THIS ARTICLE IS PART OF A SERIES ON CIVIL COMMITMENT AND TREATMENT
For further reading:
- “Minnesota State’s Other Prison”: The Inside Story of the MSOP-Moose Lake Treatment Center: A discussion of the establishment and operations of one of America’s civil commitment centers
- True Lies: The harsh truth about polygraphs as a “treatment tool”: A critique of polygraphs, which have been used in MSOP and other programs
- Castration of Sex Offenders: “Off with their heads!”: a critique of the practice of chemical and surgical castration.
- Prevention 101: An overview of treatment for those convicted of sexual offenses
You may also wish to cisit the following sites maintained on behalf of civilly committed persons:
- https://thevoicesofocean.net/ — End MSOP, Minnesota
- http://chriskrych.blogspot.com/ — Chris Krych, Moose Lake MN
- https://coalingawhistleblowers.blogspot.com/ — Coalinga CA
Civil Commitmentand Extreme Treatment: A Very Uncivil Proposal
Derek W. Logue of OnceFallen.com
Published 17 May 2009 — Last Updated 18 March 2021
“There’s a little bit of confusion. What is this place? Is it a prison? Is it a mental health center? A residential treatment facility where people are clients? What is it? We ask that question sometimes too. We really don’t have a lot of guidance around what it is the state wants the facility to be, and we would encourage the state to look at that.” – Susan Keenan Nayda, VP of operations at Liberty Behavioral Health Corp., in a court deposition in Arcadia, FL (“A Record of Failure at Center for Sex Offenders.” Ocala StarBanner. 4 March 2007. https://www.ocala.com/story/news/2007/03/05/a-record-failure-at-center/31189454007/)
INTRODUCTION
Civil commitment is the practice of confining individuals considered a “significant risk to the community” for an indeterminate period of time. The practice has preceded public registries, practiced as far back as the 1930s. But the landmark decision of Kansas v. Hendricks in 1997 has made this practice “constitutional” when used properly. The Adam Walsh Act now demands every state pass civil commitment laws. But are these laws merely another tool to circumvent the constitution and detain these individuals beyond their original sentences? The evidence strongly suggests civil commitment laws have been used more for detention than for treatment.
BRIEF HISTORY OF THE CIVIL COMMITMENT LAWS
The modern concept of civil commitment arose from the “sexual psychopath laws” of the 1930s, which stressed rehabilitation of the individual they believed were more likely to offend than other convicted sex offenders. It can be argued the socioeconomic factors such as the Great Depression contributed to the rising popularity of the “sexual psychopath laws,” the laws were used largely to curb homosexual activity, which was seen as the source of many types of deviant behaviors. However, by the 1970s this policy fell out of favor for a variety of reasons, including doubts to effectiveness and the changing of emphasis on punishment rather than rehabilitation. By 1989, 13 states and DC had civil commitment laws, but most were no longer enforced. [1]
The 1990s saw the rise of the modern civil commitment laws with a lower standard of commitment [2]. A number of lawsuits followed, leading up to the landmark Supreme Court case Kansas v. Hendricks, 521 US 346 (1997). Like many rulings of SCOTUS in the past generation, this case was a 5-4 split based on political ideology, with the conservatives upholding the practice of civil commitment.
The Hendricks decision opened up a disturbing trend of lowering strict standards that existed in the past. The decision upheld the Kansas statute which allowed civil commitment for a lesser standard of “mental abnormality” or “personality disorder.” SCOTUS stated they never made a standard of proof for civil commitment, instead opting to allow legislatures the discretion to determine the standard for civil commitment and the legal definition of mental illness or similar definitions. Each state legislature can essentially adopt their own standards and burden of proof for civil commitment.
Seeing the punitive nature of these laws and criticizing the lack of the medical standard of mental illness, the National Association of State Mental Health Program Directors (NASMHPD) offered opposition to modern civil commitment practices for many reasons, including:
- Since the laws are strictly punitive, civil commitment undermines treatment
- Takes away resources from those who are truly mentally ill and need and desire treatment
- Endangers the safety of those in facilities who have treatable illnesses [3]
In Kansas v. Crane, 534 U.S. 407, (a 7-2 opinion delivered by Justice Stephen Breyer) the US Supreme Court held that Hendricks set forth no requirement of total or complete lack of control, but that the Constitution does not permit commitment of the type of dangerous sexual offender considered in Hendricks without any lack-of-control determination. Required proof had to be sufficient to distinguish the dangerous sexual offender whose serious mental illness, abnormality, or disorder subjected the offender to civil commitment from the dangerous but typical recidivist convicted in an ordinary criminal case. The Court concluded that an absolute finding of lack of control since this approach would risk barring the civil commitment of some highly dangerous persons suffering severe mental abnormalities.
The Court noted, “Hendricks referred to the Act as requiring an abnormality or disorder that makes it ‘difficult, if not impossible, for the [dangerous] person to control his dangerous behavior.’ Id., at 358 (emphasis added). The word ‘difficult’ indicates that the lack of control was not absolute. Indeed, an absolutist approach is unworkable and would risk barring the civil commitment of highly dangerous persons suffering severe mental abnormalities.”
In short, SCOTUS set the bar fairly low for allowance of civil commitment by allowing civil commitment under the lower standard of “mental abnormality” or “personality disorder” that makes it “difficult” (not impossible) to control certain sexual urges. While some degree of proof of dangerous must be proven, there is not universal standard, and the Courts have not offered a definitive standard.
CIVIL COMMITMENT PROCESS
The state of Minnesota’s process of civil commitment is a typical procedure for confining certain convicted sex offenders. The commitment petition is filled before the release date from prison, and goes before a civil judge. The defendant is granted the right to counsel, cross-examine, and present evidence, but is not allowed the right to a jury trial. Furthermore, allegations not leading to an arrest or criminal charge can be considered (thus a false allegation could be considered). The judge then makes his decision using the lower standard “clear and convincing evidence.” If a person is civilly committed, s/he will remain at the civil commitment center during the appeal, and a review hearing is conducted to determine the need for further commitment. The patient, the patient’s attorney, or the facility medical director can start the process for a hearing before a special review board. The review board makes the recommendation, but the Commissioner makes the final decision, though that decision can be appealed through the courts [4].
“What Does the State Need to Prove to Commit Someone?
Typically, three elements must be proven by the state in order to confine a person under an SVP law:
- The defendant must have been charged with a sexual offense
- The defendant must have a “mental disorder” or “abnormality”
- The defendant is likely to commit sexually violent acts in the future.” [5]
COMMITMENT CONTROVERSY
Civil commitment laws, as currently practiced, open up many concerns beyond the medical community. One article criticizing theNew York civil commitment laws posed the question in light of a state study on recidivism asked how exactly we determine which 8% of the sex offenders released from prison will re-offend in the next eight years and commit them accordingly. The article also cites numerous concerns of civil commitment, including:
- Promoting and basing decision-making on mass hysteria
- The high probability of committing innocent people
- Inability and overconfidence in ability to determine risk
- Mistakes in assuming what works or does not work in reducing recidivism
- Gender inequality in sex crime convictions [6]
An article by Dr. Joseph D. Bloom, a mental health professional with 35 years experience with civil commitment laws, also notes the civil commitment laws are losing their prominence. The evolution from the medical model to the criminal justice method is lamented as anti-therapeutic [7] and diminishing the ability to effectively use the statutes [8]. The prisons have become the dumping ground for the mentally ill [9].
A series of New York Times articles have reinforced the perception of civil commitment as dumping grounds for offenders who have completed their sentences. Of the nearly 3,000 convicted sex offenders sent to civil commitment centers in 18 states from 1990 to 2007, only 50 “graduated” from the courses, while 115 have been released due to legal technicality, old age, or terminal health; and even those few who were released wind up living on state prison grounds because communities shun the released [10].
An investigation into one center run by a private company in Arcadia, Florida described the facility as a “free-for-all prison.” The poor record of failures included escapes, murders, sex, and drug use within the facility. Only one of the committed ever graduated from the program during the tenure of the program run by Liberty Behavioral Health Corporation. The state of Florida accused Liberty of mismanagement, while Liberty accused the state of not funding the program sufficiently [11].
The state of Florida spent an average of $41,835 per committed individual; by contrast, the state spent $19,000 per prison inmate per year. By contrast, Pennsylvania spent $180,000 per year per committed individual and $31,363 per inmate per year. The cost of civil commitment is exponentially higher than prison time [12]. While civil commitment is more expensive than prison, the fact is, those who are civilly committed have completed their sentences before entering a civil commitment center.
Another controversy arose in 2009 when Tyson Lynch, a hearing examiner at the Massachusetts SOMB, was investigated by a local media outlet. “He’s expressing opinions about how these hearings have been conducted, essentially showing that he’s made up his mind before they’re finished,” said attorney Eric Tennen. For example, Lynch wrote on his Facebook account how he gets “great satisfaction” out of denying motions and that: “It’s always a mistake when people testify because they get destroyed in cross examination.” Fellow hearing examiner Mel Maisel used her Facebook account to comment, “But it’s so entertaining….” Once he bragged about “putting the smack-down on some crazy attorney.” Without naming anyone he called others “incompetent.” One morning he wrote: “It’s always awkward when I see one of my pervs in the parking lot after a hearing…” “Every case that he’s heard has to be re-examined to determine whether or not he was biased, whether or not he was fair and whether or not he gave the person a legitimate hearing and classification,” Tennen said [13].
In one case challenging Lynch’s assessment of a registrant as high-risk, the court determined “the hearing examiner’s comments, certainly when viewed cumulatively, clearly reference his work as a hearing examiner and are unquestionably inappropriate, unprofessional, troubling, and suggestive of a prejudicial predisposition…We have significant doubt whether the plaintiff received a hearing conducted by a fair, unbiased, and impartial hearing examiner. Consequently, the plaintiff has met his burden of proof with respect to due process violations caused by the hearing [14].” According to one legal blog, Lynch accepted a layoff around 2011 and, as of 2013, was working as a real estate agent [15].
LEGAL ISSUES
While the Hendricks decision upheld the practice of civil commitment, the constitutionality of civil commitment hinged on applying the law without serving a punitive purpose. A recent essay by Eric S. Janus suggests the possibility of “facial invalidity” of the current civil commitment laws as currently practiced. The constitutionality of an SVP law “depends on its purpose, the contours of its target (mentally disordered and dangerous), its procedures, and the provision of treatment and conditions of confinement [16].”
The Hendricks case was upheld but could be challenged under the following conditions:
- If civil commitment was used punitively
- If civil commitment “threatens the primacy of criminal law as the tool for addressing antisocial behavior-” they must make
distinctions between those subject to civil commitment and those dangerous persons better handled by the criminal justice
system - If the one civilly committed is not “dangerous” and does not exhibit a constitutionally adequate mental disorder, i.e, so
dangerous they cannot control their behavior to the degree that separates them from those in the justice system - If the committed individual is held beyond the time necessary for treatment
- If the right to treatment and the conditions of confinement are violated [17]
Janus’s rationale is that the law is inapplicable because of how it is used. It would be reasonable to assume based upon the many reports listed thus far, the law should be invalidated.
At least two recent court decisions found civil commitment unconstitutional under certain circumstances. In May 2008, a federal judge in Minnesota ruled congress exceeded authority in confining people past their sentences [18], a ruling preceded by a similar court ruling in North Carolina [19]. The North Carolina federal court also determined the standard of proof for civil commitment should be “beyond a reasonable doubt,” not the lesser standard of “clear and convincing evidence [20]. Both cases involved the controversial Adam Walsh Act.
Other legal issues involving civil commitment:
- The committed still possess the right not to incriminate themselves during the course of any proceeding where it may be used against them in future proceedings. Lefkowitz v. Turley, 414 US 70, 77 (1973)
- A person on supervised release cannot be forced to detail sexual history in treatment without being given immunity against future prosecution; cannot be forced to submit to a polygraph. US v. Antelope, 395 F. 3d 1128 (9th Cir. 2005)
- 5th Amendment rights continue through sentencing; silence cannot be used to draw adverse inference, cannot be compelled to admit facts beyond evidence. Mitchell v. US, 526 US 314 (1999)
In 2010, the US Supreme Court upheld the practice of civil commitment in US v. Comstock, 560 U.S. 126 (2010), which had been extended to federal inmates as the result of the Adam Walsh Act. SCOTUS had focused on the “necessary and proper” clause, which gave Congress the power to enact the law, rather than other Constitutional issues raised in the case. Below are the “five considerations, taken together,” that influenced the High Court’s decision in Comstock:
- The Necessary and Proper Clause grants Congress broad power to enact laws that are “rationally related” and “reasonably adapted” to executing the other enumerated powers,
- The statute at issue “constitutes a modest addition” to related statutes that have existed for many decades,
- The statute in question reasonably extends longstanding policy,
- The statute properly accounts for state interests, by ending the federal government’s role “with respect to an individual covered by the statute” whenever a state requests, and
- The statute is narrowly tailored to only address the legitimate federal interest.
The practice of civil commitment itself hasn’t experienced a significant setback since Comstock; however, there were two notable ruling in lower courts against the administration of civil commitment in the states.
In Karsjens v. Jesson, Civil No. 11-3659 (DWF/JJK) (D. Minn. 15 June 2015), Minnesota U.S. District Court Judge Donovan Frank, in a 76-page decision, concluded the Minnesota MSOP’s “civil commitment” program was unconstitutional as currently practiced. “The Court concludes that Minnesota’s civil commitment statutes and sex offender program do not pass constitutional scrutiny. The overwhelming evidence at trial established that Minnesota’s civil commitment scheme is a punitive system that segregates and indefinitely detains a class of potentially dangerous individuals without the safeguards of the criminal justice system.”
In Orden v. Schafer, 4:09-cv-00971-AGF (US Dist Ct E Mo., E Div. 2015), Missouri U.S. District Judge Audrey G. Fleissig ruled that MO’s civil commitment program violated Due Process. “The overwhelming evidence at trial — much of which came from Defendants’ own experts — did establish that the SORTS civil commitment program suffers from systemic failures regarding risk assessment and release that have resulted in the continued confinement of individuals who no longer meet the criteria for commitment, in violation of the Due Process Clause… “The Constitution does not allow (Missouri officials) to impose lifetime detention on individuals who have completed their prison sentences and who no longer pose a danger to the public, no matter how heinous their past conduct.”
The common denominator in both of these 2015 US District Court cases is that both Missouri and Minnesota’s civil commitment programs have not released anyone. Minnesota’s Sex Offender Rehabilitation and Treatment Services (SORTS) program was accurately described by the St. Louis Post-Dispatch as looking “like a prison [21].” It seems the Post-Dispatch is stating the obvious.
Amanda C. Pustilnik, Professor of Law at the University of Maryland School of Law, considers the current sex offender civil commitment regime is “a perversion – of facts, of medical ethics, and of justice.” Pustilnik argues “genuine civil commitment…is a form of emergency medical treatment; that is strictly limited in duration; and must be for the patient’s benefit.” Pustilnik rightfully states that the current practice of holding sex offenders beyond their criminal sentences is not “civil commitment” but “preventive detention” using vague criteria as justification for confinement [22].
While the 2015 ruling was overturned in Karsjens v Piper, 845 F.3d 394 (8th Cir. 2017), the 2015 ruling led Minnesota to release a handful of the state’s civil detainees in recent years. The first provisional release from Minnesota’s civil commitment program was in 2012, nearly 20 years after the program formed specifically to detain people convicted of sex offenses. [23]
Federal civil detainees have even less victories to celebrate. In Matherly v. Andrews, 859 F.3d 264 (4th Cir. 2017), a detainee filed a “pro se complaint is that his confinement at FCI Butner violates the Due Process Clause of the Fifth Amendment because certain conditions applicable to him are more restrictive than, identical to, or similar to conditions applicable to prisoners housed at FCI Butner. He also alleges violations of his rights under the First Amendment and the Fair Labor Standards Act (the “FLSA”).
With respect to his claims under the Fifth Amendment and as is relevant here, Matherly resides in the Maryland Unit at FCI Butner, which houses all—and only—civil detainees. As such, he is subject to BOP policies that are ‘punitive in effect.’ J.A. 31. Matherly must wear the same uniform as a prisoner, is limited to purchasing the same items from the commissary that a prisoner can purchase, and can watch only those television programs that a prisoner can watch. Furthermore, he is double-bunked with another civil detainee.
Matherly comes into contact with criminal detainees on a daily basis. He eats in FCI Butner’s mess hall, where prisoners serve him his food and otherwise congregate. The Maryland Unit contains offices for BOP staff, which prisoners visit daily to see staff members. Prisoners also walk through the Maryland Unit three times a day to bring a food cart to the Special Housing Unit, even though there is a separate entrance to that unit. And when Matherly needs his hair cut, a prisoner cuts it.
Prisoners “often taunt and harass” Matherly and the other civil detainees, “calling them ‘[b]aby rapers’ and ‘child molest[e]rs.’ ” J.A. 29. Matherly contends that “[t]his threatening and harassing behavior … could very likely lead to a physical confrontation at some point.” J.A. 29. That is especially true because “in a prison setting a sex offender is the most despised type of inmate.” J.A. 32. However, “BOP Food Service staff often laugh when this harassment occurs.” J.A. 29.
As to actions by the BOP, employees strip search civil detainees to punish them, often after one of them complains about living conditions or staff members. The searches are conducted to intimidate and humiliate. Matherly “has been subjected to these types of searches after arguing or disagreeing with correctional staff that he isn’t an ‘inmate.’ ” J.A. 34. The BOP also conducts random mass shakedowns, which involve a search of detainees’ living quarters for contraband.
Matherly also alleges that he would like to take more educational and vocational training courses, but doesn’t have the same opportunities as a prisoner. Furthermore, prisoners can participate in Narcotics Anonymous and Alcoholics Anonymous, but civil detainees cannot.
With respect to his First Amendment claim, Matherly says that all of his incoming and outgoing mail is inspected. He suggests as an alternative that he be allowed to open his mail in the presence of a BOP official. Finally, as for his FLSA *270 claim, Matherly has a job at FCI Butner which pays 29 cents per hour, and he contends that he should be paid at the federal minimum wage.”
In Matherly, conditions for detainees at FCI Butner is no different than those of a regular at the prison camp, but civil detainees have even less opportunities for access to educational resources and library access due to the demands of the program. It looks like a prison, behaves like a prison, and it contained in a prison run by prison guards and employs federal inmates as staff within the walls. Yet, the Court ruled, “Matherly hasn’t shown that the BOP imposed these conditions with an expressed intent to punish. Rather, he takes issue with them because prisoners are subject to the same conditions. But, as we explained above, that isn’t enough to make out a constitutional violation. All of these conditions are incident to the legitimate nonpunitive governmental objective to confine individuals like Matherly who are sexually dangerous.” It is only through Matherly do we even get a glimpse into the federal civil commitment system.
“The survey confirmed that only twenty-two jurisdictions (twenty states, the federal government, and the District of Columbia) have specialized civil commitment statutes for “sexually dangerous” or “sexually violent” persons. Of these, the results demonstrate that five states—Illinois, Massachusetts, New Hampshire, New Jersey, and North Dakota—explicitly authorize sex offender civil commitment to their respective departments of corrections. In addition, although the federal government’s statute does not specify which type of facility is permissible for the detainment of its civil committees, court documents reveal that those committed under the Adam Walsh Act are committed to a special unit of a federal prison in North Carolina.”
Eight additional states—Florida, Iowa, Kansas, Missouri, New York, South Carolina, Virginia, and Wisconsin—commit sex offenders to state health or human services departments but authorize these agencies to contract with their respective departments of corrections or private companies to detain committees. Although some statutes that directly commit or permit commitment to prison contain language requiring civil committees be kept separate or segregated from criminally convicted inmates except for incidental contact, none appear to specify that civil committees must receive more comfortable or less restrictive treatment than their criminally convicted counterparts. Furthermore, Minnesota, Illinois, Washington, and Texas authorize commitment of some sex offenders to secure treatment centers separate from both their health departments and their departments of corrections.”
“There are, however, five jurisdictions with sex offender civil commitment statutes that do take, at least facially, a more traditional civil commitment approach. Arizona, for example, commits sex offenders to a state hospital or to a less restrictive alternative. California, Washington, D.C., and Nebraska commit their sex offenders to state hospital systems. Pennsylvania commits its detainees to an inpatient treatment facility operated by the Department of Public Welfare.”
“In sum, seventeen of the twenty-two jurisdictions with specialized civil commitment statutes for sex offenders permit civil commitment to prison or prison-like facilities. On one end of the restrictiveness spectrum, there are statutes that commit civil detainees to prison (or explicitly authorize such an arrangement). On the other end of the spectrum are more traditional civil commitment arrangements, in hospital or outpatient settings. In the middle are statutes that authorize civil commitment to separate secure treatment facilities. [24]
CIVIL COMMITMENT RELATED ISSUES
There are other issues with civil commitment outside of the civil commitment process. Many civilly committed offenders are subjected to psychological and risk assessment tests, polygraphs, plethysmographs (“peter readers”), and even castration. Below is a synopsis of each of these provisions.
Risk Assessment Tests
Actuarial risk assessment tests try to determine which individual is more likely to re-offend based upon the score they earn on each test. Some of the known actuarial tools are the Violence Risk Appraisal Guide (VRAG), the Sex Offender Risk Appraisal Guide (SORAG), the Rapid Risk Assessment of Sex Offense Recidivism (RRASOR), the Static-99, the Minnesota Sex Offender Screening Tool-Revised (MiSOST-R), and the Multifactorial Assessment of Sex Offender Risk for Recidivism (MASORR). One recent study determined all but the MiSOST-R and the MASORR to be fairly effective at predicting sexual recidivism [25].
All actuarial risk assessments measure “static” or factors in a person’s life that do not change over time (or doesn’t change easily), such as age of offense, presence of mental illness or substance abuse, prior sex offenses, childhood events such as single parent raising or trouble in school, or relationship status. And scoring utilized by the tests assign group risk to the individual based on people with similar scores. Below is a basic breakdown of the various tests:
- Violence Risk Appraisal Guide (VRAG): The VRAG looks at 12 static factors and scores test from -26 to +38, falling into a risk scale from 1 (low) to 9 (high)
- Sex Offender Risk Appraisal Guide (SORAG): The SORAG looks at 14 items, 10 of those similar to the VRAG, and scores test from -27 to +51 and falling into a similar scale of 1 (low) to 9 (high)
- Rapid Risk Assessment of Sex Offense Recidivism (RRASOR): A more simplified risk assessment based on 4 high risk factors: Multiple offenses, male victims, age of offender, and unrelated victims. Scores are on a scale of 0 to 6, and study was developed using a sample of those with prior sex offenses
- Static-99: Uses 10 risk factors including the 4 RRASOR factors, scores range from 0 to 12, with a score of 6+ considered high risk.
- Minnesota Sex Offender Screening Tool-Revised (MiSOST-R): Uses 16 factors, 12 historical factors (like prior sex offenses) and 4 institutional factors (such as cooperation with prison sex offender treatment). This test is unique in not taking related or “incest” victims into consideration in scoring. Total scores of -10 to +30 determines risk on a scale of 1 (low) to 6 (high)
- Multifactorial Assessment of Sex Offender Risk for Recidivism (MASORR): Individual ratings of 1 to 5 are initially assessed, and a separate score is assessed after treatment, measuring motivation to participate in treatment, degree of change achieved, and impressions made upon the treatment provider. The test scores are combined to determine risk [26].
Of course, it should be noted that recidivism rates were low even in the survey of the clinical tests, and personal bias and difficulty in scoring can hinder evaluation results [27]. Bias can also extend to those in charge of determining civil commitment, as judges or assessment committees can reject the test results.
Penile Plethysmographs (PPG)
Penile plethysmographs (derogatorily known as “Peter Readers” or ‘Peter Meters”) are devices which measure blood flow to the penis and measure arousal. While widely used in risk assessments, plethysmographs have not been proven scientifically accurate, as it is possible for a person to “manipulate mental images” to override visual cues [28]. One study found about 16% of tests was indeed manipulated [29].
A few court cases have set precedents for rejecting the practice. In US v. Powers, 59 F. 3d 1460 (4th Cir. 1995), the Court found the tests lead to a number of false positives and was not determined to be scientifically valid under the Daubert standard, a decision shared by a North Carolina appeals court in North Carolina v. Spencer, 459 S.E.2d 812, 815 (N.C. Ct. App. 1995). In Billips v. Commonwealth, No. 062180 (Va. Sup. Ct. Nov. 7, 2007) , the Virginia Supreme Court also rejected the plethysmographs, again citing lack of scientific evidence.
Despite these rulings, PPGs are still utilized in many sex offender programs, including civil commitment.
Polygraphs
Polygraphs are popular thanks in part to television shows like The Maury Povich Show, but from a scientific standpoint the practice is controversial. William Moulton Marston, the creator of the systolic blood pressure test, also created the comic book character “Wonder Woman,” who wields the “Lasso of Truth” or “Magic Lasso” which compels people to tell the truth as a special power [30]. Much like Wonder Woman, the polygraph is little more than a piece of fiction.
Polygraphs don’t actually detect lies; they just detect bodily changes, but that fact does little to deter the myth of the lie detector. One 1997 study suggests polygraphs are little more accurate than chance (61%), and certain techniques could help fool polygraph tests [31]. Another study found that those subjected to a polygraph will agree with whatever the polygrapher asks around 90% of the time, even if the polygrapher suggests something completely untrue [32]. This is particularly dangerous as polygraphs are not lie detectors, but interrogations, and results could be determined by the amount of deception committed by the examiner [33]. While the tests may not detect lies, it may be valuable as “psychological manipulation,” acting as a tool to force confessions or provide self-incriminating evidence [34]. Polygraphs are wholesale rejected in courts for many of the same reasons as plethysmographs, particularly lack of scientific evidence [35]. Furthermore, polygraphs are not even considered reliable for screening in security positions [36].
(For a more in-depth report on polygraphs, visit OnceFallen’s polygraph page by CLICKING HERE)
Castration
As of June 2019, Alabama, California, Florida, Iowa, Louisiana, Montana, Texas, and Wisconsin have active chemical castration laws on the books. Georgia and Oregon once had laws on the books but have since been repealed. [37]
Castration is not without harsh criticisms. “Researchers have found that chemical castration, or using hormonal drugs to curb sexual appetite, can be problematic, too. But while some consider antiandrogens crucial for the most predatory offenders, the drugs remain controversial, not least because they are expensive and can cause weight gain, osteoporosis and breast development. It is also hard to ensure that released offenders keep taking the drugs [38].” In addition there are other criticisms with castration laws, including:
- Assumption all sex offenders are likely to commit another sex crime;
- Castration does not necessarily eliminate sexual drive and function;
- Both types of castration are reversible thus never accomplishing intended purpose, and
- Not all sex crimes spring from sexual urges (such as the anger rapist), some sex crimes are result of social and cultural forces, such as desire for domination or power or desire for revenge for harms done [39].
The few research studies available originate mostly from Denmark and Nazi Germany from around the World War 2 era, and their validity is questionable at best, especially since non-sex crimes were usually included in the mix, and no control group was tested. In fact, none of the studies were entirely comprised of sex offenders. Furthermore, in studying people castrated for the medical purpose of removing testicular cancer, the researchers found that patients could still have erections and respond to sexually stimulating materials. Some of the medical side effects can be countered with hormone injections, which in turn, increases the sex drive. Only one study (California Legislative Report, 1952) claimed a 0% sexual recidivism rate, but only 11 of the 60 in the report were convicted of sex crimes. Finally, in one case study, the patient still displayed aggression towards women, which was attributed to his misogynist belief system as opposed to sex hormones. Not all factors involving criminal sexual behavior can be attributed to sex hormones [40].
Legally, surgical castration would not appear to pass constitutional muster, as the Courts have declared the lesser punishment of a forced vasectomy “cruel and unusual punishment [41].” The Council of Europe’s committee for the Prevention of Torture recently found two psychiatric hospitals in the Czech Republic to be a cause for grave concern. The Council questioned the issue of voluntary consent for castration where the only other alternative was indefinite civil commitment. Also, there are no standardized methods for determining appropriate treatment for sex offenders [42].
For a more in-depth report on castration laws, visit the OnceFallen page on castration by CLICKING HERE)
OCTOBER 2020 UCLA CIVIL COMMITMENT REPORT
According to a report by the UCLA School of Law Williams Institute [43], as of October 2020:
- Thousands of people are in civil commitment in the United States. There are over 6,300 people detained in the 20 state and federal civil commitment programs.
- In most states, Black men were vastly overrepresented among the population of civilly committed persons. Based on data from 13 states with reliable data, Black residents faced a rate of SVP detention more than twice that of White residents: 7.72 per 100,000 Black residents as compared with 3.11 per 100,000 White residents aged sixteen or older.
- Sexual minority men are disproportionately detained in sex offense civil commitment facilities. In the two states with reliable data about the sex of the victim, New York and Texas, men who had victims who were male were 2 to 3 times as likely to be civilly committed than men with only female victims. This trend was consistent for Black men, White men, and Hispanic men. These patterns suggest that gay/bisexual and other men who have sex with men (MSM) are seen as more violent, more dangerous or mentally ill, and more deserving commitment under SVP statutes as compared with heterosexuals.
The UCLA report, which seems to focus at least partly on the impact of civil commitment statutes on minorities and those identifying as LGBTQ+ notes three ongoing criticisms of current civil commitment practices:
- “First, critics have raised concerns that the evaluation instrument used to screen potential SVP civil commitment candidates may be intrinsically biased against gay and bisexual men and men who have sex with men (MSM). “STATIC-99” and “STATIC-99R” instruments are used to evaluate the dangerousness of an offender along a series of ten measures—higher scores can designate a person SVP and provide a basis for recommending civil commitment.”
- “Second, critics have also noted the potential misuse of paraphilic disorders, a group of psychiatric diagnoses related to “atypical sexual interest.” This category is extremely broad and includes pedophilic disorder as well as consensual sexual “kinky” behaviors such as sexual masochism and sadism. The critique is that such diagnoses can be used a justification for civil commitment for a wide range of offenders. Paraphilic disorders diagnoses are so broad that they could be used to characterize as mentally ill many practitioners of kink, bondage, sadomasochism, or any sexual practice perceived to be deviant.”
- “Third, racist ideologies have denigrated and stigmatized Black sexualities for centuries. Racist ideologies portray Black people as over-sexualized and less refined than White people to justify their oppression. Racism and homophobia also intersect.”
As of 2018, the states with the most civil commitment detainees were California (949), Minnesota (741), Florida (654), and Illinois (565). The federal system had 49 civil detainees in 2019.
This report concluded:
“In most states, Black men were overrepresented among the population of civilly committed persons. This may reflect pattens of over representation of Black men and women in the criminal justice system. It may also, in part, reflect factors intrinsic to the civil commitment process.”
“This report also demonstrates that in New York and Texas, the two states for which data were available, sexual minority men are disproportionately detained in sex offense civil commitment facilities. We believe these findings are unlikely to be unique to the only two states for which data were available but data for more states would be required to establish that this pattern is consistent across other states. Our analyses were limited by the data that we could use.”
“We urge the federal government Department of Justice and states to collect data on people in civil commitment, including data on sexual orientation and gender identity of inmates, and to release to this important data to the public. We also urge the federal government, states, and other independent researchers to assess the various factors that contribute to higher rates of commitment among Black and sexual minority men.”
There is the possibility that even today, old stereotypes about minorities and homosexuals can influence the decision to subject someone to indefinite detention. At the least, the actuarial tests like the STATIC-99 rates sexual acts higher if it is conducted with someone of the same biological sex.
DESPERATE TIMES CALL FOR DESPERATE MEASURES
Frustrated at the lack of any clear pathway for freedom, inmates at “civil commitment centers” have tried various measures over the year to raise awareness to their plights. There have been protests, hunger strikes, and even a name change attempt to bring attention to those seeking freedom from these indefinite detention facilities.
On Sunday, 2 March 2008, a joint protest conducted inside and outside the walls of the Coalinga State Hospital was conducted to protest the practice of civil commitment. While inmates inside the facility staged a sitdown strike, protesters held a rally outside the gates as a show of support for those protesting within the “hospital.” [44] In an interview with Fox 26 News, Jammie Stallworth, whose husband was receiving “rehabilitation” at Coalinga, stated, “I’m not saying that it wasn’t wrong. But they’ve done all their time like any other criminal.” Anti-Registry Movement activist Tom Madison told Fox 26 he doesn’t think the extra treatment is worth the sex offender’s time or the taxpayer’s dollars. Madison stated, “They simply want to get on with their lives, but the fear and hysteria is in the stratosphere today.” [45]
On 11 Nov 2011, William Dewey and Victor Johnson, 29, indefinite detainees at the Virginia Center for Behavioral Rehabilitation, staged a rooftop protest. The two men had fashioned nooses out of bedsheets and maintained a standoff with officials for over three and a half hours. Dewey lated told reporters, “I’m not mad about being here. It’s not about wanting to be in the facility. It’s about wanting to facility to be what it’s supposed to be.” Dewey added that he had no desire to escape. The two men had taken jackets, blankets and food crackers, peanuts and Pop Tarts and planned to stay the night if necessary. Dewey and other offenders have complained about an increase in security and having their privileges cut back while security measures increase. [46]
In 2019, the Minnesota Appeals Court upheld a lower court ruling that rejected an effort by Hollis Larson to change his name to “Better Off Dead.” Larson, incarcerated at the Minnesota Sex Offender Program (MSOP) since February 2008, filed an application to legally change his name to “Better Off Dead” citing both religious freedom (primarily Taoism, with influences from Buddhism and Hindu faiths) and his right to protest against the conditions of his civil confinement. As Larson explained, “I could go on for days and reams describing the punitive and torturous conditions of MSOP, but these suffice to show why I feel like I would be Better Off Dead. Also, due to my pretty much life-long incarceration… I’m sure I have Post-Incarceration syndrome, Segregation Psychosis, and who knows what else due (to) the virtual limitless sensory deprivation and torture to which I’ve been subjected. Of course, I am also attempting to exercise my constitutional rights to protest the way I’ve been ‘treated’ by the government relating to/ regarding my civil commitment. Having my name Better Off Dead would at least (hopefully) make my captors stop and think whenever they hear
my name. It also… draws attention to not only my plight, but hopefully all persons’ plight of falling into the civil commitment industry ‘rabbit hole.’ By the same token, it is virtually my only way to peacefully protest, to the public at large, what a witch hunt civil commitment is and the extent to which it negatively affects not only the committed person, but their families, friends, etc. On top of all this, add the pervading atmosphere of utter hopelessness of knowing I will probably never be released from MSOP and my legitimate diagnosis of major depression/ dysthymia, and you have the basic rationale and mindset for me knowing that I am truly better off dead.” [47]
Inmates at the Moose Lake Civil Commitment in Minnesota engaged in a 14-day-long hunger strike in January 2021 to protest the Minnesota Sex Offender Program (MSOP) and the lack of a clear pathway for release. Minnesota has only give 13 full releases between the founding of the MSOP in 1993 and 2020. Prisoners began refusing to eat on 21 January 2021. About 20 relatives and loved ones of the MSOP inmates protested at the home of Department of Human Services Commissioner Jodi Harpstead. Hunger strikers ended a two-week hunger strike after state officials agreed to discuss possible changes to the MSOP through a series of monthly meetings between Febrary 2021 and May 2021. “I am relieved that no one was seriously hurt or died, but this system of indefinite confinement has gone on far too long,” said Merry Schoon of Appleton, Minn., whose 33-year-old son, Daniel A. Wilson, is being held at Moose Lake. “These men have families and they deserve a second chance to be productive members of society just like everyone else.” [48]
CONCLUSION
“Civil Commitment of Sex Offenders Pretends Prisoners Are Patients.” A headline at Reason Magazine succinctly describes the practice of civil commitment. The subtitle states, “The practice evades constitutional constraints by casting punishment and preventive detention as treatment.” The condemnation continues:
“Twenty states, the District of Columbia, and the federal government have laws that authorize civil commitment of sex offenders who would otherwise be released after serving their prison terms. The Supreme Court upheld the practice in 1997, saying it was appropriate for people who ‘suffer from a volitional impairment rendering them dangerous beyond their control.’ That logic is puzzling. The state punishes people who commit sex crimes based on the assumption that they could and should have controlled themselves. But when it is time for them to be released after completing the punishment prescribed by law, the state says that was not actually true; now they must be locked up precisely because they can’t control themselves. If the government decided to retroactively increase an offender’s penalty, it would be clearly unconstitutional, amounting to double jeopardy or an ex post facto law. The trick is to cast continued confinement as treatment rather than punishment. But what if treatment almost never produces a cure that allows a detainee’s release? In Minnesota, only 13 detainees have been unconditionally released since the program was established in 1994; more than six times as many have died in custody…”
“Virginia, which began civilly committing sex offenders in 2003, has a much better track record than Minnesota. While Minnesota has conditionally released less than 4 percent of its detainees, meaning they are no longer imprisoned but are still subject to supervision, Virginia has granted that status to 60 percent of its detainees. State Sen. Joe Morrissey (D–Richmond) nevertheless argues that Virginia’s program is ‘abhorrent to everything that our democracy and our criminal justice system believes in.’ Morrissey recently introduced a bill that would have abolished the program. Last month the Senate Judiciary Committee derailed Morrissey’s bill, referring it to the Virginia State Crime Commission for a study. ‘We don’t sentence people because of what they might do,’ Morrissey says. For now, that remains an aspiration rather than a reality.” [49]
Civil commitment is unconstitutional as currently practiced. It is self-evident that current civil commitment laws are used as detainment rather than treatment, as few individuals ever leave civil commitment centers in anything outside a body bag. There is currently no solid plan to determine who is at risk for re-offending, as risk assessments are subject to human bias and misinterpretations. Furthermore the scores can simply be ignored by the judges presiding the civil commitment hearing. Other methods of assessing risk, such as penile plethysmographs and polygraphs, are largely rejected by the courts yet are commonly used in civil commitment centers. These tests are not considered scientifically valid and ample evidence suggests these tests are largely interpreted by human bias rather than fact and may lead to large numbers of false positives. And castration leads to a number of negative consequences including physiological side effects that may ultimately rule the practice cruel and unusual punishment.
If civil commitment is to ever be utilized, the practice should be used only to handle only the “worst of the worst,” utilizing scientifically and non-intrusive means to achieve the goal of rehabilitating the truly ill. Unfortunately, “predator panic” has led to the abuse of a safeguard against the worst of the worst, a trend sure to only worsen with the advent of the Adam Walsh Act.
References
- Trevor Hoppe, Ilan H. Meyer, Scott De Orio, Stefan Vogler, and Megan Armstrong. “Civil Commitment of People Convicted of Sex Offenses in the United States.” UCLA School of Law Williams Center. October 2020. Accessed on 10/23/2020 at https://williamsinstitute.law.ucla.edu/wp-content/uploads/SVP-Civil-Commitments-Oct-2020.pdf
- Nathan James, Kenneth Thomas, Cassandra Foley. “CRS Report for Congress: Civil Commitment of Sexually Dangerous Persons.” Congressional Research Service, 2 July 2007. Accessed 8 Mar 2009 at http://assets.opencrs.com/rpts/RL34068_20070702.pdf. pp. CRS-2 to CRS-4Kansas v. Crane, 534 U.S. 407
- National Association of State Mental Health Program Directors, “Position Statement on Laws Providing for the Civil Commitment of Sexually Violent Criminal Offenders.” Sept. 9, 1997, http://www.nasmhpd.org/general_wp-content/uploads/2021/04/position_statement/sexpred.htm
- “Sex Offender Civil Commitment Fact Sheet.” Minnesota Office of the Ombudsman for Mental Health and Mental Retardation, Civil Commitment Training and Resource Center, January 2004. http://www.ombudmhdd.state.mn.us/cctrc/sexoffenderccfactsheet.pdf, Retrieved May 13, 2009
- Supra., Hoppe et al. UCLA Oct 2020
- Jeanne Curran and Susan R. Takata. “Civil Commitment of Sex Offenders.” Dear Habernas, February 6, 2006. http://www.csudh.edu/dearhabermas/sexoffend01.htm, Retrieved May 8, 2009
- Joseph D. Bloom. “Thirty-Five Years of Working With Civil Commitment Statutes.” The Journal of the American Academy of Psychiatry and the Law, Vol. 32, Vol. 4, 2004, pp. 433
- Ibid., pp. 430
- Ibid., pp. 438
- Monica Davey and Abby Goodnough, “Doubts Rise as States Hold Sex Offenders After Prison.” New York Times, March 4, 2007, http://www.nytimes.com/2007/03/04/us/04civil.html, Retrieved May 8, 2009
- Monica Davey and Abby Goodnough, “A Record of Failure at Center for Sex Offenders.” New York Times, March 5, 2007. http://www.nytimes.com/2007/03/05/us/05civil.html, Retrieved May 8, 2009
- “A Profile of Civil Commitment around the Country.” [Chart] New York Times, March 3, 2009. http://www.nytimes.com/imagepages/2007/03/03/us/20070304_CIVIL_GRAPHIC.html, Retrieved May 8,2009
- “Sex Offender Registry Board Workers Questioned Over Facebook Use: Team 5 Investigates Uncovers Bias.” WCVB News 5, May 19, 2009. http://www.thebostonchannel.com/investigative/19505809/detail.html, retrieved May 19, 2009.
- JOHN DOE, SEX OFFENDER REGISTRY BOARD NO. 29481 v. SEX OFFENDER REGISTRY BOARD, 84 Mass. App. Ct. 537 (2013)
- Eric Goldman, “Facebook Rant Against ‘Arial’ Font Helps Reverse Sex Offender Determination.” Technology & Marketing Law Blog, Nov. 26, 2013. http://blog.ericgoldman.org/archives/2013/11/facebook-rant-against-arial-font-helps-reverse-sex-offender-determination.htm, Retrieved Sept. 12, 2015
- Eric S. Janus and Brad Bolin. “An End-Game for Sexually Violent Predator Laws: As-Applied Invalidation.” Ohio State Journal of Criminal Law, Vol. 6, 2008, pp. 28. http://moritzlaw.osu.edu/osjcl/Articles/Volume6_1/Janus-Bolin-PDF.pdf, Retrieved May 9, 2009
- Ibid., pp. 28-30
- Larry Oakes. “Judge rules federal civil commitment law unconstitutional.” Minneapolis Star-Tribune, May 29, 2008. http://www.startribune.com/templates/Print_This_Story?sid=19375989, Retrieved May 13, 2009
- Sarah Ovaska. “Sex crime terms have a limit.” The News-Observer, Sept. 13, 2007. http://www.newsobserver.com/print/thursday/front/v-print/story/702387.html, Retrieved May 13, 2009
- See US v. Comstock, Case 5:06-hc-02195-BR [US Dist. Ct. ED N. Car. Sept. 9, 2007)]
- “Editorial: Missouri’s SORTS program looks a lot like prison.” St. Louis Post-Dispatch, April 27, 2015. http://www.stltoday.com/news/opinion/editorial-missouri-s-sorts-program-looks-a-lot-like-prison/article_466a148c-d3bd-50a0-8152-98e8beab68d1.html, Retrieved Sept. 12, 2015
- Amanda Pustilnik, “Let’s Stamp Out Perversion.” Cato Unbound. 9 June 9 2015.Accessed 12 Sept. 2015 at http://www.cato-unbound.org/2015/06/09/amanda-pustilnik/lets-stamp-out-perversion
- Derek Logue, “‘Minnesota State’s Other Prison’: The Inside Story of the MSOP-Moose Lake Treatment Center.” OnceFallen.com, 21 August 2020.
- Arielle W. Tolman. “SEX OFFENDER CIVIL COMMITMENT TO PRISON POST-KINGSLEY .” 113 Nw. U. L. Rev. 155 (2018). https://scholarlycommons.law.northwestern.edu/nulr/vol113/iss1/4
- Howard Barbaree, Michael Seto, Calvin Langton, and Edward Peacock. “Evaluative the predictive accuracy of six risk assessment instruments for adult sex offenders.” Criminal Justice and Behavior, Vol. 28, No. 4, August 2001, pp. 490
- Ibid., pp. 498-502
- Ibid., pp. 517
- DSM-IV, pp. 524
- Blanchard, R., Klassen, P., Dickey, R., Kuban, M. E., & Blak, T. (2001). Sensitivity and specificity of the phallometric test for pedophilia in nonadmitting sex offenders. Psychological Assessment, 13, 118-126.
- “William Moulton Marston.” Wikipedia, 2009. http://en.wikipedia.org/wiki/William_Moulton_Marston, Retrieved May 17, 2009
- Dan Vergano. “Telling the truth about lie detectors.” USA Today, Sept. 9, 2002. http://www.usatoday.com/news/nation/2002-09-09-lie_x.htm. Retrieved May 17, 2009
- Ron Kokish, Jill Levenson, and Gerry Blasingame. “Post-Conviction Polygraph Examination: Client-Reported Perceptions of Utility and Accuracy.” Sexual Abuse: A Journal of Research and Treatment, Vol. 12, No. 5, Apr. 2005.
- George W. Maschke and Gino J. Scalabrini. “The Lie behind the Lie Detector, 4th Digital Ed.” AntiPolygraph.org, 2005, pp. 20, 86, 129
- Theodore P. Cross and Leonard Saxe. “Polygraph Testing and Sexual Abuse: The Lure of the Magic Lasso.” Child Maltreatment, Vol. 6, No. 3, Aug. 2001
- See US v. Scheffer, 523 US 303 (1998); US v. Henderson, F. 3d 1293 (11th Cir. 2005), US v. Antelope, 395 F. 3d 1128 (9th Cir. 2005)
- “Polygraph Test Too Flawed for Security Screening.” The National Academies, Oct. 8, 2002.
- Derek Logue. “Castration of Sex Offenders: “Off with their heads!” Oncefallen.com, 14 June 2019. http://www.oncefallen.com/castration.html
- Abby Goodnough and Monica Davey. “For Sex Offenders, a Dispute over Therapy’s Benefits.” New York Times, March 6, 2007. http://www.nytimes.com/2007/03/06/us/06civil.html?_r=2&pagewanted=all, Retrieved May 17, 2009
- John Q. La Fond. “Preventing Sexual Violence: How Society Should Cope With Sex Offenders.” American Psychological Association, 2005, p. 184 -5
- Weinburger, Sreenivasan, Garrick, et al. “The Impact of Surgical Castration on Sexual Recidivism Risk Among Sexually Violent Predatory Offenders.” The Journal of the American Academy of Psychiatry and the Law, Vol. 33, No. 1, 2005
- La Fond. “Preventing Sexual Violence,” p. 179, citing Weems v. US, 217 US 349 (1910), Oklahoma v. Skinner, 316 US 535 (1942), Williams v. Smith, 131 N.E. 2 (Ind. 1921), Davis v. Berry, 216 F. 413 (S.D. Iowa 1914) rev’d, 242 U.S. 468 (1917)]
- Rob Cameron, “Council of Europe expresses concern at Czech castration of sex offenders.” Radio Prague, July 16th, 2007
- Supra. Hoppe et al., UCLA Oct. 2020
- David Kennerly. “Tom Madison discusses the Sit-Down INSIDE the Hosprison.” Youtube. 12 Mar 2008. Accessed 10 Feb 2021 at https://youtu.be/Jh-ZMC1nOvg
- Ariana Duarte & Charlene Lee. “Dozens Rally Outside Coalinga State Hospital.” Fox 26 News. 3 Mar 2008. Accessed 10 Feb
2021 at https://kmph.com/archive/dozens-rally-outside-coalinga-state-hospital - Daniel Miller. “Sex offenders threaten to hang themselves from rehab centre rooftop in protest against conditions.” Daily Mail. 22 Nov 2011. Accessed 10 Feb 2021 at https://www.dailymail.co.uk/news/article-2064584/Sex-offenders-threaten-hang-
rehab-centre-rooftop-protest.html - Letter from Hollis Larson postmarked 07 Feb 2020; See also In re: Larson, A18-2153 (MN Ct of Appls, 30 Dec 2019)
- Chris Serres. “Sex offenders at Moose Lake end 14-day hunger strike after reaching deal with state officials.” Minneapolis Star-Tribune. 4 Feb 2021. Accessed 10 Feb 2021 at https://www.startribune.com/sex-offenders-at-moose-lake-end-14-day-hunger-strike-after-reaching-deal-with-state-officials/600019058/
- Jacob Sollum. “Civil Commitment of Sex Offenders Pretends Prisoners Are Patients.” Reason. 10 Feb 2021. Accessed 10 Feb 2021 at https://reason.com/2021/02/10/civil-commitment-of-sex-offenders-pretends-prisoners-are-patients/
CIVIL COMMITMENT STATUTES IN THE US
- Federal: 18 U.S.C.A. § 4248
- Arizona: Ariz. Rev. Stat. Ann. § 36-3701
- California: Cal. Welf. & Inst. Code § 6600
- District of Columbia (DC): D.C. Code § 22-3803
- Florida: Fla. Stat. Ann. § 394.910
- Illinois: 725 Ill. Compiled Stat. 207/1
- Iowa: Iowa Code Ann. § 229A.2
- Kansas: Kan. Stat. Ann. § 59-29a02
- Massachusetts: Mass. Gen. Laws Ann. Ch. 123A § 1
- Minnesota: Minn. Stat. Ann. § 253D.02
- Missouri: Mo. Ann. Stat. § 632.480
- Nebraska: NEB. REV. STAT. § 71-1203
- New Hampshire: N.H. Rev. Stat. Ann. § 135-E
- New Jersey: N.J. Stat. Ann. § 30:4-27.26
- New York: N.Y. Mental Hygiene. Law § 10.03
- North Dakota: N.D. Cent. Code Ann. § 25-03.3
- Pennsylvania: 42 Pa. Cons. Stat. Ann. § 6402
- South Carolina: S.C. Code Ann. § 44-48-30
- Texas: Tex. Health & Safety Code Ann. § 841.002
- Virginia: Va. Code Ann. § 37.2-900
- Washington: Wash. Rev. Code Ann. § 71.09.020
- Wisconsin: Wis. Stat. Ann. § 980.01