Opinion ID: 557986
Heading Depth: 2
Heading Rank: 3

Heading: Nature of the Facility.

Text: 62 The psychiatric profile of the Treatment Center population can be plotted generally along a continuum. 11 At the poles are two relatively small inmate groups: under 15% of the population do not suffer from any known mental disorders whereas, at the opposite pole, perhaps 10% suffer from extreme psychoses (such as schizophrenia and bipolar disorders). Individuals in the large middle group are afflicted by an array of moderate mental disabilities, including problems associated with substance abuse, borderline personality disorders, and paraphilia. 63 Commitment to the Treatment Center is intended not only to provide an opportunity for treatment but also to protect society. Knight v. Mills, 836 F.2d 659, 667 n. 11 (1st Cir.1987). Because every patient is a convicted sex offender, and a majority of them have some kind of mental deficiency, the defendants face legitimate security concerns. These concerns are exacerbated by the absence of statutory authority to deny commitments or to transfer intractable patients. Thus, the Treatment Center is forced to accommodate patients who are continually disruptive and who show no signs of rehabilitation. According to expert testimony, credited by the lower court, the lack of transfer authority, combined with the involuntary nature of the commitment process, distinguishes the Treatment Center from every other facility for sexually dangerous persons in the United States. 64 In light of the security risks that the patients pose to the staff and to each other, officials have implemented the movement control pass (MCP) procedure. This procedure enables the administration to keep track of patients' locations by requiring them to obtain authorization before entering or leaving certain sections of the facility. The tier system, under which patients are theoretically treated in the least restrictive environment, is also driven by security concerns: a patient is housed in a particular privilege unit according to the threat he is perceived as posing to others' safety. To illustrate, persons assigned to the pre-release house or a maximum privilege unit are thought to present the fewest security problems, and so forth. In other words, a patient's privilege status is inversely proportional to his status as a security risk. 12 The evidence was quite clear that none of the criteria under which classification decisions were made countervailed, or were inappropriate in regard to, treatment purposes. 65 The trial judge found the MCP procedure and the tier system to be reasonable in light of the violent and aggressive nature of certain patients. He also found them in conformity with the consent decrees. He concluded that both policies gave acceptable weight to the professional judgment of the Treatment Center's administrators. In this respect, the judge relied specifically upon Tink's testimony that a security-based classification system materially advanced the therapeutic environment. 13