Can child sex offenders be cured?


WHILE many would not hesitate to throw away the keys to the jail cell of Mara student Nur Fitri Azmeer Nordin who was caught with 30,000 explicit and pornographic images of children, there are a few psychologists and sexual health experts who say he might have a mental health condition that needs to be treated.

As consultant clinical andrologist and sexual health and reproductive activist Dr Mohd Ismail Mohd Tambi puts it, "Although we need to protect our children from scourges like this, if he is really diagnosed as a child pornography enthusiast or addict, which is a mental health condition, then he needs treatment too."

Explains Dr Mohd Ismail, "Paedophilia is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children, generally age 11 years or younger.

"It is termed as a disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the manual defines it as a paraphilia in which adults or adolescents 16 years of age or older have intense and recurrent sexual urges towards and fantasies about prepubescent children that they have either acted on or which cause them distress or interpersonal difficulty."

Although he does not condone the acts of "looking at children's naked genitals, and worse still, added with other elements like abuse, torture and children performing sexual acts," he concedes that Nur Fitri's condition needs to be considered too.

"The issue here is also that of a bright student indulging in child pornography. There is no second party involvement, just he, his laptop computer or a smartphone, in his closed enclosure.

"Probably one in two adults like him has indulged in pornography, considering that it is easily available on the internet and I am sure there are a few who expanded their pornography horizon by indulging in child pornography."

Dr Ismail stresses that the authorities need to do more to weed out and block sites that promote and contain child sexual abuse images. "In fact, all forms of pornography need to be blocked because some of them contain child pornography."

He stresses, the police also have to closely monitor known sex offenders by keeping a registry of their names and whereabouts to ensure that they behave and keep in touch with their rehabilitation counsellors.

According to criminologist and psychologist at Universiti Sains Malaysia Dr Geshina Ayu Mat Saat, a complete assesment needs to be done by a qualified professional to determine if Nur Fitri is a paedophile.

"There are two main elements with regards to the paedophile's psychological state: obsession and urge (or compulsion). From these, the characteristics widen to include victim's gender, type of deviant sexual fantasies, victim preference, triggers, cognitive distortion, risk factors, protective factors, and belief system; to name a few."

She says, if Nur Fitri is deported, he can be assessed at our Prison Department which has trained personnel who can conduct a holistic assessment and make referral to the appropriate mental health professional if the need arises.

"Following assessment and diagnosis, the next step is formulating an individualised rehabilitation programme. This is also already in place at our prison department. The programme must at least address deviant sexual fantasies, cognitive distortions, risk and protective factors."

Recommending the programme at Malaysia's prison department for its proven track record, Dr Geshina says, "Rehabilitation can be done in prisons or mental institutions away from distractions that may slow down the rehabilitation programme and reduce its success."

Prior to release or programme completion, the patient or prisoner must go through a recidivism risk appraisal to determine the likelihood of him returning to his obsession. The appraisal includes the use of psychometrics, professional observations and judgements, and an electroencephalogram (EEG) test. Scores are then validated and used to justify whether the individual has been sufficiently rehabilitated and is safe to rejoin society.

"The process is lengthy and slow. And it should be, as incorrect or incomplete rehabilitation poses the very real danger of obsession relapse and crime victimisation."