Problems continue at newest California civil commitment center

I haven't seen much media coverage of a 3-month strike by civilly detained sex offenders at the new Coalinga State Hospital in California.

Today, the detainees issued a press release claiming that a patient's death last Thursday illustrated a pattern of inadequate medical care for the aging men. Frank Valado, 45, apparently collapsed and died while playing basketball last Thursday.

Although hospital administrators are denying the strike's existence, sex offenders say the nonviolent revolt is in its third month and that they have effectively shut down all sex offender treatment. Among the patients' main grievances are inadequate psychological evaluations and medical treatment. The average age of detainees is 51, about 20 years older than the average state prisoner in California, and many of the men have substantial and costly medical problems.

The $400 million hospital, which opened two years ago amid great fanfare, houses more than 600 patients out of a capacity of about 1,500. Most are sex offenders who completed their prison terms and were then civilly committed as Sexually Violent Predators.

The hospital has had enormous trouble recruiting staff; I personally have received multiple enticing offers to relocate to the tiny, out-of-the-way Central Valley hamlet that in my mind will always be connected with its 1983 earthquake. (After the quake, a popular T-shirt read, "Where the hell is Coalinga?") Last year, the L.A. Times reported on unrest among both patients and in-house police over the hospital's suspension of normal staffing levels due to an inability to recruit qualified staff. According to detainee spokesman Michael St. Martin, the hospital currently has only four licensed psychologists and only three psychiatrists, the latter recruited from India.

The latest problems come as the U.S. Department of Justice continues its probe into deficiencies in the state hospital system, including at Coalinga.Four of the five state hospitals in California are operating under a sweeping federal consent judgment reached last year. Earlier this year, staff members at Coalinga and other state hospitals protested outside their facilities to decry unsafe and deteriorating conditions, according to an L.A. Times article on May 22.

The detainees have a web site that is worth checking out. Other sources of information include a web site at Geocities and the Sex Gulag blog. On Aug. 27, KPFA radio also covered the strike, which started Aug. 6.

My related blog posts are here and here.

Mother prosecuted for talking to her children about sex

Just when you think you've heard the most ridiculous extreme to which the current sex hysteria can go, along comes something even more bizarre.

A Wisconsin woman was successfully prosecuted for talking to her children, ages 11 and 15, about sex, according to the Portage Daily Register.

Amy Smalley was prosecuted for the felony crime of exposing children to harmful descriptions, which carries a maximum penalty of three years in prison. She pleaded guilty so that her children would not have to testify. She was sentenced to probation and mandatory counseling.

Smalley's attorneys had argued unsuccessfully that Smalley's conversation with her children was protected free speech, and that the law under which she was prosecuted was aimed at protecting children from pornography, not preventing parents from providing their own children with information about sex.

Do mental health courts work?

From a new study published in the American Journal of Psychiatry:

Many communities have created specialized mental health courts in recent years. However, little research has been done to evaluate the criminal justice outcomes of such courts. This study evaluated whether a mental health court can reduce the risk of recidivism and violence by people with mental disorders who have been arrested. In this study, 170 people who went through a mental health court were compared with 8,067 other adults with mental disorders booked into an urban jail during the same period. Statistical analyses revealed that participation in the mental health court program was associated with longer time without any new criminal charges or new charges for violent crimes. Successful completion of the mental health court program was associated with maintenance of reductions in recidivism and violence after graduates were no longer under supervision of the mental health court. Overall, the results indicate that a mental health court can reduce recidivism and violence by people with mental disorders who are involved in the criminal justice system.

The report, “Effectiveness of a mental health court in reducing criminal recidivism and violence,” is by DE McNiel and RL Binder of the Langley Porter Psychiatric Institute in San Francisco. It was published in the September 2007 issue of the American Journal of Psychiatry (Volume 164 Number 9). For a reprint, contact the authors at dalem@lppi.uscsf.edu.

Claim in 15-year-old girl's stabbing will highlight prison failures

The family of a 15-year-old San Francisco girl who was severely stabbed by a paroled prisoner plans to file a claim against prison officials next Monday.

Scott Thomas, who was accidentally paroled from San Quentin Prison due to a clerical blunder, had a documented history of bipolar disorder and was flagged by guards as needing treatment that he never received, two prison clinicians secretly told the San Francisco Chronicle. He randomly stabbed the 15-year-old girl and a man who came to her rescue at a bakery. After his arrest, he mumbled, "I'm taking on the world" before breaking into incoherent song, according to a police report.

Accidental releases are lawsuits waiting to happen. And it is lamentable when prisoners slip through the cracks of psychiatric treatment. But these issues miss the bigger picture: Thomas, a repeat theft offender who was only violent when in prison, was released to the streets straight out of solitary confinement.

Recipe for violence

Imagine being locked up all by yourself in a windowless cement box no bigger than a bathroom. Imagine being all by yourself in that box for months on end. (Thomas was only in "the hole" for four months; some prisoners in supermax prisons are kept in isolation for decades).

As depicted in the 1973 Steve McQueen film Papillon, based on a true story about an escape from a prison colony in French Guiana, it doesn't take long to have a mental breakdown under these conditions. Just a couple of days of solitary confinement with sensory deprivation can trigger psychotic hallucinations. Ellectroencephalogram research shows that after only a few days in solitary confinement, prisoners' brain waves shift into a stuporous, delirious pattern.

Now imagine that you are locked up in that windowless little box when you are already mentally ill and tormented by demons inside of your head.

Many prisoners, such as Thomas, are already fragile and unstable. They are even more prone to psychiatric breakdown than are healthy people who did not undergo severe childhood trauma. Putting mentally ill prisoners in solitary confinement is like putting an asthmatic person in a room with no air, as a federal judge once put it.

When I worked in a segregation housing unit (SHU) for the mentally ill, I saw these effects first-hand. After a short time on the unit, many prisoners began to babble incoherently or to lie semi-comatose in a fetal ball. They screamed and yelled and hurled excrement and urine through the narrow slits in their cell doors. They tried to kill or mutilate themselves.

Further demolishing the psyches of these vulnerable prisoners is not only cruel, it is also a surefire recipe for community endangerment when they get released, as most eventually will. Some prison administrations have realized that discharging convicts straight from the hole to the streets is a dangerous practice. Oregon, for example, integrates prisoners back into the prison mainstream through classes and jobs before releasing them.

Despite the demonstrated, permanent harm to prisoners' psyches – which ultimately translates into harm to vulnerable victims such as the 15-year-old San Francisco girl – solitary confinement is on the rise. From 1995-2000, its use rose by a dramatic 40%, surpassing the overall prison population rise of 28% during that period.

"We have to ask ourselves why we're doing this," psychiatrist Stuart Grassian, a Harvard professor and expert on segregation psychosis, told Time magazine. (For more on Grassian and his research, see my web page on "segregation psychosis.")

Wouldn’t it be great if rationality and community safety prevailed, and this barbaric practice was put to rest? Perhaps more lawsuits like this family's will get the attention of prison officials.

National Public Radio has an excellent, three-part series by Laura Sullivan on solitary confinement. In one episode, she spends the day with Daud Tulam, a New Jersey man adjusting to life on the outside after 18 years in solitary confinement. Tulam struggles with the common everyday things that we all take for granted, such as smalltalk, noise, and mere human companionship.

Circumcision: Sexual abuse or religious freedom?

Circumcision is a hot topic this week. It's made its way in front of its highest court ever, in oral arguments before the Oregon Supreme Court.

In one corner, a father who recently converted to Judaism and wants to circumcise his 12-year-old son, over whom he has custody.

In the other corner, a mother who contends the religious rite is dangerous and amounts to sexual abuse.

It's not clear what the boy wants. According to an affidavit by the mother, the boy told her he did not want to be circumcised but was afraid of contradicting the father. (How many 12-year-old boys relish the prospect of a knife to the genitals?) But anyway, the father maintained in response to a question from one of the high court justices, the child's wishes are not legally relevant.

Do custodial parents have the right to impose genital mutilation or a nose job "on children whose faces are just fine," another justice asked the father. Yes, the father responded during this week's oral arguments; parents may do anything to their children that is not illegal, except perhaps tattoo "a swastika on the forehead."

The original trial court had ruled in favor of the husband, and an appellate court upheld that ruling.

Anti-circumcision groups and Jewish groups are weighing in with opposing amicus briefs in the case, which has a colorful history. According to court papers in a 1998 dispute over a restraining order, the wife - a Russian bride - was whipped by her husband while playing the role of "slave girl" to her "god" and "master."

With this week's hearing before a state high court, the ex-slave girl has certainly found her voice. Although if I had to bet, I'd wager that her ex-master will win this battle; courts do not like to interfere with custodial parents.

The Wall Street Journal's Law Blog, the New York Sun, and the Concurring Opinions blog have interesting coverage and commentary.

Thanks to subscriber Kirk Witherspoon for sending me the cool bear photo.

Of profiling, astrology, and magic

Malcolm Gladwell exposes the tricks of forensic profilers

The Rainbow Ruse, the Barnum Statement, the Fuzzy Fact, the Greener Grass technique, the Diverted Question, the Russian Doll, Sugar Lumps, Forking, and the Good Chance Guess.

These are all magic tricks described in the classic how-to manual of magician Ian Rowland, "The Full Facts Book of Cold Reading." When skillfully woven together, these tricks can convince even the most skeptical observer that you possess uncanny wisdom and insight.

For example, take the Rainbow Ruse. Here, one attributes to the listener both a personality trait and its opposite, as in: "I would say that on the whole you can be rather a quiet, self effacing type, but when the circumstances are right, you can be quite the life and soul of the party if the mood strikes you." Or, the Barnum Statement, an assertion so general that anyone would agree. And the Fuzzy Fact: a seemingly factual statement couched in ambiguity, as in: "I can see a connection with Europe, possibly Britain, or it could be the warmer, Mediterranean part?"

Writing in the Nov. 12 New Yorker magazine, Malcolm Gladwell presents a crash course in how such time-worn magic tricks have convinced the world of the scientific legitimacy and deductive powers of forensic profiling.

Like a fortune teller's prognostications, the profiles generated by famous FBI profilers John Douglas and Robert Ressler are "so full of unverifiable and contradictory and ambiguous language that [they] can support virtually any interpretation." The magic lies in the fact that police detectives and laypersons alike do not realize this without the aid of detailed, sentence-by-sentence analyses.

Gladwell cites the research on profiling, which shows they are accurate enough to lead to an arrest in only a tiny fraction of cases, less than 3% in one study by the British Home Office.

Partly, the failure of profiling may be due to the unscientific manner in which its premises were generated. For example, the well-known organized/disorganized typology of serial killers – which falls apart under empirical scrutiny – came out of a convenience sample of offenders interviewed using no scientific, standardized method. FBI profilers Douglas and Ressler just "sat down and chatted" with "whoever happened to be in the neighborhood." That's not how one generates good science.

Criminal profiling is glorified in prime-time TV shows such as Criminal Minds. Perhaps as a result, I get multiple queries from youngsters interested in becoming criminal profilers. And I typically get at least one such student each year in my graduate courses on forensic psychology. As a result, I devote at least one lecture to debunking profiling as pseudoscience; I also make this point in my online essay on becoming a forensic psychologist. Thus, I am tremendously excited to see this lucid and wonderfully written essay in the popular press. Perhaps naively, I hope it may lay to rest some of the unwarranted allure of profiling.

Further resources:

The Forensic Psychologist's Casebook: Psychological Profiling and Criminal Investigation, edited by Laurence Alison

"The organized/disorganized typology of serial murder: Myth or model?" by Canter, D.V., Alison, L.J., Alison, E., & Wentink, N. (2004). Psychology, Public Policy, & Law, Vol. 10, pp. 293-320.

"Validities and Abilities in Criminal Profiling: A Critique of the Studies Conducted by Richard Kocsis and His Colleagues," by Bennell, C., Jones, N.J., & Taylor, P.J. (2006). International Journal of Offender Therapy & Comparative Criminology, Vol. 50, pp. 344-360.

Minds on Trial: Great Cases in Law and Psychology, edited by Charles Patrick Ewing and Joseph T. McCann (see especially Chapters 1 & 11, the latter a great account of profiling in the USS Iowa disaster)

"Criminal profiling: the reality behind the myth: Forensic psychologists are working with law enforcement officials to integrate psychological science into criminal profiling," by Lea Winerman, American Psychologist, August 2004.

Photos: Top: Robert Ressler (left) and John Douglas (right); Bottom: The presence of actor Shemar Moore in television's prime-time drama Criminal Minds hasn't hurt the popularity of criminal profiling.

ADDENDUM: Criminal profiler John Douglas, critiqued in Gladwell's essay, has issued a lengthy response that is printed in full at the Crimson Shadows blog.