Medical Management of Problematic Sexual Arousal for People with a Sexual Conviction in England and Wales: Progress and Challenges

• In Event: Evaluation research on correctional treatment for people convicted of sex offences

Abstract

Background: In England and Wales, the primary treatments for individuals convicted of sexual offences are psychological. However, the Medical Management of Sexual Arousal (MMSA) is gaining importance as an alternative. This article reviews the current evidence surrounding the MMSA approach.
Aim: This paper aims to assess the advancements and learnings accumulated over 14 years of the MMSA treatment pathway in England and Wales.
Methods: The research employed a mixed-methods approach, consisting of cohort studies involving men serving custodial sentences and referred to the MMSA service. It also included qualitative studies featuring the experiences of men undergoing MMSA treatment and insights from prison and probation staff managing these cases.
Results: Evaluations of treatment outcomes showed promising results regarding the effectiveness of the MMSA service. Qualitative analyses and case studies provided insightful details regarding patient and staff concerns that may hinder the efficiency and reach of the treatment pathway. Research with community clinicians highlighted issues regarding the ‘off-label’ use of medication for this purpose. A significant finding from the analysis of sexual compulsivity scores indicated that 37% of the target population may benefit from the MMSA service.
Conclusions: The MMSA treatment service is available in a limited number of prisons in England and Wales. Supported by promising service evaluations and existing literature, a larger population could benefit from MMSA treatment. Furthermore, the MMSA service necessitates enhancements to facilitate smoother transitions for individuals leaving prison and should ideally be expanded to ensure that those in community settings can access the MMSA service.

Authors

• Belinda Winder, Nottingham Trent University

• Michael Underwood, Nottingham Trent University

• Zoe Antoniadis, Nottingham Trent University

• Monica Carvalheiro, Nottingham Trent University

• Christine Norman, Nottingham Trent University

• Don Grubin, Newcastle University

• Adarsh Kaul, Nottinghamshire Healthcare NHS Trust