By Tony Butler and Lee Knight -
Could treating impulsivity in repeat violent offenders be part of the solution to violent crime in Australia?
Violence – including domestic violence – is a significant social problem in Australia. From 2012-14, about one woman a week and one man a month were killed as a result of violence from a current or previous partner (Bryant & Bricknell 2017). Violent crimes account for about 20 per cent of all recorded offences in NSW.
However, with few evidence-based, effective interventions available to tackle this problem, new approaches are needed.
ReINVEST is a world-first clinical trial to determine if treatment with a common antidepressant (sertraline) is effective in reducing offending behaviour in highly impulsive men with histories of violence.
Why this approach? The premise is based on a well-established association between impulsivity and offending behaviour. Impulsivity may be related to the naturally occurring brain neurotransmitter, serotonin, not functioning properly in the brain. So, regulating brain serotonin neurotransmission – as one driver of violent behaviour – may reduce impulsivity, aggression and anger, and give participants more time to think before they act.
A 2008 pilot study that preceded the REINVEST trial showed significant reductions in impulsivity, irritability, anger, and depression in men following administration of sertraline, and resulted in a team of researchers winning a grant from the National Health and Medical Research Centre (NH&MRC) to undertake the ReINVEST trial in NSW, commencing in 2014.
Anecdotal feedback suggests that, for some, the treatment is effective in reducing impulsive-aggressive behaviour and improving interactions with others – and providing the participant with greater insight into their potentially harmful behaviour.
One private lawyer reported to the ReINVEST team: “My client received a suspended sentence for nine months, reflecting the need for him to continue with the ReINVEST program. My client reports positive results from his participation including better impulse control and better management of his emotional responses. He is currently on a 50mg dosage and the court has expressed its desire for him to continue his participation in the program.”
Stakeholder engagement and the preliminary trial results have resulted in a high level of support for the ReINVEST approach; more specifically, Local Court Chief Magistrate Judge Graeme Henson has given support to the trial and has approved a court procedure for defendants to participate.
