Citation

Weinberger LE, Sreenivasan S, Azizian A, Garrick T. J. Am. Acad. Psychiatry Law 2018; 46(1): 63-70.

Affiliation

Dr. Weinberger is Professor Emerita and Dr. Sreenivasan is Professor of Clinical Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA. Dr. Sreenivasan is also with Forensic Outreach Services, and Dr. Garrick is Chief of General Hospital Psychiatry, Greater Los Angeles VA Medical Center, Los Angeles, CA. Dr. Azizian is Assistant Professor of Criminology, California State University, Fresno, and Senior Psychologist, Department of State Hospitals, Sacramento, California. Dr. Garrick, is Professor of Psychiatry, Geffen School of Medicine, University of California, Los Angeles, CA.

Copyright

(Copyright © 2018, American Academy of Psychiatry and the Law, Publisher American Academy of Psychiatry and the Law)

DOI

unavailable

PMID

29618537

Abstract

A common criticism of sexually violent person (SVP) laws is that psychiatric commitment has been co-opted to continue the incarceration of dangerous criminals, not dangerous individuals with mental illness. This opinion may have credence because some forensic clinicians use a "silo" approach (i.e., diagnosing based on historical criminal behavior rather than current symptomatology, and formulating risk for future sexual violence based on actuarial scores rather than characteristics and features of the mental condition). A silo process fosters a missing link; namely, the absence of a nexus between the mental condition and risk. This approach violates the necessary predicate for involuntary civil commitment, that the symptoms of an individual's current mental disorder be linked to and support a present sexual danger to others. In this article, we provide a brief overview of SVP statutes; describe how the silo approach compromises accurate diagnosis and identification of relevant risk factors; and present actual and fictitious cases illustrating the presence and absence of the missing link.

© 2018 American Academy of Psychiatry and the Law.

Language: en