ABSTRACT
Sexually violent predator (SVP) laws are a recent phenomenon, with Washington the first state to enact such a law in 1990. These laws provide for the civil commitment and involuntary treatment of selected sexual offenders at the end of their criminal incarceration. The laws have been surrounded by controversy from the beginning, as they seek to establish policy in a conceptually murky and ethically polarized area in which the notoriously fuzzy line between criminal behavior and psychiatric illness appears to be particularly difficult to draw. Some have critiqued the laws as medicalizing what is essentially a social problem, and for misusing psychiatry as an agent of social control instead of applying it toward legitimate therapeutic ends. Others respond that psychiatrists have long been responsible for the care and treatment, as well as custodial management, of sexual as well as other criminal offenders. In fact, the differentiation between ‘criminal’ and ‘mentally ill’ behavior is of relatively recent vintage, operationally. For most of recorded history, society’s rejects – the poor, the criminal, the mentally ill – were housed in the same facilities. As for sex offenders in particular, we seem not to have made up our collective mind yet about whether they are bad, mad, or both, and where they ‘belong.’ The following is a brief review of the history of laws in the United States governing psychiatry’s involvement in the assessment and management of sexual offenders, a discussion of the SVP laws in particular, and some thoughts regarding the implications these laws hold for the field of psychiatry.
