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Lookup NU author(s): Emeritus Professor Don Grubin
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 The Author(s). Criminal Behaviour and Mental Health published by John Wiley & Sons Ltd. Background: In England and Wales, the primary treatments for individuals convicted of sexual offences are psychological. However, medication to manage problematic sexual arousal (MMPSA) is gaining importance as an alternative. This article reviews the current evidence surrounding the MMPSA approach. Aim: This paper synthesises challenges encountered, advancements achieved and learnings accumulated over 16 years of the MMPSA treatment pathway from 2009 to 2025 in England and Wales. Methods: Drawing on a programme of mixed-methods research, including cohort studies, case studies, qualitative interviews with patients and professionals and implementation evaluations, this paper seeks to bring together key findings to present a consolidated picture of the research on the MMPSA pathway to date. The focus is on synthesising findings and identifying implications for service delivery. Results: Evaluations of treatment outcomes showed promising results regarding the effectiveness of the MMPSA 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. Conclusions: The MMPSA 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 MMPSA treatment. Furthermore, the MMPSA service would benefit from improvements to create smoother transitions for individuals leaving prison and entering the community, and it should ideally be expanded to ensure that those in the community can also access the MMPSA service.
Author(s): Winder B, Grubin D, Underwood M, Antoniadis Z, Carvalheiro M, Marshall E, Norman C, Bourne R, Kaul A
Publication type: Article
Publication status: Published
Journal: Criminal Behaviour and Mental Health
Year: 2026
Pages: Epub ahead of print
Online publication date: 21/03/2026
Acceptance date: 09/03/2026
Date deposited: 07/04/2026
ISSN (print): 0957-9664
ISSN (electronic): 1471-2857
Publisher: John Wiley and Sons Ltd
URL: https://doi.org/10.1002/cbm.70030
DOI: 10.1002/cbm.70030
Data Access Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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