Opinion ID: 1276594
Heading Depth: 1
Heading Rank: 1

Heading: Need for Inpatient Treatment

Text: The evidence in the record indicates that petitioner has never undergone serious treatment for his sexual deviancy despite his numerous and lengthy commitments at the Security Hospital. He has completed a sex education program. However, this program was educational and not therapeutic and, therefore, is not regarded as effective treatment for sexual disorders like petitioner's. Petitioner also saw a psychologist and a social worker at the Dakota County Mental Health Center approximately two times per month while on the partial hospitalization program. The sessions with the psychologist mostly involved testing and counseling. They touched very little on petitioner's past sexual behavior. The sessions with the social worker were largely devoted to reviewing the log of petitioner's activities which he prepared while on home passes. Petitioner had sessions with a psychiatrist from the Center for Behavior Modification at Fairview-St. Mary's Hospital. These sessions were spent collecting information concerning petitioner's past sexual history and evaluating him on the basis of that information. Very little time, if any, was spent on treatment or therapy. Petitioner testified that he has had between 150 and 200 hours of group therapy concerning sexual attitudes in the Security Hospital. The sex education class, the group therapy, and the outpatient counseling sessions comprise the only treatment petitioner has received for his sexual problems in the 30 years since his initial commitment. Although the Security Hospital does have a successful treatment program (ITPSA) for non-mentally ill sex offenders, petitioner has never been considered a good candidate for that program because of his continued denial of his sexual problems. As noted in a June 1983 psychological report, Mr. Enebak continues to minimize the seriousness of his sexual misconduct, and he denies that he has problems in the area of his sexuality at the present time. He attempts to present a facade of morality, religiosity and suitability for release to the open community. Nevertheless, Mr. Enebak does not appear to be an appropriate candidate for any of the treatment programs available to him at the Minnesota Security Hospital with the exception of the Intensive Treatment Program for Sexual Aggressives (ITPSA). He has not, and says that he will not, accept treatment in that Program. Petitioner's testimony at the discharge hearing indicates his avoidance of his problems. He testified that he believes that his sexual problems are behind him because of his renewed commitment to God and to his family. He also stated that now that he is older, his sexual drives have burned out and that he has it out of his system now. He claims that he no longer craves that kind of excitement on his weekend visits home. Petitioner admits to making the same claims at his 1974 guilty plea, and he, nevertheless, again committed a criminal sexual assault in 1976. The testimony in the record supports the conclusion that petitioner's perception of his problems is not a reliable basis for predicting his future behavior. The medical director of Security Hospital testified that persons with petitioner's psychiatric disorder tend to manipulate and to present themselves in the best light. A psychological report by a hospital staff psychologist in February of 1982 also gave that view: [Mr. Enebak] seemed to wish to present himself as morally righteous and in the most favorable light. An attempt to want to cover up undesirable personal faults was noted. The report went on: It is my impression that Mr. Enebak attempts to minimize the seriousness of his sexual problems and uses denial in trying to persuade people concerning his sincerity and readiness to re-enter the community. Minnesota Multiphasic Personality Inventory results also indicate that he minimizes his sexual problem and that he lacks personal insight and tends to present himself in the best possible light. Evidence in the record as a whole indicated that outpatient treatment would be ineffective in dealing with petitioner's sexual problems. The medical director testified that ordinary outpatient counseling of sex offenders is not effective in changing character. He also stated that sex offenders like petitioner are deterred from inappropriate behavior only by extensive supervision and control. He did not believe that appropriate supervision in the community was available through outpatient treatment. Other psychiatric opinions in the record confirm this view. Although there are opinions in the record indicating that petitioner is amenable to outpatient treatment, those opinions were made with considerable caution, noting the patient's continued denial of his sexual problems, his tendency to present himself in the best light, and the absolute necessity for close supervision of his activities in the open community. The record shows the lack of any substantial treatment over the past 30 years, petitioner's continued denial and minimization of past sexual problems, his failure to control his impulses despite past protestations that he could do so, and the fact that sex offenders who go without treatment are highly recidivistic. The evidence as a whole supports the panel's determination that petitioner continues to need inpatient treatment.