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Forensic services and people with learning disability: in the shadow of the Reed Report

Learning disability is a colloquial and political rather than diagnostic term, accepted by user groups. Formerly known as mental handicap, it is now subsumed under the rubric of mental retardation in the two internationally recognized systems of mental disorder, those of The International Classication of Diseases, 10th edn (World Health Organization, 1992) and the Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM IV) (American Psychiatric Association, 1994). In the latter the criteria for mental retardation are threefold: (1) signicant sub-average intellectual functioning, resulting in or associated with (2) de cits in adaptive behaviour and (3) onset before the age of 18 years. ‘Sub-average’ is dened as having an intelligence quotient (IQ) of below 70 on standardized individual tests. Further subdivisions are made: mild mental retardation refers to those with IQs of 50 to 69; moderate to those with IQs of 35 to 49; severe to those with IQs of 20 to 34; and profound to those with IQs below 20. Stereotypes still exist about people with learning disability. One is that of the good-natured fool, the other that of the moral defective (for example, the child-molesting deviant). There is also, even now, a belief that people with learning disability live in institutional care. None of these is accurate as people with learning disability vary as much in their personal characteristics as does the rest of the population; however, the persistence of these outmoded The Journal of Forensic Psychiatry Vol 12 No 1 April 2001 8–12