles with non-IDD forensic patients. Results show that forensic patients with IDD and without IDD have similar profiles, with the exception that patients with IDD are more likely to have a psychiatric disorder and to be younger, rural, and have high or very high morbidity. Strong support was found for disproportionate admission: individuals with IDD are 12.2% of forensic inpatients but only 0.8% of the general population (d?=?1.57). Support for disproportionate utilization was less dramatic and mixed. Little difference was found in terms of the per cent of longer-stay (treatment) admissions or multiple forensic admissions; however, patients with IDD did have longer number of bed days over 10 years (averaging 220.6 days more, d?=?0.28). A better understanding of the barriers to discharge for individuals with IDD will support implementation of appropriate pathways out of the hospital.     

从《残疾人权利公约》反思国际人权机制

2007年3月起开放签字的《残疾人权利公约》是联合国体系在保护人权领域的最新努力。与以往的多数人权条约一样,《残疾人权利公约》列举了具体权利、构划了报告体制,同时通过任择议定书设计建立一套来文制度。这意味着在国际人权法上又添加了一套体制。虽然从权利保护发展本身看,这一公约的出现丰富了联合国体系的人权保护内容,但是从国际法治的理念上看,它是国际法不成体系的特征的继续与延伸,本质上不仅无益于国际法治的完善,而且有可能进一步提高国际法维护人权各个环节的成本。现阶段有必要考虑将包括人权、环境等领域的规范进行编纂,将相应机构进行整合,以推进国际法治的目标。