Characteristics of low IQ arsonists at psychiatric assessment

The Subjective Experiences of Firesetting by Men With Mild Intellectual Disabilities Detained in a Secure Hospital

This article explores the lived experiences of men with mild intellectual disabilities who have deliberately set a fire and are detained in a secure hospital. Semi-structured interviews were used to explore the subjective experiential claims of seven male firesetters with mild intellectual disabilities residing in a forensic intellectual disability hospital. Interpretative Phenomenological Analysis was used to interpret participants' meaning making of their firesetting. Five super-ordinate themes emerged from the analysis: (a) "the importance of the first fire," (b) "firesetting to escape distress," (c) "firesetting to enable positive emotional experiences," (d) "firesetting to communicate with services," and (e) "Fire Setters Treatment Programme." The analysis provides an understanding of why some firesetting behaviours emerge and highlights factors that contribute to the maintenance and desistence of repeat firesetting acts. The findings are considered in relation to evolving risk assessment measures and risk reduction strategies for facilitating rehabilitation into community settings.

Developing an assessment of fire-setting to guide treatment in secure settings: the St Andrew's Fire and Arson Risk Instrument (SAFARI)

BACKGROUND

Arson and fire-setting are highly prevalent among patients in secure psychiatric settings but there is an absence of valid and reliable assessment instruments and no evidence of a significant approach to intervention.

AIMS

To develop a semi-structured interview assessment specifically for fire-setting to augment structured assessments of risk and need.

METHOD

The extant literature was used to frame interview questions relating to the antecedents, behaviour and consequences necessary to formulate a functional analysis. Questions also covered readiness to change, fire-setting self-efficacy, the probability of future fire-setting, barriers to change, and understanding of fire-setting behaviour. The assessment concludes with indications for assessment and a treatment action plan. The inventory was piloted with a sample of women in secure care and was assessed for comprehensibility, reliability and validity.

RESULTS

Staff rated the St Andrews Fire and Risk Instrument (SAFARI) as acceptable to patients and easy to administer. SAFARI was found to be comprehensible by over 95% of the general population, to have good acceptance, high internal reliability, substantial test-retest reliability and validity.

CONCLUSIONS

SAFARI helps to provide a clear explanation of fire-setting in terms of the complex interplay of antecedents and consequences and facilitates the design of an individually tailored treatment programme in sympathy with a cognitive-behavioural approach. Further studies are needed to verify the reliability and validity of SAFARI with male populations and across settings.