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News : Critics Target Missouri Sex Offender Treatment Program
Posted by Randy on 2014/1/20 7:53:58 (507 reads) News by the same author

ST. LOUIS (AP)- The director of the Missouri Department of Mental Health once wrote in an email that the agency’s controversial program that locks up sexually violent predators indefinitely could be a “sham” if no one is ever released back into society for completing treatment.
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The costly program, most recently called Sex Offender Rehabilitation and Treatment Services, or SORTS, began confining people deemed too likely to commit future sex crimes in 1999. The number of patients has risen each year, reaching nearly 200, including several who are elderly.

So far, nobody has completed treatment, making critics and patients believe SORTS is a prison disguised as a mental health hospital.

Initially based at the Southeast Missouri Mental Health Center in Farmington, Mo., the SORTS program has since also occupied dozens of beds at Fulton State Hospital. At last count, SORTS cost taxpayers $25 million a year, more than $300 a day per patient. About 20 names are added to the patient list annually.

“No one has ever graduated from [SORTS] and somewhere down the line, we have to do that or our treatment processes become a sham,” Keith Schafer, the leader of the Department of Mental Health, wrote in an email in 2009, according to documents obtained by the Post-Dispatch.

In a prepared statement this week, the Department of Mental Health played down the e-mail and indicated it was dated or out of context.

The department said the program meets nationally accepted standards for hospital care and is similar to other state programs.

The statement said three residents have been placed in conditional release since 2009, demonstrating that “residents can progress through treatment, which addresses Dr. Schafer’s concern.”

But those three are not allowed to venture far from the facility in Farmington, which sits next to a prison and residential area. They don’t leave SORTS overnight, or without security measures such as alerting local police well in advance.

The records the Post-Dispatch obtained are part of a class-action civil rights lawsuit that seeks to improve treatment so the patients have a reasonable chance of being released. The documents have not been filed for public view in court.

In 2009, Richard Scherrer, lead litigator for Clayton-based law firm Armstrong Teasdale, was appointed to the case on a pro bono basis by the U.S. District Court of Eastern Missouri. In a typical case, Scherrer is paid more than $500 an hour for his services.

The American Civil Liberties Union has also signed on to help plaintiffs.

Through discovery in the case, which is at a standstill, 500,000 pages of documents, internal emails and memos have been analyzed, including some that didn’t turn up for public view in other lawsuits levied against the facility.

Neither the ACLU nor Armstrong Teasdale provided the Post-Dispatch with records for this story. They were obtained after Scherrer, 66, recently asked the court to be relieved from the case for health reasons, which was said to devastate plaintiffs.

A new attorney was appointed Tuesday.

Scherrer declined to comment for this story because of the status of the litigation. Though he and other plaintiff attorneys have argued that SORTS is a “publicly run disaster, where the blame for such a mess falls at the feet of the highest levels of state government.”

In the internal correspondence, state officials exchange similar concerns.

“We are [a] disaster waiting to happen,” wrote Alan Blake, the former chief of operations at SORTS.

LEGAL CHALLENGES

Few people in the state are aware SORTS exists.
Former Gov. Mel Carnahan, a Democrat, pushed for its creation in the 1990s. It opened after a sex offender from St. Louis County promised he’d molest children again to embarrass officials once his prison sentence was fully served.

Now, he and others are held indefinitely after serving prison terms until their risk to re-offend falls to an acceptable level, which some argue will never happen.

Nineteen other states have civil commitment laws for violent sexual predators.

In September, SORTS was the topic of a lengthy report in the Post-Dispatch that laid out the case of pedophile Lester Bradley, a new arrival to the Farmington facility. He — along with others — refuses to participate in treatment because he said there’s no hope of completing it.

Prosecutors believe it’s a necessary program to protect some of society’s most vulnerable people from sexual predators. In the initial stages of the first state programs, the U.S. Supreme Court approved civil commitment law for sex predators.

Scores of lawsuits have since been filed by civil libertarians and other legal purists who say it’s a violation of rights, arguing that people are being punished twice for the same crime. Some patients say they would prefer to be in prison.

In Minnesota, a federal court has appointed a task force that recommended major reforms to its program. The state’s Legislature is debating the issue.

Mental health professionals have called the practice of civilly committing people deemed sex predators an “abuse of psychiatry.”

Some patients deemed low risk, like Bradley, were committed at the end of their prison terms despite agreement from a state-sanctioned panel of mental health professionals that believed they shouldn’t be in SORTS.

Juries that hear these cases often agree with state lawyers who argue that offenders should not be put back on the street, but rather in treatment until their “mental abnormality” is under control. But jurors aren’t told that no one has completed the treatment.

INTERNAL STRUGGLES

Correspondence among high-level SORTS employees portray the facility as struggling.
Schafer, director of the Department of Mental Health, at one point, seemed to want to distance the agency from civil commitments, hoping that stiffer sentencing laws for criminal trials would take over. But prosecutors have said tougher sentencing could hurt sex cases because evidence can be weak and cases tend to end in plea agreements.

Schafer wrote in a 2008 memo to the Legislature that the “end game” related to SORTS “is to avoid building new facilities for sexual predators as long as possible. New tougher sentencing laws will ultimately reduce the number of referrals to DMH, but this impact will not be felt until at least 10 years from now.”

Blake, the former director of operations at SORTS, wrote in emails that SORTS struggled with staff turnover and with obtaining treatment resources.

Blake’s emails include concerns that the “state keeps trying to get by on the cheap” with the program, saying it is “the DMH redheaded stepchild and they don’t care if we fail.”

Blake apparently thought SORTS could “take on the effect of a prison and be in violation of Supreme Court rulings” if cuts in funding were made.

“All this opens us to a federal lawsuit for providing substandard care. A successful lawsuit in this area will cost the state millions.”

In its response, the Department of Mental Health said this week that SORTS meets nationally accepted standards and that Blake’s comments “do not reflect the DMH position.”

“Since 2009, overall funding has not been reduced,” the agency said.

MEDICALLY FRAIL

One of the SORTS patients last summer was 85. Others have died there.
As many of the patients grow older, SORTS leaders have considered sending some of them to skilled nursing facilities, including those who “don’t represent a risk to the community,” according to internal correspondence.

But the transfers never happened outside of the security fences at SORTS.

“Conditional release of sex offenders, much less sexually violent predators, to a skilled nursing setting has recently been a state controversy,” Blake once wrote. “I fear we are going to have some major care failure that will contribute to my early retirement.”

In response to the comment, the Department of Mental Health said in its prepared statement: “There have been public discussions about moving some of the more medically frail SORTS residents to skilled nursing facilities. In lieu of that, a medically frail unit was established in 2012 at the SORTS facility at Southeast Missouri Mental Health Center.”

The agency did not respond to internal comments regarding the possible transfer of 16 SORTS patients to the St. Louis Psychiatric Rehabilitation Center, or SLPRC.

“The top 5 could go today,” Blake wrote. “The setting would likely enhance their treatment and provide motivation … a couple of them would make better employees at SLPRC than SLPRC has currently. Certainly they would be good peer counselors.”

Blake retired from the Department of Mental Health in 2012 and now works in South Carolina. He declined to comment.

Mark Carich has since started as director of treatment of SORTS, after doing similar work in Illinois. Somebody from an out-of-state civil commitment program asked Carich for a copy of the “goals grid” at the Missouri program for patients and treating staff.

In response, Carich wrote in July 2013: “The current goals grid is dysfunctional & is why we are developing something new.”

The Department of Mental Health played down the statement, emphasizing instead that “under Dr. Carich’s leadership, this system is currently under revision.” So is overall leadership of the SORTS facility in Farmington. Its director is leaving soon for a new job in Alaska.

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