All practitioners who deal with sexual offenders need to possess one essential quality: patience; that is undeniable. Hence the title of this article, which refers to the considerable amount of time and patience that are required of us in order to manage to provide appropriate services to sexual offenders.
Major costs
According to the National Clearing House on Family Violence, a number of health problems can at times lead to sexual violence perpetrated against children. In addition, a Canadian study suggests that 44% of the expenditures associated with the treatment of eating disorders and 50% of those linked to alcoholism are attributable to sexual violence against children.
It is estimated that, in Canada, the costs resulting from the sexual abuse of children are in excess of 3.6 billion dollars. The real costs are likely higher still because of the secrecy that shrouds this problem and because, in many cases, children are reliant on their abusers.
It is estimated that the overall health costs associated with the sexual abuse of children amount to $1,718,643,751 —, an amount that could very well increase by more than $900,000 if one factors in the costs of social and other public services. Some $47,557,090 per year are invested in treatment programs for sexual abusers of children.
The past ten years have been devoted to documenting the issues pertaining to sexual assault and to highlighting the shortcomings of the system. However, few concrete measures have been implemented to improve services for sexual offenders.
In 1996, the Correctional Service of Canada (1) estimated the average length of stay in a federal penitentiary for sexual offenders was a little more than four years, at a cost to the State of some $50,000 per year. If one factors in other costs (2) (court and legal costs, costs relating to victim compensation and hospitalization), the stated cost of incarceration can easily rise by another $25,000. On the other hand, the cost of treatment for a sexual offender is approximately $7,400 per year. Hence, even if treatment was effective for a small minority of offenders and even if its impact was of short duration, it would nonetheless minimize the financial burden borne by society. Finally, any reasonable person will acknowledge the extremely damaging impact of sexual offences on victims. While it may be very difficult to assess a person’s emotional distress objectively, the long-term harmful consequences of sexual assault on victims are undeniable (3). Marshall and Pithers (1994) have aptly noted that (4):
“ … we have a moral obligation to offer treatment to as many clients as possible, given the disastrous consequences to innocent women and children of reoffending. Because sex offenders who reoffend typically do so against more than one victim, effectively treating just one avoids considerable human suffering.” (p.23).
Achievements in the area of treatment
The Quebec government has tried to contribute to the advancement of treatment for sexual offenders in recent years through the setting up of task forces, as well as the development of policy guidelines pertaining to sexual assault. The results of these initiatives have been very disappointing. Following is a brief review of what has been achieved over the past decade.
In December 1993, the ministère de la Santé et des Services sociaux (Department of Health and Social Services) of the time created a task force on sexual offences. This task force was charged with pondering the issue of sexual offences with a view to ensuring greater coherence relative to the choices, actions, organizational structure and coordination of services available for sexual offences. This task force tabled its report in May 1995. It called for Quebec to develop policy guidelines relative to treatment and recommended the establishment of a steering committee. The recommendations contained in the report were endorsed by the five departments concerned with this issue (Health and Social Services, Justice, Public Security, Education, Status of Women), all of which committed to doing all they could do to address the stated needs.
In February 1996, in response to pressure from a number of practitioners involved in treating sexual offenders, the Regroupement des intervenants en matière d’agression sexuelle (RIMAS) was established. It emerged spontaneously, with no funding from the State or the private sector. This coalition is a not-for-profit community-based organization; it is managed by an elected board of directors. The board is made up of seven practitioners originating from different sectors having a stake in this issue—hospitals, universities, private sector, youth services and community services, federal and provincial corrections—, as well as an executive director.
An innovative approach
The RIMAS is an innovative concept and one that holds a great deal of promise for the improvement of the treatment of sexual offenders. It emerged as a result of observations on the part of practitioners involved in the treatment and monitoring of sexual offenders on a daily basis.
They first noted that there existed within various regions of Quebec a lack of resources able to deal with sexual offenders. In addition, they deplored the absence of a national vision pertaining to the implementation of adequate resources throughout the province. They also pointed to the absence of evaluation mechanisms to assess the impact of existing programs, which would facilitate a clearer determination of which practices are effective. Finally, these practitioners called for the development of national standards and a continuing education scheme for those who were already involved in the delivery of treatment programs. Hence, the RIMAS was established in response to the needs identified by the task force and practitioners in the field. Part of its mandate includes providing a forum for practitioners dealing with sexual offenders, as well as ongoing training opportunities with a view to ensuring that skills and knowledge remain up to date in a field that is constantly evolving.
The RIMAS is also involved in developing general guidelines pertaining to the quality of evaluation and treatment applicable to sexual offenders, in providing advice on policy issues having to do with sexual offenders, and in fostering an integrated and collaborative vision of case management for sexual offenders. Finally, another important element of the RIMAS’ mandate is to work toward the recognition and affirmation of the importance of treatment for sexual offenders.
Few concrete measures
In December 1995, shortly after the RIMAS was established, the Quebec government tasked an inter-ministerial committee responsible for coordination in the areas of spousal and domestic violence with ensuring the follow-up of the recommendations of the report entitled Les agressions sexuelles: Stop [Sexual Assault: Stop]. The ministère de la Santé et des Services sociaux thereby committed itself to coordinating the development of government directions in the area of sexual assault. An advisory committee was struck with a view to highlighting the importance of this problem and reducing its impact on victims, as well as on the general public. Guidelines were tabled in March 2001. The report set out a number of directions for assistance to victims, as well as for the treatment of sexual offenders, but no funding was made available for treatment programs.
In February 2002, Pierre Michaud, Deputy Minister (Health and Social Services) called upon Jocelyn Aubut, President, and the Executive Director of the Regroupement des intervenants en matière d’agression sexuelle (RIMAS) to set up a committee of experts and managers to review the organizational structure of services available to sexual offenders in Quebec.
The committee was tasked with producing an inventory of existing treatment resources within each region of the province, including prevailing practices. It was also tasked with clearly identifying how services could be streamlined between institutions in order to contribute to the achievement of the desired outcomes. Part of its terms of reference required the committee to set forth a proposed organizational structure for the treatment of sexual offenders, including the development of a case management model, the strengthening of community controls and the enhancement of services for adult and young sexual offenders alike. Finally, the committee also looked at means of adapting services to aboriginal realities.
The resulting document was produced collaboratively by experts having a stake in the treatment of sexual offenders and was presented to Renée Lamontagne, Deputy Minister (Health and Social Services) in January 2003. No position has yet been expressed relative to the document. The redrafting process has been completed and the report has been gathering dust ever since; the authors of the original document have not been given the opportunity of reviewing the revised document nor to assess the recommendations that were retained.
Hence, the past ten years have been devoted to documenting the issues pertaining to sexual assault and to highlighting the shortcomings of the system with regards to the provision of adequate treatment for sexual offenders within all regions of Quebec. Few concrete measures have been implemented to improve services for sexual offenders.
Yes, services do exist within certain regions and for this we are indebted to the patience and perseverance of practitioners concerned with protecting society; I salute them for what they are doing for us all and urge them to continue believing in their organizations: therein lies the key to our success!
(1) Blanchette, K. (1996). Sex Offender Assessment, Treatment and Recidivism : A Literature Review, Ottawa : Correctional Service of Canada.
(2) Williams, S. M. (1996b). A National Strategy for Managing Sex Offenders. FORUM on Corrections Research, 8(2), 33-35.
(3) West, D. J. (1991). The Effects of Sex Offences. In : Clive R. Hollin & Kevin Howells (Eds.), Clinical Approaches to Sex Offenders and their Victims. Wiley Series in Clinical Approaches to Criminal Behaviour (pp. 55-74). Chinchester, England : John Wiley & Sons.
(4) Marshall, W. L. & Pithers, W. D. (1994). A reconsideration of treatment outcome with sex offenders. Criminal Justice and Behavior, 21 (1), 10-27.
