Australians: Proposed paraphilia diagnoses 'dangerously circular'

Proposed expansions of the sexual disorders in the DSM are getting negative attention Down Under, with critics worried about the blurring of lines between bad behavior and mental illness, according to an article in today's Sydney Morning Herald.

The article in Australia's fourth-largest newspaper focuses on the expansion of pedophilia to include a hebephelic subtype and the placement of a "so-called paraphilic coercive disorder" (rape-proneness) in the upcoming manual's appendix as a proposed condition meriting further study.

Most mental health professionals in Australia use the American Psychiatric Association's diagnostic nomenclature, enshrined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), rather than the International Classification of Diseases (IMD), the international standard promulgated by the World Health Organization.

Australian psychiatrists and psychologists worry that the sexual disorder expansions will pave the way for more civil detention, in violation of the United Nations' International Covenant on Civil and Political Rights or, conversely, may be used by sex offenders to minimize or avoid legal punishment.

Indeed, in a case currently in the news in Melbourne, a well-known chef who sexually exploited vulnerable 13- and 14-year-old girls has introduced expert testimony on hebephilia as a mitigating factor. At a presentencing hearing, a defense-retained psychiatrist testified that Simon Humble suffered from hebephilia and would find prison difficult.

In addition to quoting clinicians and scholars in Australia, reporter Amy Corderoy reached across the Pacific to discuss the issue with your faithful blogger, a recent guest in Queensland; her article links back to this blog.

Forensic psychologist blackballed over competency opinions

Imagine that every time you evaluated a criminal defendant, a partisan advocate was standing by your shoulder, ready to accuse you of bias if you thought the defendant was incompetent to stand trial. To make matters worse, imagine you were assigned those defendants most likely to be impaired, due to developmental disabilities that interfere with their ability to understand their cases or work with their attorneys.

That's the pressure being applied to Ray Hendrickson, a respected forensic psychologist in the state of Washington. Accusing him of bias, local prosecutors have succeeded in getting him barred from examining criminal defendants in one Washington county.

"We have made it very clear that we don't approve of Dr. Hendrickson,"' a representative of the Pierce County (Tacoma) prosecutor's office told the local newspaper.

Prosecutors accuse Hendrickson of endangering public safety by finding too many defendants incompetent to stand trial. Hendrickson is a lead psychologist and training director at the Center for Forensic Services at Western State Hospital, one of two state hospitals where criminal defendants undergo competency and sanity evaluations and treatment under Washington’s centralized system.

The beleaguered psychologist is one of the only in-house experts qualified to evaluate defendants who have developmental disabilities as well as mental illness. As a hospital spokesperson pointed out, such defendants often are found incompetent to stand trial because they are too impaired to understand their cases or assist their attorneys in their defense.

The hospital said it acceded to prosecutors' demands under duress, because state law entitles the prosecuting attorney to approve one of the two experts appointed to conduct a competency or sanity evaluation.

To challenge Hendrickson, prosecutors pored over felony cases in which defendants were found incompetent to stand trial. Hendrickson was involved in almost half of 30 such cases over a 3-year period, they claim. One case highlighted in the news involved a developmentally disabled man accused of stabbing his girlfriend. After being found unrestorable to competency, the man was ultimately released from the hospital.

(The local news article incorrectly states that defendants found incompetent to stand trial on violent felony charges typically have their cases dismissed. In actuality, most stand trial after undergoing competency restoration treatment; only a small percentage are found unrestorable after one year of treatment, making them eligible for civil commitment if they remain dangerous.)

Defense attorneys are livid, calling the attack on Hendrickson a naked power play intended to strip criminal defendants of their right to an impartial evaluation. This is at least the second time in recent memory that Pierce County authorities have successfully objected to a respected and skilled evaluator with whom they did not see eye to eye.

Such partisan interference will only increase the pressure faced by many evaluators in state hospital settings, where beds are increasingly scarce, to find defendants competent in order to help the criminal justice process speed things along.

Having done my forensic postdoctoral fellowship in the forensic unit at Western State Hospital in the 1990s, I find this news especially sad. Back when I was there, the unit was a top-notch training site, where evaluators were given the resources, training and support to perform neutral, high-quality forensic evaluations.

Although even back then the state evaluators had a reputation of prosecutorial bias, in reality we had the independence to let the chips fall where they may. As prosecutors were fond of eliciting from us under direct examination, we didn't have to worry about earning referrals, and we got paid the same no matter which side won or lost a case.

But if prosecutors blackball experts with whom they disagree, it will be hard for them to honestly claim that their hand-picked psychologists are truly independent.

Even more ominous is a bill being considered by the state’s legislature that would require only one expert -- approved by the state -- in competency cases. The defense could request a second expert under the proposed law, but such a request would not be automatically granted.

Such a move might seem to make fiscal sense. But, given the poor rates of agreement among competency evaluators, it may be penny-wise but pound-foolish. According to a new study out of Hawaii, for example, competency evaluators disagree in about two or three cases out of every ten. That's in part because competency is nuanced. Evaluators tend to concur in obvious cases involving florid psychosis, but may arrive at different opinions in gray cases in the middle of the competency continuum.

Since judges tend to rubber-stamp experts' opinions, having only one evaluator will substantially increase rates of error. Some cases will be unnecessarily delayed while defendants undergo needless (and costly) treatment; at the other end of the spectrum, some defendants will  be unfairly convicted, undergoing trials without understanding the proceedings or being able to assist their attorneys.

Winnowing the process down to one potentially idiosyncratic opinion, or forcing out well qualified evaluators based upon their rates of incompetency findings, will make the process more unreliable and, in the end, hinder justice.

Related blog post:

How competent are the competency evaluators? Largest real-world study finds modest agreement among independent alienists (Jan. 21, 2011)

Hat tip: Ken Pope

Blogger urges new paradigm for sex offenders

Clarence Opheim, sentenced to 4 years
in prison back in 1988

Among sex offenders in Minnesota, Clarence Opheim is a very important man. After 20 years of treatment, the 64-year-old pedophile will be the second person ever released from civil detention in the North Star State, which holds the dubious distinction of having the highest per capita civil commitment rate.

The other 639 detainees are pinning all their hopes on next month's provisional release. If Opheim can make it, maybe they can too. The only other guy who came out except in a body bag violated his release conditions and in 2003 was returned to detention, where he died at age 45 of a heart attack. [See comments section for more on him.]

The program has been under pressure to release someone; otherwise, it might be found Unconstitutional: The legal premise behind civilly detaining people for crimes that are only remote future possibilities is not that they will be locked up forever, but that they will be treated and then released.

Although some are cheering this as a major turning point in the civil commitment industry, one prominent Minnesota clinician says the celebration is premature: What we really need is a bold paradigm shift in which industry leaders reject civil commitment altogether.

Comparing the civil commitment of sex offenders to the interment of Japanese during World War II, Jon Brandt asks, “If hindsight is 20/20, when we look back at sex offender civil commitment many years in the future, will we be proud of the roles that we had today?"

Brandt, a social worker, directs a residential treatment program for adolescent boys. He is also an expert witness in juvenile proceedings and a frequent professional trainer and media commentator who has addressed the Minnesota legislature on child welfare issues.

In his guest post on the blog of the influential Association for the Treatment of Sexual Abusers (ATSA), Brandt says the industry may have painted itself into a corner through its timidity about releasing sex offenders back into the community:

The Moose Lake detention site

It is not just in everyone's interest that Mr. Opheim succeeds; it is imperative. Consider the alternative: If the second of only two discharges in MSOP [the Minnesota Sex Offender Program] history fails, for any reason, both failures will be seen as a malfunction of both MSOP and SOCC [sex offender civil commitment]. A second unsuccessful discharge is not only likely to have far-reaching consequences for sexual offender management in Minnesota; a seismic "thud" may well be heard at ATSA listening posts across the country. In addition, it would be hard for the courts to ignore.

SOCC in Minnesota may now be painted into a corner. In the interest of public safety we may have compromised Constitutional protections beyond integrity. Perhaps Ben Franklin's quote is apt, that "those who would give up essential liberty to purchase a little safety deserve neither liberty nor safety."

Brandt urges ATSA to take the lead in challenging civil commitment, based on the low rates of sex offender recidivism established through empirical research including a new survey in Connecticut that found that only 3.6 percent of parolees who had served a prison term for a sex crime were arrested and charged with a new sex crime:

We have very solid empirical evidence to challenge current misguided public policies. We need to get good research to the right folks. We need to infuse policy makers with the necessary information for bureaucracies to champion productive recommendations into meaningful change…. If we use our knowledge and expertise to educate the public, inform our colleagues, and persuade policymakers that best practices should emanate from good science, we might not have to settle for incremental changes. We can help create new paradigms….

If professionals who work with sexual offenders do not challenge the politics, misinformation, and misguided management of sex offender civil commitment, where is a more credible voice going to come from? In an area of public policy where reason is often eclipsed by emotion, ATSA members may be in the best position to know the research, understand competing principles, and advocate for sound rationales. If forensic psychology with sexual offenders is being dominated more by forensics than psychology, I would suggest that the tail might be wagging the dog.

I recommend reading the entire post, available HERE.

Treatment and risk among the most dangerous sex offenders

 Study questions need for lengthy treatment of detainees 

McNeil Island with prison ferry in foreground

McNeil Island is a lonesome place these days. In a cost-saving moving, the state of Washington has shuttered the prison. The McNeil Island Correctional Center was the last of its kind, the twin sister of the more infamous Alcatraz Penitentiary in the San Francisco Bay.

Back when I briefly worked there in the late 1990s, it was a rustic place, its forests and overgrown orchards teeming with deer and other wildlife. Now, it is dominated by a modern civil detention site housing about 284 sex offenders. Built at a cost of $60 million, the Special Commitment Center costs another $133 million* per year to run, at a time of massive cuts to essential public services.

Special Commitment Center (photo credit: Seattle Times)

Although Washington holds the distinction of housing civil detainees on a remote island that can only be reached by air or water, the state's larger quandary is not unique. Swept along by public panics and political posturing, 20 U.S. states have approved civil detention programs that are becoming costly albatrosses.

The 30 other U.S. states, as well as other countries around the world, are in a position to ridicule the obscenely high costs of indefinitely quarantining such small handfuls of offenders.

Our neighbors to the north are far more sensible, as it turns out. At the Regional Treatment Centre (RTC) in Kingston, Ontario, Canada, civil commitment is nonexistent, and the highest-risk sex offenders may be released after an average of just seven months of treatment.

And how many of those bad actors go on to sexually reoffend after their brief but intensive treatment?

Fewer than 6 percent, according to a new study. Although the study's 2.5-year follow-up period is relatively short, the findings echo those of a previous study by co-author Jeffrey Abracen and colleagues, finding that even after nine years, only about 10 percent of offenders released from the RTC had reoffended.

Comparing high-risk Canadian sex offenders with similarly dangerous offenders civilly committed in the U.S. state of Florida, the researchers found the two populations to be virtually identical. Of the 31 sex offenders released in Florida, only one (or 3 percent) sexually reoffended. Because so few sex offenders are being released from civil detention sites in the United States, it is difficult to accurately estimate how many of them might reoffend in the community; this study could help to fill this gap, by providing a proxy group.

The low recidivism rates in Canada after only brief treatment suggests that the interminable treatment regimens at U.S. civil commitment sites, which typically last for years and years, are "more cultural than practical," reflecting the U.S. propensity for severe punishment, according to the study's authors, Robin Wilson and Donald Pake Jr. of Florida and Jan Looman and Jeffrey Abracen of Canada. One downside of such interminable treatment is that offenders may become institutionalized, with negative affects on their personalities, the authors suggest.

The researchers highlighted the fact that despite being among the highest-risk sex offenders from their respective prison systems, both the Canadian and U.S. offenders reoffended at rates far below those predicted by the Static-99 and Static-99R, the most widely used actuarial instruments for predicting recidivism.

These researchers are not the only ones coming to the conclusion that the actuarial instruments drastically overpredict recidivism. In the state of Virginia, lawmakers are questioning the use of the Static-99 after noting that civil commitment recommendations shot up when the state began mandating use of the Static-99 in 2006, jumping from about 7 percent to 25 percent of all sex offenders being released from prison.

"When the test was designated in law in 2006, it was believed that a score of 5 meant that the offender was 32 percent likely to commit another sex crime," according to a news report. "Updates have brought that risk down to about 11 percent. Researchers say that even may be too high."

Echoing what many of us have been saying for several years now, a study by Virginia's Joint Legislative Audit and Review Commission, the investigative arm of that state's General Assembly, concluded that the Static-99 is not all that accurate for assessing the risk of specific individuals, as opposed to groups.

Rather than scrapping the civil commitment program altogether, and saving themselves a cool $23 million per year, the first state to mandate the Static-99 almost did a 180 to become the first state to scrap its use altogether. Proposed legislation would have entirely "eliminate[d] the use of the Static-99 assessment instrument" for civil commitment purposes. For some reason, though, that language was removed from the most current version of House Bill 1271.

Stay tuned. As more solid research begins to overtake the hype, these and other political skirmishes are likely to become more common in financially desperate states. Eventually, I predict the entire civil commitment enterprise will hit the scrap pile as did the old sexual psychopath laws of the 1950s, but not before 20 U.S. states and the federal government squander many, many more millions of public dollars.

The study is: Comparing Sexual Offenders at the Regional Treatment Centre (Ontario) and the Florida Civil Commitment Center by Robin Wilson, Jan Looman, Jeffrey Abracen and Donald Pake Jr., forthcoming from the International Journal of Offender Therapy and Comparative Criminology. To request a copy of this article, you may email co-author Jan Looman (CLICK HERE). Thank you, Dr. Looman.

*See comment by Becky, below, who found the exact cost in the current state budget.

Who wants us to wear wizard suits, and why?

A blog subscriber from Spain, Professor Antonio Andres Pueyo of the Universidad de Barcelona, asked me to play Snopes detective on some blogosphere buzz: Was legislation really introduced in New Mexico stating that psychologists and psychiatrists must wear wizard outfits when testifying as experts?

The story turns out to be true. Here’s the actual text:

When a psychologist or psychiatrist testifies during a defendant's competency hearing, the psychologist or psychiatrist shall wear a cone-shaped hat that is not less than two feet tall. The surface of the hat shall be imprinted with stars and lightning bolts. Additionally, the psychologist or psychiatrist shall be required to don a white beard that is not less than eighteen inches in length, and shall punctuate crucial elements of his testimony by stabbing the air with a wand. Whenever a psychologist or psychiatrist provides expert testimony regarding the defendant's competency, the bailiff shall dim the courtroom lights and administer two strikes to a Chinese gong.

The amendment was tacked onto a 1995 bill addressing licensing guidelines for psychiatrists and psychologists in the Land of Enchantment. Approved by a voice vote in the state senate, it fizzled out in the house of representatives.(1)

Although it was never enacted, its author likely owes his 15 minutes of fame to that single little dead-end amendment. It continues to be widely cited in articles and books; now, 17 years later, it has suddenly gained notice in the blogosphere, ping-ponging from Magraken’s BC Injury Law blog to Overlawyered to Mind Hacks, and many more.(2)

But Professor Pueyo's query about the veracity of the fated legislation sparked my curiosity. Why was it written? And why its lasting allure?

Is that all there is?

Yes, it's catchy and colorful. But what accounts for its remarkable staying power and ability to bounce back from the dead? (Can you tell I’ve been reading zombie novels? I just finished Colson Whitehead's Zone One, which I recommend to any of you zombie fans out there.)

The amendment's author, ex-state senator Duncan Scott, wrote it not just as a harmless prank. Satire is a powerful weapon, and the goal of the hard-core Republican, as he told Harper's Magazine at the time, was to highlight his disapproval of the use of insanity pleas in criminal trials. (Ironically, his language confuses insanity with incompetency, which as we all know is a different matter altogether.)

Just as panic over bogeyman sex offenders is all the rage today, a perceived rise in insanity verdicts was a hot-button topic in the 1980s and 1990s, in the wake of John Hinckley's insanity acquittal in the attempted assassination of President Ronald Reagan. The verdict triggered widespread public concern over the reliability of psychiatric testimony, and the U.S. Congress and half of the states changed their laws to limit or eliminate the insanity defense.

In reality, the popular concern was misplaced. Insanity is very rarely invoked as a defense, being used in less than one percent of cases, and it is successful even more rarely. And, contrary to public opinion, forensic psychologists and psychiatrists who evaluate a defendant's mental state are most likely to conclude that he or she does not meet the legal threshold for insanity.

So who continues to cite the wizard amendment in books and articles, and for what purpose?

Not surprisingly, the Scientologists -- haters of all things psychiatric -- were among the first to embrace it. A 1997 article in the Scientology front magazine USA Today (no relation to the newspaper), blaming psychiatry for "the breakdown of law and order," leads off with the amendment.

Other critics of psychiatry, including Thomas Szasz and Tana Dineen, jumped aboard the train, approvingly citing the wizard passage in their books. Even the authors of forensic how-to texts, such as Christopher Slobogin, Ralph Slovenko, and Robert Meyer and Christopher Weaver, took to citing the passage, as a cautionary message about forensic excesses and overconfidence in prediction.

Walter Olson, Senior Fellow, Cato Institute

And then there's the resurrection of the wizard amendment in the blogosphere. No doubt, many posters are just enchanted by the guffaw factor. But it is no coincidence that its most prominent disseminator is Overlawyered. This blog (which claims to be "the oldest law blog") is the mouthpiece of Walter Olson, a senior fellow at the conservative think tank the Cato Institute; formerly, Olson was with the Manhattan Institute, a right-wing think tank founded by former CIA director William Casey.

You have to give these people their props. They are pure geniuses when it comes to spinning the news to illustrate the supposed excesses of the civil trial system, as in the infamous case of the scalding McDonald's coffee. (For more on that, check out the new movie, Hot Coffee.) By exaggerating the costs and ignoring the benefits of the U.S. tort system, they aim to limit class action lawsuits and other methods for citizens to seek redress when they are injured by corporate greed and malfeasance.

And the wizard satire is brilliant in tapping into not only rancor toward the trial system, but also deep-seated cultural hostility toward the intelligentsia, the class resentments so deftly harnessed by Sarah Palin and the Tea Party back in 2008.

As readers know, I am the last to defend arrogant forensic psychiatrists and psychologists; this blog is known for blowing the whistle on our field's excesses: The $500,000 competency report, the "boatloads" of cash earned by some government evaluators, the bogus psychiatric diagnoses being promulgated in sexually violent predator cases.

But, let's face it. By and large forensic evaluators are pawns, not chess masters. We are invited into the legal realm by attorneys and courts, and serve at their discretion. While a few of us may exhibit an arrogance meriting a wizard hat, by and large forensic practitioners are appropriately humble and honest, and make every effort to remain within the limits of our science.

So, while the wizard amendment may be humorous at first blush, the meaning behind the message turns out to be anything but funny.

Notes:

(1) There are different versions of its progress through the legislature. Harper's Magazine, in a July 1995 report, said it was approved by the state senate but rejected by the house of representatives. Another popular scenario has it winning in both the senate and the house, the latter by a vote of 46-14, before being vetoed by the governor. The amendment's author, Duncan Scott, gave a different account to blogger Erik Magraken, saying the language was removed before the bill even reached the house. The online records of the New Mexico Legislature only go back as far as 1996, but if anyone wants to dig back through the paper records, the citation is: Senate Floor Amendment 1 to Senate Bill 459 (Richard Romero), 42nd Leg., 1st Session (New Mexico 1995). 

(2) My favorite blog post on the wizard amendment is by Tom Freeland, a Mississippi lawyer, who said the provision reminded him of one tacked onto a "victim’s rights" bill being pushed through the Mississippi senate, which would have granted victims the right to sit at the counsel table in a criminal trial. A Mississippi senator, Hob Bryan, "annoyed proponents by moving that the provision be waived in murder cases," Freeland reported.

Ambitious competency project launched

The National Judicial College has just launched an amazing online resource on competency. The goal of the "Mental Competency – Best Practices Model" is to present practices deemed to be most effective and efficient for handling mental competency issues in the criminal justice and mental health systems.

If you do any competency related work, I strongly encourage you to check out the fabulous website. It's got step-by-step tutorials, taking you all the way from the initial referral to the evaluation and report to contested hearings and competency restoration treatment. The website boasts an array of other resources, including videos of mock competency hearings, sample reports and templates, and links to articles, case law, and state-by-state statutes.

They’ve even started a mental competency blog, which aims to keep readers apprised of court decisions and other competency related news.

With funding from the Department of Justice, the National Judicial College plans to present a series of three webinars on best practices in competency. You can sign up on the website to be notified of the dates, or just watch them after they are posted on the website.

Forensic psychologists who assisted with the ambitious project include Patricia Zapf of the John Jay College of Criminal Justice in New York, Mary Alice Conroy of Sam Houston State University in Texas, Joel Dvoskin of the University of Arizona, Floyd Jennings of the Harris County (Texas) Public Defender's Office, and Karen Bailey-Smith and Lenny Bailey, both of the Georgia Department of Behavioral Health and Developmental Disabilities.

Kudos to all!

California adopts Edwards: OK to deny self-representation to mentally ill

Mentally ill defendants in California may be barred from representing themselves at trial even when they have been found competent to stand trial, the state Supreme Court has decided.

This week's ruling stems from the 2008 U.S. Supreme Court case of Indiana v. Edwards, which held that states may set higher standards for self-representation than for competency to proceed to trial with an attorney.

The court upheld the conviction of Andrew D. Johnson of Vallejo, sentenced under California’s three-strikes law to 85 years to life in prison for two severe assaults.

Earlier in the proceedings, a jury had found Johnson competent to stand trial.The trial judge had initially let Johnson represent himself, but changed his mind based on Johnson’s bizarre behavior and filing of nonsensical motions.

The state high court cautioned that trial courts "must apply this standard cautiously," as under normal circumstances defendants have a Sixth Amendment right to represent themselves: "A court may not deny self-representation merely because it believes the matter could be tried more efficiently, or even more fairly, with attorneys on both sides."

No uniform standard

Several interested parties -- including the California Attorney General, San Francisco Public Defender, California Attorneys for Criminal Justice, and the Office of the State Public Defender -- had filed amici curiae arguing that California courts should have discretion to deny self-representation to "gray-area" defendants such as Johnson.

In their briefs, these parties proposed various standards for competency for self-representation that the court might adopt. But the court declined to adopt any of these specific standards, or those proposed in two recent law review articles, "pending further guidance from the high court."

In a footnote, the court also suggested that courts may choose to include the question of self-representation competence in routine trial-competency evaluation requests, even when the issue has not been raised.

This will leave court-appointed experts in an awkward position, tasked with evaluating "simply whether the defendant suffers from a severe mental illness to the point where he or she cannot carry out the basic tasks needed to present the defense without the help of counsel."

Such murkiness will increase the complexity of competency evaluations for forensic psychologists and psychiatrists. This is especially problematic in that court-appointed experts are grossly undercompensated, which attracts inexperienced and poorly trained professionals willing to perform what one attorney I know refers to as "drive-by competency evaluations."

When a defendant refuses evaluation

In his appeal, Johnson also complained that none of the experts appointed to evaluate his trial competency ever interviewed him personally. In fact, that was because he refused to meet with any of them.

The court said that the when a defendant refuses to be evaluated, the judge and jury must "do the best they can under the circumstances," as occurred here.

At the competency trial, psychologist Kathleen O'Meara, called by the defense, made clear that her opinion was tentative in that it was based solely on transcripts of the pretrial proceedings, defendant's letters, medical records and conversations with correctional staff. She speculated that defendant might have a paranoid delusional disorder, but that he could also be malingering.

Two psychiatrists called by the prosecution, Herb McGrew and Murray Eiland, both testified that it was not possible to form an opinion on competency without interviewing the defendant.

Sticky wicket

The Edwards decision expands the parens patriae doctrine, subordinating autonomy for ostensible fairness. In deciding that the mentally ill do not have the same constitutional rights as everyone else, the U.S. Supreme Court set up a very difficult situation.

On the one hand, allowing floridly psychotic defendants to represent themselves sanctions court-assisted suicide in that conviction is almost always assured, as in the farcical spectacle of Colin Ferguson's trial in the Long Island Railroad massacre.

On the other hand, since the U.S. trial system gives full authority to the attorney to conduct the defense as he or she sees fit, a defendant who has not consented to legal representation is stripped of the right to present his own defense. And, since no judge wants an inexperienced, potentially disruptive defendant mucking up their courtroom, it is tempting to find a problem defendant competent to stand trial, but then force him to accept an attorney -- and a defense -- that he may not want.

Related reading:

How will Edwards affect competency evaluations? (June 20, 2008 blog post)

Mentally ill: No constitutional right to self representation (June 19, 2008 blog post)

Fools competent to represent themselves at trial: Buffoonery doesn’t qualify under Edwards, appellates rule (July 7, 2010 blog post)

Defending the Right to Self Representation: An Empirical Look at the Pro Se Felony Defendant, Erica J. Hashimoto, North Carolina Law Review (2007) [free, open-access download]

Defending Oneself, Erica Hashimoto

COMPETENCY CASE RESOURCES WEB PAGE

Why does the United States lock up so many people?

Freedom is seldom found

By beating someone to the ground

-- Amos Lee, Freedom

Prisoner sketch, Pelican Bay SHU

The statistics are shocking: One out of every 99 adults quarantined behind bars in the United States, with larger and larger swaths of the civilian work force deployed as a captor class. Although academic scholars have been analyzing the social costs of our 30-year punishment binge for some time, the American public has been oddly disinterested in our de-evolution into a full-blown prison nation.

Finally, that appears to be changing, perhaps in no small part due to the staggering financial costs of mass incarceration during these tough economic times. The direct costs of prisons have quadrupled over two decades, to almost $40 billion a year in the 40 states sampled in a new report by the Vera Institute of Justice's Center on Sentencing and Corrections.

Now, award-winning New Yorker writer Adam Gopnik has stepped up to ask the essential question: WHY do we lock up so many people?

After all, he points out in his essay, "The Caging of America," New York City has managed to buck the incarceration trend, while seeing its crime rate plummet by as much as 80 percent (the topic of criminology scholar Franklin E. Zimring's new book, The City That Became Safe).

Gopnik writes with the outrage of an outsider whose blindfolds were suddenly yanked away to reveal the carceral state in all of its nightmarish savagery:

Death row, Tennessee

Mass incarceration on a scale almost unexampled in human history is a fundamental fact of our country today -- perhaps the fundamental fact, as slavery was the fundamental fact of 1850.

The scale and the brutality of our prisons are the moral scandal of American life. Every day, at least 50,000 men -- a full house at Yankee Stadium -- wake in solitary confinement, often in "supermax" prisons or prison wings, in which men are locked in small cells, where they see no one, cannot freely read and write, and are allowed out just once a day for an hour's solo "exercise." (Lock yourself in your bathroom and then imagine you have to stay there for the next ten years, and you will have some sense of the experience.)

How did we get here? How is it that our civilization, which rejects hanging and flogging and disembowelling, came to believe that caging vast numbers of people for decades is an acceptably humane sanction?

To answer his question, Gopnik weaves together two strands of American history, what we might call the Southern and the Northern penal traditions.

Juvenile In Justice, Richard Ross

The new Jim Crow

The Southern strand, most recently articulated by Michelle Alexander, posits that penal colonies arose to replace the slave plantations in the post-Reconstruction South, with mass incarceration functioning as "The New Jim Crow" for poor African American men in the post-civil rights era. It's hard to argue with the statistics: More than half of American black men without a high-school diploma go to prison at some time in their lives, and more of these men are trapped in today's criminal justice system than were enslaved prior to the Civil War:

Young black men pass quickly from a period of police harassment into a period of "formal control" (i.e., actual imprisonment) and then are doomed for life to a system of "invisible control." Prevented from voting, legally discriminated against for the rest of their lives, most will cycle back through the prison system. The system, in this view, is not really broken; it is doing what it was designed to do.

Procedural justice

Many of you may be familiar with this notion of South's white supremacist contribution to the carceral state, but you may be surprised to learn about the North's major hypothesized contribution: the Bill of Rights.

Wait a minute. Weren't our founding fathers all about protecting our rights, making sure that we were never again victimized by the cruel rule of tyrants?

In blaming the Bill of Rights, Gopnik channels Harvard Law School professor William J. Stuntz, who died just before last fall's publication of his The Collapse of American Criminal Justice, which argues that the Enlightenment era saw the elevation of procedural rights at the expense of moral justice.

The trouble with the Bill of Rights, [Stuntz] argues, is that it emphasizes process and procedure rather than principles…. This emphasis, Stuntz thinks, has led to the current mess, where accused criminals get laboriously articulated protection against procedural errors and no protection at all against outrageous and obvious violations of simple justice.

Thus, in our increasingly impersonal and bureaucratic world, rather than the nemesis of the brutal prison, due process is actually its mirror image:

The more professionalized and procedural a system is, the more insulated we become from its real effects on real people…. Once the procedure ends, the penalty begins, and, as long as the cruelty is routine, our civil responsibility toward the punished is over. We lock men up and forget about their existence.

Gopnik's essay, which I highly recommend, can be found HERE.

Juror’s bad dream becomes defense nightmare

What would you do if you were defending a man accused of bludgeoning someone to death with a baseball bat, and a juror disclosed having a nightmare in which the defendant chased her around with a baseball bat?

You might request that the juror be dismissed.

That’s what happened this week in a murder trial St. Lawrence County, New York.

But the judge denied the defense request, despite a plea from the juror's family that she is emotionally overwhelmed by the case. Besides her nightmare, the juror also told the court that she started crying when she saw her father sitting in a recliner that reminded her of the chair in which the dead man was found.

The ruling shocked the defendant.

"I just about fell over," defendant Wayne T. Oxley Jr told a reporter. "I was pretty shocked she stayed on the jury. I kind of lost my breath."

The prosecuting attorney said it wouldn't be fair to discharge a juror just because of what she dreamed. "Dreams are dreams, you can't make them not happen," said the attorney.

Prominent forensic psychologist Saul Kassin of the John Jay College of Criminal Justice disagreed.

"It's clear she has formed a negative emotional opinion," Kassin told a reporter from the Watertown Daily Times. "If I were on the defense team, that would make me nervous. People often have difficulty separating reality from fantasy."

This is Oxley's third trial. The first ended with a conviction for second-degree murder, later overturned on appeal. A retrial ended in a hung jury. If Oxley is convicted and successfully appeals based on the juror's emotional bias, Judge Jerome J. Richards's ruling could end up a nightmare for him as well.

Federal judge tosses hebephilia as basis for civil detention

Hebephilia is too controversial for the government to use it to claim that a sex offender has a serious mental disorder meriting civil commitment in order to protect the public, a federal judge ruled Thursday.

Judge Terrence Boyle

In ordering the release of convicted sex offender Jeffrey Neuhauser, the judge also found that the government had failed to prove that the prisoner was at high risk to reoffend or would have serious difficulty controlling his impulses.

"The Court finds that it would be inappropriate to predicate civil commitment on a diagnosis that a large number of clinical psychologists believe is not a diagnosis at all, at least for forensic purposes," wrote Judge Terrence W. Boyle of the U.S. District Court for the Eastern District of North Carolina. "Although hebephilia has been proposed to be included as a mental disorder in the revision of the DSM, it has been rejected as a proper mental disorder by numerous psychologists.”

Two of those psychologists, Diane Lytton and Richard Wollert, were retained in the case by Suzanne Little of the Federal Public Defender. Lytton testified that the residual diagnostic category of "paraphilia not otherwise specified" was never intended to turn criminal behaviors such as sex acts with minors into mental illnesses.

Even the government's own expert, Gary Zinik, conceded that the legitimacy of hebephilia is a hotly contested issue in the mental health community, the judge noted.

The pseudoscientific label is typically assigned by government experts when an offender is neither a rapist nor a pedophile, bur rather has offended against more physically mature minors.

Neuhauser acknowledged a sexual preference for pubescent boys. He served federal prison time for distributing child pornography and two counts of interstate travel with the intent to engage in sex with a minor. He also had previous convictions for contributing to the sexual delinquency of a child and assault and battery in connection with the attempted sodomy of a 14-year-old boy.

Disturbance Control Team patch, Butner prison

Boyle's ruling may impact other federal prisoners facing civil detention, as nearly all of the 130 or so federal prisoners that the government is seeking to detain under the Adam Walsh Act of 2006 are housed at a federal prison in Butner, North Carolina, and so are processed through the North Carolina federal court.

Yesterday's ruling follows on the heels of another dismissal of a civil commitment petition by Senior U.S. District Judge Bernard A. Friedman. In a scatching critique of the prosecution's overblown claims of mental illness and risk, Judge Friedman opined that sex offender Markis Revland had fabricated accounts of child molestation in order to placate therapists at the Butner prison.

In Neuhauser's case, Judge Boyle stated that even if hebephilia was a legitimate diagnostic label, the government still did not meet its burden of proving by clear and convincing evidence that the convicted sex offender is at a high risk to reoffend.

He credited the defense experts' analyses of risk as being more accurate than the prosecution's. Wollert relied on an actuarial tool he helped to develop, the Multisample Age-Stratified Table of Sexual Recidivism Rates (MATS-1). (See my review here.) Other actuarial tools used by the various experts included the Static 99-R, the Static 2002-R and the MnSOST-R, which is widely known to overestimate sex offenders' risk of recidivism.

"It should be noted that results of these assessments depend heavily on the choice of reference group to which the respondent is compared," the judge aptly noted. "Because Drs. Wollert and Lytton analyzed their actuarial results in light of Mr. Neuhauser's advanced age, his ability to control his behavior while in the community, his pattern of offending (in particular, the fact that his first victim was by force and later victims willingly participated even though they could not give legal consent due to their age), and the fact that Mr. Neuhauser had not been subject to any deterrent sanctions until his most recent prison sentence, the Court finds their actuarial assessments to more accurately reflect Mr. Neuhauser's likelihood of recidivism."

Boyle said he was impressed by the offender's honesty, remorse and genuine desire to control his illegal behavior: "He openly discussed his sexual orientation toward pubescent boys but demonstrated a true understanding that boys of that age are unable to legally consent to sexual activity, even if they appear to him to be willing to engage in sexual contact…. Mr. Neuhauser's sexual orientation toward pubescent boys … is, standing alone, insufficient to justify his civil commitment under the Adam Walsh Act.… [T]here must be proof of serious difficulty in controlling behavior."

Boyle, by the way, is no political liberal. A former legislative assistant to arch-conservative Senator Jesse Helms of North Carolina, he was appointed to his present post by President Ronald Reagan back in 1984. Democrats later blocked President George W. Bush’s attempt to elevate him to an appellate judgeship, citing concerns over his civil rights record.

Neuhauser will be under parole supervision for five years, during which time he must undergo sex offender treatment and polygraph testing, avoid contact with minors, and submit to other special restrictions.

Further information on the hebephilia controversy is HERE.

Tearing the child apart: Free training in San Francisco

What motivates parents to -- either consciously or unconsciously -- damage or destroy their own children?

We know the complex psychological effects of high-conflict divorce, but how do we understand the contribution of narcissism, envy and perverse thinking?

This Saturday, Jan. 21, forensic psychologist Michael Donner, a psychoanalyst, child custody evaluator and ethicist, will take an analytic approach to questions usually considered part of the family court system.

Sponsored by the San Francisco Center for Psychoanalysis, Saturday's event features H. Spencer Bloch, MD,  author of Adolescent Development, Psychopathology, and Treatment, as discussant.

The event runs from 10:00 a.m. to noon and is free. To register, call Aaron Chow at (415) 563-5815 or email him HERE. More information and online registration is HERE.

Donner authored an excellent article by the same title in Psychoanalytic Psychology. Contact him (HERE) to request a copy of "Tearing Children Apart: The Contribution of Narcissism, Envy and Perverse Modes of Thought to Child Custody Wars."

Our broken family court system: Free training in Arizona

Another free training geared toward child custody evaluators is coming up March 16-17 in Phoenix, Arizona. Co-sponsored by the National Alliance of Professional Psychology Providers and the Nicholas and Dorothy Cummings Foundation, it features a cast of well-known experts, including:

• Dr. Lenore Walker (author of the classic, The Battered Woman’s Syndrome)
• David L. Shapiro, PhD
• G. Andrew H. Benjamin, JD, PhD, ABPP
• Judge Marjory Fields 
• John Caccavale, PhD (speaking on Business Ethics for Custody Evaluators)

More information and online registration is available HERE.

SEX PANIC: Highly recommended

As nightfall does not come at once, neither does oppression. In both instances, there is a twilight when everything remains seemingly unchanged. And it is in such twilight that we all must be most aware of change in the air – however slight – lest we become unwitting victims of the darkness.

-- Justice William O. Douglas 

The strands of modern American containment were woven so gradually that today's prison culture has come to feel almost natural. But imagine how the landscape might look to someone who was experimentally cryopreserved in, say, 1981, and thawed out 30 years later:

People cheerfully taking off their shoes and queuing up to be x-rayed by robotic agents of "Homeland Security," GPS satellite monitoring, DNA databases, civil detention for future crimes, online registries of drug offenders, surveillance cameras everywhere, "zero tolerance" schools where children are viewed as pint-sized criminals.

And, underlying it all, the new carceral state: A massive underclass of surplus labor (one out of every 99 adults) quarantined in prisons, with large swaths of the former industrial and agricultural laboring classes transformed into a security force of prison guards, parole agents and police working to generate yet more prisoners.

"By design this penal system churns the poor and marginal, rendering them all but unemployable, thus poorer and ever more marginal," writes anthropologist Roger Lancaster. "No legitimate theory of corrections, crime, or social order justifies this approach, which can only be understood as vindictive."

In Sex Panic and the Punitive State, Lancaster meticulously explains how 35 years of virtually nonstop panics over crime -- urban unrest in the 1960s, street crime in the 1970s, crack wars in the 1980s, predatory gangs in the 1990s, and terrorists in the 2000s -- have congealed into a durable regime dominated by irrational fear: "Power flows through the nervous system of a body politic paralyzed by dread. Ruled and rulers are equally trapped in fear."

Laying the groundwork for wave after wave of panics, Lancaster convincingly argues, is a synergy between deeply ingrained (but now covert) fears of black criminal-rapists and homosexual child molesters:

Sexual anxieties and fear of crime have come to form a dynamic feedback loop. On the one hand, it seems unlikely that revived sex panics would have put down such deep social roots except in the context of a wider war on crime. On the other hand, it also seems unlikely that crime fears could have become so finely woven into the fabric of everyday life without the element of sex panic.

The resulting system of social control is an amalgam of old and new elements. Its Puritanism, its paranoia about strange outsiders, its enactment of dramas of peril and rites of protection are as old as the United States itself; they are deeply embedded in the national psyche…. At the same time the resulting system of social control departs from long-standing liberal traditions that begin with a presumption of innocence, restrain the reach of law, defer to zones of privacy, and resist the application of excessive punishments or the tacking on of ex-post-facto provisions.

Lancaster sees the creation and privileging of a novel social category -- "the victim" -- as a powerful force in this new social order. In the name of this iconic crime victim, the enormously successful Victim's Rights Movement has led the charge to dismantle traditional legal protections, a trend that may be difficult if not impossible to ever reverse.

Perversely, increased repression of the American citizenry has arisen in tandem with the loosening of economic restraints on "capitalism’s most predatory forms" -- privatization, globalization and the corporations' relentless squeezing of what we now call the 99 percent.

In Lancaster's dystopic vision, America has degenerated into "a broken social order based on mistrust, resentment, and ill will," manifested in a mass addiction to dumbed-down, commercialized vengeance spectacles. We need look no further for evidence of this grim state of affairs than the vitriolic comments of YouTube viewers beneath the video of U.S. Marines urinating on the bodies of murdered Afghanis.

As with Abu Ghraib, we can safely bet that the four Marines will be sanctioned, while the structures that fostered their callous behavior will remain untouched. As Lancaster notes, this is all par for the course: "Any cultural system that equates punishment with justice will foster complicated forms of sadism. And any institutional system that inculcates intense fear and rage will produce technicians who periodically depart from standard operating procedures."

Many of you blog readers will have read other fine books on sex panic and the carceral state. But this meticulously researched and eloquently written analysis goes deeper and wider, masterfully integrating disparate historical, economic, religious and social trends. Lancaster delves at length into the complex interplay of racism and homophobia, even weaving in personal experiences as a gay man that helped to shape his thinking.

Bottom line: Read this landmark book; I guarantee it will enlighten.

A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual death.

-- Martin Luther King Jr. 

MANY THANKS TO BLOG READER JAMES H. FOR DONATING THIS BOOK.

AND THANKS TO THE ANONYMOUS BLOG READERS FOR THE OTHER BOOK DONATIONS.

As usual, if you appreciate this review, I will greatly appreciate your visiting the Amazon site (HERE) and clicking on "yes" (this review was helpful). 

Martin Luther King Jr. on maladjustment

Last year, in honor of Martin Luther King Day, I excerpted a large portion of a keynote speech the visionary civil rights leader delivered at the 1967 convention of the American Psychological Association, just seven months before he was gunned down and at a time when he was drawing larger connections between racial oppression and the Vietnam War. This year, I am excerpting only one short section, but I have made the entire speech, "The Role of the Behavioral Scientist in the Civil Rights Movement," available for download (HERE). It's 45 years old, but still remarkably relevant today.

There are certain technical words in every academic discipline which soon become stereotypes and even clichés. Every academic discipline has its technical nomenclature. You who are in the field of psychology have given us a great word. It is the word maladjusted. This word is probably used more than any other word in psychology. It is a good word; certainly it is good that in dealing with what the word implies you are declaring that destructive maladjustment should be destroyed. You are saying that all must seek the well-adjusted life in order to avoid neurotic and schizophrenic personalities.

But on the other hand, I am sure that we will recognize that there are some things in our society, some things in our world, to which we should never be adjusted. There are some things concerning which we must always be maladjusted if we are to be people of good will. We must never adjust ourselves to racial discrimination and racial segregation. We must never adjust ourselves to religious bigotry. We must never adjust ourselves to economic conditions that take necessities from the many to give luxuries to the few. We must never adjust ourselves to the madness of militarism, and the self-defeating effects of physical violence....

Thus, it may well be that our world is in dire need of a new organization, The International Association for the Advancement of Creative Maladjustment. Men and women should be as maladjusted as the prophet Amos, who in the midst of the injustices of his day, could cry out in words that echo across the centuries, 'Let justice roll down like waters and righteousness like a mighty stream'; or as maladjusted as Abraham Lincoln, who in the midst of his vacillations finally came to see that this nation could not survive half slave and half free; or as maladjusted as Thomas Jefferson, who in the midst of an age amazingly adjusted to slavery, could scratch across the pages of history, words lifted to cosmic proportions, 'We hold these truths to be self evident, that all men are created equal. That they are endowed by their creator with certain inalienable rights. And that among these are life, liberty, and the pursuit of happiness.' And through such creative maladjustment, we may be able to emerge from the bleak and desolate midnight of man’s inhumanity to man, into the bright and glittering daybreak of freedom and justice.

I have not lost hope. I must confess that these have been very difficult days for me personally. And these have been difficult days for every civil rights leader, for every lover of justice and peace.

Emboldened DSM-5 critics issue public challenge

In October, I reported on the Society for Humanistic Psychology's online petition urging the American Psychiatric Association to reconsider the mental illness expansions and biomedical emphasis proposed for its new diagnostic manual, due out in 2013.

Since then, the effort has taken off like wildfire. More than 10,000 people have signed the petition, and the fledgling Coalition for DSM-5 Reform has mushroomed to include 41 concerned mental health organizations in the United States, Britain and Denmark.

Now, the Coalition has posted an open letter calling upon the developers of the Diagnostic and Statistical Manual of Mental Disorders to submit controversial proposals in the DSM-5 to an independent group of scientists and scholars with no ties to either the DSM-5 Task Force or the American Psychiatric Association for an independent, external review.

"We respectfully ask that you not respond again with assurances about internal reviews and field trials because such assurances, at this point, are not sufficient," says the letter. "We believe an external, independent review is critical in terms of ensuring the proposed DSM-5 is safe and credible."

As the critics gain ground and the battle heats up, it will be very interesting to see how the beleaguered DSM-5 Task Force responds.

More developments on the sex offender front

Study finds problems with real-world reliability of Static-99

Evaluators differ almost half of the time in their scoring of the most widely used risk assessment instrument for sex offenders, the Static-99, according to a report in the current issue of Criminal Justice and Behavior. Even a one-point difference on the instrument can have substantial practical implications, both for individual sex offenders and for public policy. In by far the largest and most ecologically valid study of interrater agreement in Static-99 scoring, the research examined paired risk ratings for about 700 offenders in Texas and New Jersey. The findings call into question the typical practice of reporting only a single raw score, without providing confidence intervals that would take into account measurement error. The study, the latest in a line of similar research by Marcus Boccaccini, Daniel Murrie and colleagues, can be requested HERE.

California reining in SVP cowboys

Psychiatrist Allen Frances has more news coverage of a memorable state-sponsored training at which Sexually Violent Predator (SVP) evaluators were cautioned to be more prudent in their diagnostic practices. Ronald Mihordin, MD, JD, acting clinical director of the Department of Mental Health program, warned evaluators against cavalierly diagnosing men who have molested teenagers with “hebephilia” and rapists with “paraphilias not otherwise specified-nonconsent,” unofficial diagnoses not found in the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. California evaluators have come under fire in the past for billing upwards of $1 million per year conducting SVP evaluations of paroling prisoners. The PowerPoints of the 3-day training are now available online, at the DMH's website.

The neuroscience of sex offending

In preventive detention trials of sex offenders, forensic evaluators often testify about whether an offender lacks volitional control over his conduct. But how much do we really know about this? In the current issue of Aggression and Violent Behavior, forensic psychologist John Matthew Fabian explores the neuroscience literature on sex offending as it applies to civil commitment proceedings. The article can be viewed online, or requested from the author HERE.

Challenge to sex offender registry

Although the sex offender niche is by far the most partisan and contentious in forensic psychology, one thing that just about all informed professionals agree about is that sex offender registration laws do more harm than good. By permanently stigmatizing individuals, they hamper rehabilitation and reintegration; as Elizabeth Berenguer Megale of the Barry University School of Law explores in an essay in the Journal of Law and Social Deviance (full-text available HERE), they lead to a form of “social death.” Now, the California Coalition on Sexual Offending (CCOSO) and the Association for the Treatment of Sexual Abusers (ATSA) have filed a joint amicus brief in a challenge to California's "Jessica's Law," which bars registered sex offenders from living within 2,000 feet of any school or park. The amicus contends that the restriction is punishment without any rational purpose, in that it does not enhance public safely or deter future criminality. The challenge was brought by Steven Lloyd Mosley. After a jury found Mosley guilty of misdemeanor assault, a non-registerable offense, the sentencing judge ordered him to register anyway, ruling that the assault was sexually motivated. The 4th District Court of Appeal granted Mosley’s appeal, and the California Department of Corrections has appealed to the state's supreme court. We'll have to wait and see whether the high court will tackle the issue of registration laws directly, or will sidestep with a narrow, technical ruling.