Military veterans with sexual offenses committed after discharge are often eligible for Veterans Affairs (VA) services including health care. There are few, if any, studies of sexual recidivism among military veterans with sexual offense histories to guide clinical management. This study examined diagnostic and postrelease sexual and nonsexual recidivism among military sexual offenders released from California sexually violent predator (SVP) commitment. The sample consisted of 363 males; 131 were identified as military veterans and 232 as civilians. The rates of recidivism were assessed for two follow-up periods: a fixed 5-year and a total 21-year follow-up. Recidivism was operationalized as any new sexual, violent, or general criminal arrest or conviction occurring after discharge to the community in California. We found a low risk for sexual reoffense for both groups. Specific to veterans, the rates for sexual and nonsexual violent recidivism were under 7% for both follow-up periods. Diagnostically, veterans had a significantly higher rate of pedophilic disorder and lower rate of antisocial personality disorder than civilians; neither were predictive of sexual recidivism or any other recidivism. On average, veterans were 61 years old at discharge; and older age at discharge was associated with a significantly lower likelihood of recidivism of any type. A relatively high proportion of veterans had a history of childhood sexual abuse and head trauma. Trauma-informed care may be a particularly valuable treatment approach for veterans with sexual offenses. These data may aid the VA and other providers in forming evidence-based decisions regarding the management of veterans with sexual offenses.
Though the U.S. Department of Veterans Affairs (VA) provides housing, residential treatment, and mental health care to justice involved veterans, those with sexual offenses face daunting obstacles to securing such services, including exclusion from housing programs, and lack of mental health services to treat sexual deviancy disorders. The VA's strategy to date may reflect a large system's caution in systematically addressing a problem that involves a population with an even higher degree of stigma than homelessness. Failure to develop strategies to address this problem reflects the need for a VA system-wide, consistent, and effective approach across relevant domains that incorporate the current state of knowledge and practice. Since 2006, the VA's program serving justice system veterans has been highly effective in serving the reentry veteran population. The challenge of serving veterans with sex offenses can and must be met with a similar level of effectiveness. In this commentary, we propose that the VA, beginning with the Secretary, adopt a "reset" policy and programmatic action agenda to enhance access to housing and treatment for sexual deviancy disorders. We offer specific pathways for implementation. Impact StatementAcross U.S. Department of Justice (DoJ) surveys conducted since 1998, male U.S. military veterans are incarcerated for sexual offenses at nearly twice the rate of civilians. However, postincarceration, these veterans face daunting obstacles to securing such services, including exclusion from housing programs, and lack of mental health services to treat sexual deviancy disorders. The VA system from top to bottom should "reset" policies to enhance public safety and the veteran's successful community integration.
Sexually violent predator (SVP) hearings represent a unique set of postincarceration civil commitment proceedings, where expert psychological or psychiatric testimony plays a central role in the commitment determinations. Psychologists are often asked to offer their testimony to a recognized professional standard. Courts have a gate-keeping role to exclude unreliable expert testimony, and testifying experts must offer opinions that are relevant and reputable. That standard has been a “reasonable degree of certainty.” A review of SVP court cases over almost 25 years demonstrated that testifying experts recite the term but do not define the threshold. This lack of a standard definition has direct implications for determining the diagnoses that are key components in SVP hearings, as the data used by experts represent varying standards of proof. In order to standardize the term and because forensic psychologists are quite familiar with legal thresholds, the legal standards can provide sufficient guidance to define reasonable psychological certainty. The consequential nature of indefinite civil commitment calls for experts to move away from an undefined or vaguely defined threshold of probability to a defined probability. We argue that the threshold should be at the level of a clear and convincing standard.
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