Note from Lisa: Tina originally posted this article on her blog here.
Recently there has been much debate over the civil commitment of sex offenders who are still deemed dangerous, but have served out their sentences. Instead of releasing these dangerous criminals back into society, many states have chosen to use civil commitment for the mentally ill as a way to keep some of these convicted sex offenders from re-entering the community.
While I am all for the idea of confining violent sex offenders for as long as possible- or even permanently, I am NOT one who believes that it is desirable or appropriate to confine these individuals in state psychiatric facilities. There are numerous reasons for my opinion on this matter.
First, let’s get cost out of the way. It is not my main consideration, but it will be for many people: In some areas of the country it can cost the state (taxpayers) as much as $250,000 per patient per year for treatment in a state psychiatric hospital . It costs about one tenth of that- $25,000 to $30,000 per year for the housing of a criminal in a prison.
That being said, there are sex offender treatment programs in prisons which are often required to be completed before the offender qualifies for parole. That may be the only way a sex offender will undergo treatment in many cases. Psychiatric patients in New York State- involuntary or otherwise- have the right to refuse treatment except under “emergency” circumstances, or in cases where medication compliance is coerced through a court order. They cannot be forced to actively engage in psychotherapy even if they are expected and ordered to attend therapy sessions. Sex offenders often refuse therapy, and do not require medications for mental illness unless they are mentally ill. So, $250,000 per year just to warehouse a violent criminal is not justifiable, especially when those financial resources are being taken away from programs to treat and rehabilitate those who suffer from legitimate mental illnesses.
I will not say that sex offenders are “normal”, but many are not mentally ill either. Socially deviant behaviors of all kinds are committed everyday by people who do not suffer from mental illness. Conversely, the majority of people with mental illness do not commit violent crimes. More often, the mentally ill are the victims of violent crime .
Which brings me to my next point: People with mental illness who are hospitalized in long-term facilities such as state psychiatric hospitals are often the sickest and most poorly functioning patients in the mental health system. They are in the hospital , because they cannot care for themselves due to their illness. Most patients are hospitalized not to prevent them from intentionally hurting other people, but rather to prevent them from harming themselves and others due to a lack of insight and ability to make good judgments about their behavior. They often lack the ability to make safe choices for their own health and safety. There are usually serious and persistent mental illnesses of a psychotic nature that are causing such impairments. This is not necessarily the case with violent sex offenders.
It would be a crime to place criminals in the same hospitals with this already at-risk group of people. I have personally witnessed the devastating effects this can have on the lives of patients who end up in a locked psych unit with those who belong in jail or prison- or better yet- a forensic psychiatric facility.
There are never enough staff to care for the sick patients and the patients who may or may not be sick, but are definitely criminals. These psych units are locked, but rarely secure on the inside. Despite staff monitoring and cameras placed in certain areas, incidents do occur- including violent fighting and sexual assaults against both patients as well as hospital staff.
I think some people imagine that all patients are locked into rooms and attended to like inmates in prisons. It does not work that way. The typical psych unit is open for patients to roam around and interact with each other as well as staff. Often you have male and female patients exhibiting all types and levels of severity of mental illness- ranging from a depressed 18 year old girl to a floridly psychotic 60 year old man- and everything in between, all in one place in contact with each other.
I have never been in a state psychiatric hospital. All of my hospitalizations have been on acute psychiatric units of general hospitals. But I have been witness to what happens when criminals, mentally ill or otherwise, are placed among other patients .
I have known two different individuals on two separate occasions, one female and one male, who were raped in a hospital by other “patients” who should’ve been in jail or in a forensic psych facility. These two people were not even allowed to call the police and report it. Staff covered it up. On yet another occasion , I saw one man violently beaten and bleeding after being attacked by a young man who should’ve been in a forensic psych facility. He too was not allowed to make a police report. The young man who attacked him was sent to his room- his open and unlocked room. Both of the rapists, as well as the young man who violently assaulted an older man, had previous criminal histories.
These units are NOT safe when criminals- sick or otherwise- are introduced into the population. There are plenty of times when patients are able to harm and even kill themselves while in the hospital. Despite precautions, there is no way to “make sure” that anyone in a hospital does not harm themselves or anyone else. But in a prison, someone who intends to harm others can be stopped from doing so by locking them into a cell and having armed guards available when they come out of their cells. Even under those conditions, prison violence is rampant.
There are many people in hospitals for depression, suicide attempts, personality disorders, PTSD – all of which often occur together and along with major mental illnesses such as schizophrenia and bipolar disorder- that have been victims of abuse. They don’t need to be locked in with abusers. They are already too vulnerable.
A sex crime is not evidence of an illness just because the person who commits it has chosen to express their pain in a violent manner. While many who commit sexual offenses have been sexually abused, they make the choice to act out their rage against others. It is, however- still a crime. Most people who endure sexual abuse do not commit sexual offenses. They often suffer PTSD, depression, anxiety, and take to abusing themselves or get involved in abusive relationships . These people may or may not seek treatment. They have the right to choose how to deal with their victimization, but no one has the right to harm another.” I was abused,” is never an excuse to commit abuse. Once the line is crossed and a crime has been committed, it is no longer a civil matter. It is a criminal matter to be dealt with through the justice system.
The prison system is overburdened with mentally ill offenders. A lot of these individuals would not be in the prison system in the first place if they had had access to appropriate mental health care in the first place. They did not get the treatment they needed to keep them well enough to make good judgments about their behavior. They are not getting the treatment that they need behind bars. Many of those same people will get released back into society someday.
It is a shame that those who are truly mentally ill often cannot get treatment to prevent them from engaging in harmful behavior, thus landing them in the criminal justice system. Now society wants to use psychiatric hospitals as a last ditch effort to provide social control of sex offenders who may not even legally qualify for civil commitment under mental hygiene law.
Rather than allocate as many funds as possible to prevention and treatment for mental illness, as well as for sex offender treatment programs, we are looking at dumping millions of tax dollars into a plan that will likely only perpetuate victimization and hinder real treatment.
As I said at the beginning, I am all for the idea of continued incarceration for violent sex offenders who have served their full sentences but are still deemed to be dangerous and in need of continued confinement. I’d like to see them all permanently confined. But there are laws in place to prevent abuses of civil commitment for everyone, and those should not be tampered with. If convicted sex offenders need extended incarceration, then there needs to be changes made in criminal law. There need to be special facilities on prison grounds where these offenders can be confined and treated under order of the legal system when they are deemed to still be a threat to society. And yes, this will be a lot of work.
The civil commitment of sex offenders after they’ve served their sentences is an abuse of civil commitment laws. These criminals will challenge the legality of commitment using our legal system, and tax payers will pay for that too. I believe many of these people will win and be released anyway. As a side note: If they are mentally ill now, because of their crimes, then they were at the time they committed their crimes, and I would think – not legally responsible in the first place- not criminals, but mentally ill. What might be the legal implications of this? That’s a dangerous can of worms that we may have already opened.
If we need to keep these people out of society, and I think we do- then we need to create appropriate laws for doing so, as well as appropriate facilities to house them. Instead, our justice system is doing what appears to be easiest and just dumping the trash of society in with the other throwaways- the mentally ill.
