I spent much of yesterday afternoon writing an editorial to submit to USA TODAY about an insulting statement that U.S. Solicitor General Elena Kagan made Tuesday when she testified before the Supreme Court.
Kagan was testifying in favor of a law that would allow the government to keep inmates locked up even after they had served their time if officials felt they were “sexually dangerous.”
USA TODAY Reporter Joan Biskupic quoted Kagan as saying: ”The federal government has mentally ill, seriously dangerous persons in its custody. It knows that those persons, if released, will commit serious sexual offenses.”
I accused Kagan of insulting millions of American by insinuating that persons with mental illnesses are sexually dangerous. I explained that the Justice Department’s Bureau of Statistics has estimated that sixteen percent of persons in American jails and prisons – some 300,000 – have been diagnosed with a serious mental illness. Many of them have bipolar disorder, schizophrenia, and major depression. Did Kagan really think these prisoners, if released, would commit serious sexual offenses?
In addition to insulting persons in jail with traditional mental illnesses, Kagan’s use of the term “mentally ill” also sullied the reputation of persons with Alzheimer’s, Autism, Attention Deficit Hyperactivity, Post Traumatic Stress Disorder and a slew of phobias that are all listed by the National Institutes of Mental Illness as “mental illnesses/disorders.”
I wrote passionately about how Kagan’s poor choice of language had contributed to stigma and was just plain wrong.
I was about to hit the send button on my computer when I decided to read what the medical definition of “mental illness” actually was.
I wish I hadn’t.
According to the American Heritage Medical Dictionary, mental illness is defined as “Any of various psychiatric conditions, usually characterized by impairment of an individual’s normal cognitive, emotional, or behavioral functioning, and caused by physiological or psychosocial factors. Mental illness also is called mental disorders.”
Still confused, I looked up “mental disorders.”
“Mental Disorder: Imprecise term, primarily used by laypeople to refer to mental conditions.”
Okay, I decided, I was going about this the wrong way. Rather than looking up mental illness and mental disorders, I typed “do sexual predators have a mental illness” into my browser. Before my slow AOL connection could come up with listings, I had typed in a new command.
I consulted the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition –better known as the DSM-IV. It’s the manual published by the American Psychiatric Association that covers all mental health disorders for both children and adults. It also lists known causes of these disorders, statistics in terms of gender, age at onset, and prognosis as well as some research concerning the optimal treatment approaches.
Pedophilia was there– along with a slew of other deviant sexual acts — under Paraphilias and Sexual Disorders.
So technically, Kagan was correct — sexual predators do have a mental illness — although the blanket wording of her quote remained insulting.
My research got me thinking about how we define mental disorders. There’s more at stake here than semantics and political correctness.
The reason why Kagan was testifying in front of the Supreme Court was because the federal government doesn’t know what to do with dangerous sexual predators after they finish their sentences. At least seventeen states have passed various versions of what has come to be called “sexual predator” legislation to deal with this problem. The impetus for this legislation was the repeal of indeterminate sentencing laws. Those laws used to keep serious sex offenders confined in prison until officials were satisfied that they were no longer dangerous.
Now, as soon as these predators finish their jail time, they are immediately driven from the prison to a locked down, state mental treatment facility. They are committed under the same involuntary commitment laws as everyone else.
Mental Health America, the oldest mental health organization, has led the fight against this practice of dumping sexual predators into mental health facilities. If you want to read MHA’s reasons visit http://www.mentalhealthamerica.net/go/position-statements/55 It is really interesting.
MHA’s main reason for opposing the sexual predator laws is a sound one — the mental health system is for treatment, not punishment. It also warns that placing sexual predators into facilities with persons with serious mental illnesses is unconscionable. But the point that I found most interesting was this paragraph:
“Sex Offenders Often do not have a Diagnosable Mental Illness. Many sexual predator statutes refer generically and inaccurately to sex offenders as having a mental illness. In fact, many sex offenders do not have a diagnosable or treatable mental illness. Rather, the sex offenses under which sexual predators are convicted are a manifestation of personality disorders that are not amenable to most kinds of treatment. Because these disorders are not traditional mental illnesses, mental health professionals have difficulty determining which sex offenders will be dangerous if not committed and what if any treatment should be provided. This means that courts, which must rely on professional expertise, will regularly make mistakes in deciding who should be committed or released, with serious consequences for both the public and the offender.”
Huh? If I understand that statement, then MHA is clearly stating that the APA is wrong when it identifies pedophilia as a mental illness? Instead it is a “manifestation of personality disorders.”
Personality versus mental defects, organic versus psychosocial — the debate rages on.
So how do you define what is a “mental illness?”