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States Consider Sex Offender Commitment Laws
by W. Lawrence Fitch, J.D.

 In recent years, several states have enacted laws for the special psychiatric commitment of convicted sex offenders who are about to be released from confinement after having completed a jail or prison sentence. A 1990 Washington state statute has served as the template for legislation in many other states.
   The law is aimed, in the statutory language, at "a small but extremely dangerous group of sexually violent predators...who do not have a mental disease or defect that renders them appropriate for involuntary treatment" based on general involuntary civil commitment law. It provides for the indeterminate commitment of "any person who has been convicted of or charged with a sexually violent offense and who suffers from a mental abnormality or personality disorder which makes the person likely to engage in predatory acts of sexual violence."
   Today, seven states have laws similar to the Washington statute: Arizona, California, Illinois, Kansas, Minnesota, North Dakota and Wisconsin. All but one of these laws were enacted since 1994 and modeled on the Washington law. Minnesota's law, the exception, has been on the books since 1939. A number of other states are considering such legislation.

Historical Overview

In the United States, laws for the special commitment of sex offenders first appeared in the 1930's. Unlike the recent statutes, which provide for civil commitment after completion of a prison term, these early laws were designed to provide an alternative to imprisonment for persons found to be "mentally disordered sex offenders." The laws were grounded in the belief that "sex offenders were ill and psychiatrists could cure them."
   During the 1950's more than half of the states in the nation had special sex offender commitment laws. By the 1970's, however, the "optimism of earlier decades that psychiatry held the cure to sexual psychopathy no longer shone so brightly," and these laws began to fall out of favor. By the mid-1980's, all but a few states either had repealed their sex offender commitment laws or had halted new commitments under the laws.

Resurgence of Commitment Legislation

   Does the recent resurgence of sex offender commitment legislation reflect a new-found optimism about the efficacy of treatment? Not according to a report by the American Psychiatric Association's Task Force on Sexually Dangerous Offenders. Although the task force acknowledged that some sex offenders-those with a diagnosed paraphilic disorder-may be reasonable candidates for treatment, it questioned the notion that treatment is a primary purpose of the recent laws. If treatment were the aim, the APA task force observed, commitment would not be delayed until offenders have completed their sentences. Moreover, the laws' reach would be narrower, targeting offenders with diagnosable mental disorders. The real purpose of the statutes, the task force concluded, is "preventive detention of offenders who have completed their criminal sentences. The medical model of long-term civil commitment is used as a pretext for extended confinement that would otherwise be constitutionally impermissible."
   Cautioning that "sexual predator statutes distort the traditional meanings of civil commitment, misallocate psychiatric facilities and resources, and constitute an abuse of psychiatry," the task force recommended that punishment and incapacitation be addressed through sentencing alternatives within the criminal justice system, not through involuntary civil commitment laws that "exclude adequate diagnostic and treatment considerations."

Impact of Sentencing Reform

Recent support for the civil commitment of sex offenders, the APA task force noted, appears to be a by-product of sentencing reforms that have occurred throughout the country during the past decade, particularly the repeal in many states of indeterminate sentencing laws that prescribed lengthy prison terms for some crimes but also allowed for early release on parole. In their place, many states have enacted laws establishing fixed sentences with no possibility of parole. In these states, most offenders now serve somewhat longer terms than would have been the case under indeterminate sentencing, but some-high-risk offenders who in all likelihood would have been denied parole in the past-are released much sooner. "One obvious solution," according to the APA task force, would be to return to indeterminate sentencing.

Kansas v. Hendricks

Laws for the commitment of sex offenders have been controversial on legal as well as clinical grounds. Following a series of cases in which courts in different states expressed radically different views on the constitutional questions raised by these laws, the U. S. Supreme Court in 1997 agreed to hear the matter of Kansas v. Hendricks, a case involving Kansas' sexual offender commitment statute. The Kansas Supreme Court had struck down the statute on the ground that it violated due process rights. "The provisions of the act for treatment appear somewhat disingenuous," the state high court observed.
   The U. S. Supreme Court, however, took a different view. In a 5-to-4 decision delivered in June 1997, the Supreme Court overturned the Kansas high court ruling, declaring the law constitutional. Writing for the majority, Justice Clarence Thomas dismissed the notion that civil commitment requires a showing of mental illness, or any mental condition defined or officially recognized by the mental health professions. Moreover, he rejected the argument that treatability was a prerequisite for commitment. "Where accompanied by proper procedures," he wrote, "incapacitation may be a legitimate end of the civil law."
   In a separate, concurring opinion, Justice Anthony Kennedy agreed that the civil commitment of the offender in the case, Leroy Hendricks, was constitutional. However, he broke ranks with his colleagues in the majority by suggesting that meaningful treatment was, indeed, essential to the constitutionality of the Kansas law. "If the object or purpose of the Kansas law had been to provide treatment but the treatment provisions were adopted as a sham or mere pretext," he wrote, commitment would be unconstitutional. Expressing concern that the term "mental abnormality" may be "too imprecise a category" to serve as the basis for commitment, Justice Kennedy noted, "In this case, the mental abnormality-pedophilia-is at least described in the DSM-IV."
   Because Justice Kennedy's vote was the tie breaker, his opinion limits the scope of the Court's decision. The decision, he wrote, "concerns Hendricks alone," suggesting that the case should not be read as a blanket endorsement of the Kansas statute. If a case arises involving an offender for whom treatment were shown to be a "sham or mere pretext," it appears likely that Justice Kennedy's stand with the majority would change, tipping the balance of the Court. The message for states crafting sexual predator commitment legislation, or implementing laws already on the books, seems clear: to avoid constitutional uncertainty, civil commitment should be reserved for people with a legitimate mental disorder and should be for the real purpose of treatment.

State Mental Health Agency Concerns

   Since the Supreme Court rendered its decision in Kansas v. Hendricks, there has been renewed momentum for sex offender commitment legislation in many states, including Delaware, Georgia, Missouri, New Jersey, New York, Ohio, Pennsylvania, Tennessee and Virginia. Some states, however, appear to be reconsidering the issue in view of both its financial and clinical implications.
   According to a survey of state mental health agencies by the National Association of State Mental Health Program Directors (NASMHPD),6 the annual cost of providing inpatient services in state mental health agency (SMHA) forensic units ranges from $60,000 to more than $125,000 per person, compared with $25,000 to $35,000 per person for inpatient services in state corrections facilities. Anticipated operating costs for proposed SMHA commitment programs range from $1 million a year to operate a 12-bed unit in Indiana to $1.6 billion over five years in Illinois.
   State mental health officials and others in the mental health community caution that increased civil commitment of high-risk sex offenders could skew the entire mission of state mental health agencies and drain resources from services for persons with diagnosable mental illness.
   With these concerns in mind, NASMHPD issued a policy statement warning of the "significant risks" that sexual offender commitment legislation poses for public mental health systems and urging policymakers to address concerns about the "threat that criminally violent sex offenders may pose upon release from prison through sentencing or other alternatives within the criminal justice system." If commitment legislation is adopted, the policy statement urges, "every effort should be made to fund, administer and provide services outside the state mental health agency."
   In light of the U.S. Supreme Court's decision in Kansas v. Hendricks, it is inevitable that policymakers will be forced to consider whether involuntary civil commitment represents an appropriate response to the dangers sex offenders may pose when released from jail or prison. Both public safety and the integrity of the public mental health system demand a full exploration of the implications of all possible options.
   W. Lawrence Fitch, J.D., is Director of Forensic Services for the Maryland Mental Hygiene Administration. He is also an Adjunct Professor at the University of Maryland Schools of Law and Medicine and Secretary of the Executive Committee of the National Association of State Mental Health Program Directors' Forensic Division. Mr. Fitch is a recipient of the "Amicus Award" of the American Academy of Psychiatry and the Law in recognition of his scholarship and service in the field of mental health and the law.

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Date Last Modified: 5/7/01