Opinion ID: 1404685
Heading Depth: 2
Heading Rank: 3

Heading: Treatment

Text: Hubbart argues that involuntary confinement for mental health reasons violates due process unless it is coupled with a statutory guarantee of treatment providing a realistic opportunity to be cured. He complains that recovery is not guaranteed under the Act, and that the statutory scheme reflects an implicit determination that the mental disorders and dangerous behaviors of SVP's cannot be cured or controlled through treatment. As evidence that the Act is concerned solely with nontherapeutic long-term incarceration, Hubbart cites such provisions as section 6604, providing for confinement in a secure facility, and section 6606, subdivision (b), stating that [a]menability to treatment is not required for commitment under the Act. At the outset, we reject Hubbart's suggestion that the Legislature cannot constitutionally provide for the civil confinement of dangerous mentally impaired sexual predators unless the statutory scheme guarantees and provides effective treatment. The court reached a similar conclusion in Hendricks, supra, 521 U.S. 346, 117 S.Ct. 2072, for reasons we find persuasive here. Hendricks argued that the Kansas scheme imposed punishment for prior adjudicated sex crimes and violated the rule against ex post facto legislation, because it permitted the long-term confinement of sexually violent predators and failed to provide legitimate treatment for their underlying mental disorders. ( Hendricks, supra, 521 U.S. at pp. 361, 365, 117 S.Ct. 2072.) The high court rejected the claim. In so doing, it noted that the act's treatment provisions were susceptible of two different interpretations, neither of which revealed a punitive intent on the part of the Kansas Legislature. On the one hand, various sections in the Kansas scheme recognized an obligation on the part of state health officials to provide `treatment' to individuals who, like Hendricks, were involuntarily committed as sexually violent predators. ( Hendricks, supra, 521 U.S. at p. 367, 117 S.Ct. 2072.) These provisions suggested that beneficial psychiatric treatment was available, and was offered under the act. The high court reasoned that [e]ven if ... the provision of treatment was not the Kansas Legislature's `overriding' or `primary' purpose in passing the Act, this does not rule out the possibility that an ancillary purpose of the Act was to provide treatment, and it does not require us to conclude that the Act is punitive. ( Ibid. ) Hence, the court declined to invalidate the Kansas scheme on the ground the State had refused or withheld treatment for vindictive reasons. [27] On the other hand, legislative findings accompanying the act suggested that sexually violent predators were `unamenable to existing mental illness treatment modalities,' and would likely require care and commitment on a `long term' basis. ( Hendricks, supra, 521 U.S. at p. 351, 117 S.Ct. 2072.) The high court concluded that involuntary commitment was permissible even assuming such statutory provisions meant that effective treatment did not exist and was not offered under the act. While we have upheld state civil commitment statutes that aim both to incapacitate and to treat [citation], we have never held that the Constitution prevents a State from civilly detaining those for whom no treatment is available, but who nevertheless pose a danger to others. A State could hardly be seen as furthering a `punitive' purpose by involuntarily confining persons afflicted with an untreatable, highly contagious disease. Accord Compagnie Francaise de Navigation a Vapeur v. Louisiana Bd. of Health, 186 U.S. 380, 22 S.Ct. 811, 46 L.Ed. 1209 (1902) (permitting involuntary quarantine of persons suffering from communicable diseases). Similarly, it would be of little value to require treatment as a precondition for civil confinement of the dangerously insane when no acceptable treatment existed. To conclude otherwise would obligate a State to release certain confined individuals who were both mentally ill and dangerous simply because they could not be successfully treated for their afflictions. [Citations.] ( Hendricks, supra, 521 U.S. 346, 366, 117 S.Ct. 2072.) The foregoing language strongly suggests that there is no broad constitutional right of treatment for persons involuntarily confined as dangerous and mentally impaired, at least where no acceptable treatment exist[s] or where they cannot be successfully treated for their afflictions. To the extent Hubbart suggests the contrary is true and that the SVPA should be invalidated as a result, he is mistaken. [28] In any event, we disagree with Hubbart's suggestion that the Act's treatment provisions are a sham, either because the Legislature intended to withhold treatment or because it found that treatment was futile. The Act is based on the premise that SVP's suffer from clinically diagnosable mental disorders which require psychiatric care and treatment, and which are not a proper basis for commitment under other mental health schemes. (See §§ 6600, subds. (a) & (c), 6604, 6606.) The Legislature also evidently determined that because SVP's have committed sexually violent offenses in the past and are dangerous at the time of commitment, they should receive treatment in a secure psychiatric facility suited to addressing the special risks they present. (See §§ 6600, subds. (a) & (b), 6600.05, 6604.) Moreover, the Act is accompanied by a declaration of the Legislature's intent to establish a nonpunitive, civil commitment scheme covering persons who are to be viewed, not as criminals, but as sick persons. (§ 6250; see Stats.1995, ch. 763, § 1.) Commitment and treatment are proper under the Act only for so long as the person is both mentally disordered and dangerous. To this end, the maximum length of each commitment term is relatively brief  two years. (§ 6604.) A new mental evaluation and judicial review of the commitment are required each year, providing the SVP with an opportunity to receive unconditional release and discharge in the event his condition has materially improved. (§ 6605, subds. (a)-(e); see id., subd. (f).) The Act also provides opportunities for conditional supervised release into the community before the two-year commitment term expires. (§§ 6607, 6608.) The Legislature has also acknowledged the existence of current institutional standards for the treatment of sex offenders, and requires that they guide the Department of Mental Health in developing treatment programs under the SVPA. (§ 6606, subd. (c).) In outlining the parameters of the structured treatment protocol on which such programs must be based, the statute suggests that a course of treatment for each individual offender is appropriate, and that the individual's treatment progress and changes should be monitored. ( Ibid. ) Section 6606, subdivision (b) is not inconsistent with these therapeutic aims insofar as it states that commitment under the Act does not require [a]menability to treatment or similar findings. This provision appears to stand for the unremarkable proposition that some mentally disordered and dangerous persons might not benefit from treatment for a variety of reasons, and that commitment is not foreclosed in those cases. (See O'Connor, supra, 422 U.S. 563, 584, 95 S.Ct. 2486 (conc. opn. of Burger, C.J.) [noting that the recovery rate for some mental disorders is low notwithstanding advances in psychiatry, and that treatment rarely succeeds without the patient's cooperation].) We note that provisions containing language identical to section 6606, subdivision (b) have appeared in other civil commitment schemes in this state. Inclusion of such language has not led to wholesale invalidation of these schemes under the due process clause or to a conclusion that the treatment provisions otherwise contained therein are illusory. (§ 5300 [amenability to treatment not required for extended commitment under LPS Act]; People v. Superior Court (Dodson ) (1983) 148 Cal.App.3d 990, 196 Cal.Rptr. 431; see former § 6316.2, subd. (j), as amended by Stats.1979, ch. 992, p. 3377 et seq., repealed by Stats.1981, ch. 928, § 2, p. 3485 [amenability to treatment not required for extended commitment under MDSO scheme]; People v. Roberts (1981) 123 Cal.App.3d 684, 687-690, 177 Cal.Rptr. 11; People v. Poggi (1980) 107 Cal.App.3d 581, 586-592, 165 Cal. Rptr. 758.) No different result is warranted here. [29]