The purpose of the Mentally Disordered Offender law is to keep communities safe by paroling prisoners with documented mental illness to state hospitals. The premise is that mental illness supposedly played a part in the commission of a violent crime and that present symptoms may continue to contribute to future violent behavior.
Assessing violence potential is by no means an exact science. Psychologists have struggled for years coming to come up with a reliable formulas metric to better predict violence. At present a clinician’s ability to predict violence is less accurate than chance.
The MDO law assumes that untreated mental illness increases the chance for violent behavior – and there is some truth to that. The law is discriminatory, however, because non-mentally ill prisoners are not subjected to similar risk assessments. They, too, may be at high risk for recidivism for all together different reasons.
Prisons have become the largest providers of psychiatric care in the U.S., and so it is no surprise that prisoners receive their first psychiatric treatment while incarcerated. Receiving these psychiatric services offers a catch 22, however: if a prisoner has exhibited psychiatric symptoms within three months of the parole date, and has acted violently while exhibiting psychiatric symptoms, he or she will be paroled to a state hospital - another locked facility.
While the release date from prison is fairly predictable, the process of release from a state hospital is more ambiguous. No specific date is given, hospitalization could be six months, three years or in some cases indefinite.
Ultimately release depends in large measure on the patient. Do they, for example, accept and understand their mental illness? Do they understand its chronic nature, and the continued need for treatment? Do they appreciate the correlation between their illness and potentially violent behaviors? These are reasonable objectives, but must this treatment occur behind lock and key?
Even when these objectives are met, problems with this law continue. After patients leave the state hospital, they remain under supervision of a conditional release program. Supervision under this program is much more stringent than for those on regular parole, and as the name implies, release is conditional. Any exacerbation of symptoms, or violations of the terms and conditions could result in readmission to a state hospital – even after the parole period has ended. It is thus possible for a mentally ill offender to be incarcerated many years after the parole release date.
Many mentally ill offenders have not been told about this law, even as they undergo evaluations as to whether they meet its criteria. Not surprisingly patients arrive to the state hospital surprised and angered. Their understanding of what prompted the admission to yet another locked facility, and the arduous process of getting released, is often non-existent.
Treatment for severe mental illness is necessary and welcome. There is a correlation between violence and untreated severe mental illness and certainly some individuals are too dangerous to be released to the community. But this law most often impacts those for whom lack of treatment options in the community contributed to their criminal behavior. This law furthers the vicious cycle of institutionalization. It’s because of this that the MDO law is yet another way to criminalize the mentally ill.
Let’s support funding for programs that address severe mental illness before violence occurs. Let’s provide mentally ill parolees with comprehensive psychiatric care in the community. Let’s stop punishing mentally ill people for the struggles they face living in a society that chooses to ignore their blight.
Disclaimer: By no means is this a comprehensive description of all the ins and outs of the MDO law. For the curious, this link from Disability Rights California provides a more detailed explanation as well as references to the relevant penal code sections