Paedophilia- A Mental Illness that Can be Treated?

Should more be done to counsel paedophiles who seek treatment for their “addictions?”

In 2011 one of New South Wales’s worst paedophiles, Andrew Dean McIntosh, was sentenced to 32 years for 20 charges of sexual assault, buggery and indecent assault over the course of nearly 20 years for the sadistic rapes and assaults on teenage boys including “five charges of indecently assaulting a nine-year-old boy in Grafton between 1985 and 1986.”

In 1988 McIntosh was sentenced to a minimum of two years jail, only to resume preying on children almost immediately after his release on parole. One of his victims was 15-year-old Sydney boy Sascha Chandler, who was sexually and physically abused during 1991 and 1992. McIntosh was convicted in 2010 of 24 offences against the boy including multiple counts of rape and assault.

In 2008 former NSW minister Milton Orkopoulos was jailed for “almost 14 years for offences including homosexual assaults on a minor and assaults on two underage boys.

In an attempt to better protect children in the community, the NSW parliament announced tough new sentencing laws last May under The Crimes Legislation Amendment (Child Sex Offences) Bill 2015 for child sex offenders. Changes include: “increasing the maximum sentence for sexual intercourse with a child under 10, from 25 years to life imprisonment,” as well as “additional child sex offences, such as assault with intent to have sexual intercourse with a child under 10, have also been included in the Standard Non-Parole Period scheme.”

Are tougher criminal justice policies really what is going to keep our children safe from sexual predators like McIntosh and Orkopoulos?

The answer some say is no because it is believed that the underlying cause of the sexual assault on children is not the same in all cases. A paper by the Australian Institute of Criminology points out that “child sex offenders are a heterogeneous group with varying offender profiles. There are paedophiles and there are opportunistic child sex offenders like Brett Peter Cowan.

Cowan first started stalking children when he was nine years old at the local swimming pool and claimed to have assaulted “maybe 30” children, according to the Gold Coast Bulletin. As he confessed during an undercover sting operation Cowan “didn’t go . . . to molest a kid.” He said he was “an opportunistic offender.” Child sexual predators like Cowan are more motivated by aggression and dominance rather than sexual paraphilia.

Paedophilia – a mental health disorder
Paedophilia on the other hand according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition is a disorder that results in the acting out on the “intense and recurrent sexual interest in prepubescent children.”

A person who is diagnosed with pedophilia “must be at least 16 years old, or if an adolescent must be at least five years older than the prepubescent child.” Pedophilia is recognized by the DSM-5 as a psychiatric disorder and considered an abnormal sexual orientation that a person is born with and cannot change. If society is willing to accept that them we can come up with ways to support them while preventing the molestation of children.

Even though paedophilia is recognised as a mental health issue, society still demonises it. Therefore most people who have a sexual attraction to children never seek treatment because many jurisdictions have laws requiring psychologists and other health care providers to report a suspected paedophile to police. Once reported that person could face legal and social consequences such as losing his or her job or being disowned by family, instead of getting the help that he or she needs.

Some feel that the preconceptions and misconceptions that society has when it comes to paedophiles need to change. They say pedophilia or the sexual interest in children should not be confused with child molestation because not all people with paedophilia molest children. In fact studies show that the majority of paedophiles know it is wrong to molest children and as a result try to avoid acting on their sexual desires.

What are the current treatment options for child sex offenders and paedophiles?

There is no known cure for paedaphilia. Treatment focuses on preventing the paedophile from acting out on his or her desires.

The Relapse Prevention Model
Traditional treatments for paedophiles have been largely based on addiction treatments such as Relapse Prevention (RP). According to Marlatt and Gordon, the RP model provides for specific intervention techniques such as: “identifying specific high-risk situations and enhancing the client’s skills for coping with those situations, increasing the client’s self-efficacy, balancing the client’s lifestyle, as well as stimulus control and urge management,” in order to avoid relapse.

Chemical Castration
Chemical castration like anti-antrogens are pharmacological interventions that stop the production of sex hormones to lower sex drive and reduce sexual arousal. New South Wales courts can mandate the use of chemical castration for “dangerous sex offenders” on release from prison.

One problem with medical treatment options like chemical castration is that they focus on the idea that child sexual abuse is mostly perpetrated by paedophiles. However, as the article in The Conversation points out, “up to 90% of sexual abusers of children are known to the victim. If we say all child sex abusers as recidivist paedophiles we risk further “distorting public discourse around child sexual abuse.”

Chemical castration helps lower rates of recidivism and significantly reduces the sexual desire in men who are attracted to children. According to a report by Harvard, treatment is effective only if a patient with paedophilia wants to change his behaviour. However, according to The Conversation not only has its efficacy been overstated, forcing people to take this medication breaches their human rights and subjects them to unwanted side effects like developing breasts and decreased bone density. It also forces child sex offenders to give up their rights in exchange for freedom.

But WA attorney-general John Quigley, Cordingley quotes, says “the fact that six offenders voluntarily subjected to this treatment prior to their release overwhelmingly proves the effectiveness of this alternative.”

The Child Protection Register
In October 2001 a public “Child Protection Registry” was established under the Child Protection (Offenders Registration) Act 2000. Under the act, people convicted of a “nominated” violent or sexual offence against a child are required to register at their local police station within 28 days of either being sentenced, released from custody or upon entering NSW after being found guilty of a registrable offence in another jurisdiction.

According to the NSW Sex Crimes Squad, registrable persons must provide police with personal information like travel plans and living arrangements. The period of registration is for a minimum of eight years for an adult and four years for a juvenile offender. It is an offence not to register or to provide police with false information.

The register is kept a closely guarded secret because authorities fear that public disclosure of community based sex offenders will only drive them underground and make it much harder for police to monitor them.

The primary goal of the Child Protection Register is to reduce the number of offenders who commit new sex crimes. However, studies done by Letourneau at the Medical University of South Carolina according to an article by Jim Duffy in the spring 2012 edition of the Johns Hopkins Public Health Magazine, “showed no significant change” in recidivism rates “as the state adopted its registration law and then again as the online registry went public.” Her study actually showed that there were unintended consequences instead such as” prosecutors changing their approach to juvenile sex crimes like dismissing or diverting sex-crime charges once the registry was in place.
The other problem Letourneau points out is how the public registry effects the lives of ex-offenders. “It can be very difficult for known sex offenders to maintain stable living conditions and stable jobs while on these registries,” Letourneau says. “And when you don’t have stable living conditions and stable social connections, it makes it more difficult to re-integrate into society.”
Recidivism rates for child sex offenders
Many feel that punitive measures like Child Protection Registries, chemical castration and incarceration are the only things that will combat recidivism. However, according to research done by Fred Berlin MD., founder of the Johns Hopkins Sexual Disorders Clinic, “the recidivism rate for adult male offenders diagnosed with pedophilia, was less than 8 percent” and “among the paedophiles who were generally cooperative with terms of treatment and parole or probation, the rate was less than 3 percent.”

People who are pedophilic but who work to remain celibate their entire lives are being increasingly recognized as needing and deserving all the support society can give them. Both Letourneau and Berlin believe that prevention strategies must include both treatment for convicted offenders and outreach to potential offenders.

People who have been sexually abused as a children are at much greater risk of developing life-long major mental health disorders. James Cantor, Ph.D., an international expert on pedophilia believes “we can prevent a much greater number of victims if we put our energies into early detection and support before the first offense occurs, rather than relying only on stronger and stronger punitive measures after the fact.

As Duffy’s article highlights, we cannot base public policy on a few “monsters” profiled in the media. Paedophiles are our friends, neighbours and family members and as such deserve our help.

If you know of a child is at imminent risk of being harmed please phone the Child Protection Helpline on 132 111 or 000.