Can sexual predators be rehabilitated?

Clark, a resident at Coalinga State Hospital, agreed to the hospital's rehabilitation program. Photo by Armand Emandjomeh

By Jude-Joffe Block and Amanda Dyer

Right off the I-5 freeway nearly halfway between San Francisco and Los Angeles sits a unique facility in California’s Central Valley. It’s Coalinga State Hospital – a hospital with a unique set of patients. The patients at the hospital have been classified as “Sexually Violent Predators;” they’re convicted rapists and child molesters – sex offenders who the state has determined are simply too dangerous to be released after completing their prison sentences. So they’re committed for psychological treatment inside the walls of Coalinga.

Unlike California’s state prisons, Coalinga isn’t overwhelmed with inmates – since 1997, only 2% of incarcerated sex offenders have ended up in the Central Valley hospital – so there are around 900 in the facility built for 1,500. But for sexually violent predators, their stay at Coalinga is indefinite. 

Last summer, reporters Jude Joffe-Block and Amanda Dyer were given a rare tour of the hospital and came back with this three-part series. Jude Joffe-Block has our first report.

The following story contains mature subject matter.

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JUDE JOFFE-BLOCK: Coalinga State Hospital is just a couple of miles off Interstate 5, in a rural area best known for cattle farms. A double layer of barbed wire and a tall fence surround the hospital grounds.

At the hospital’s first security checkpoint, Nancy Kincaid, a spokeswoman for the Department of Mental Health, describes the patients inside.

NANCY KINCAID: There are about 850 high-risk sex offenders and sexually violent predators who are here and housed in Coalinga state hospital.

Sexually violent predators are sex offenders who have already served their prison sentences. In certain cases, the state determines that even though a sex offender has served his time, he is simply too dangerous to be let out. Since 1997, about 2% of cases have resulted in the person being classified as a sexually violent predator. When that happens, he is sent here, where he’ll stay indefinitely.

KINCAID: So the facility here in Coalinga was opened in 2005. The cost to build it was $400 million dollars.

About 40% of the hospital’s 1,500 beds are empty. But Kincaid says that should change in the coming years.

KINCAID: They are always opening new units, so they fully expect the hospital will be full at some point.

Each person housed here costs the taxpayers upwards of $173,000 a year. That’s almost four times the cost of prison. Security is tight. All staff must go through a metal gate to reach the hospital where the patients are. Inside it is sterile but bright. 

Most staff prefer to call inmates here “individuals,” which makes it seem less like a prison lockup. Here in the hospital’s main concourse, individuals are allowed to walk around freely.

MARIE PICCILLO: A lot of the design of this building is kind of thought of to bring the outside in.

Marie Piccillo is a psychologist at the hospital.

PICCILLO: So a lot of natural light, there are plants everywhere. You will see these store fronts, it is set up like a mall area.

In the mall, individuals have access to a barbershop, a grill and a canteen.

PICCILLO: Also a lot of the rooms we are going to walk through have California names. Fort Bragg, Muir Woods.

The idea is to keep a sense of connection to the outside world. At the moment, the hallways are mostly deserted.

PICCILLO: It is an empty hallway right now. There are three times during the day that individuals are required to be back in their units for a count, and this is one of them. So that is why you are not really seeing a lot of individuals out here right now.

There are rooms for crafts, music and vocational skills like carpentry. Outside there’s a baseball diamond. Piccillo says the hospital encourages individuals to take up hobbies.

PICCILLO: Perhaps in the past something to do with free time was to go driving around in areas that led to victimization, but now we want to teach people gardening or poetry, or kind of bring out those strengths in them that maybe they didn’t utilize before.

Clark, who would only give his middle name, is one of the individuals in custody here.

CLARK: Yes, yes. I'm learning to play the guitar. I'm learning to speak Spanish.

Clark was committed for treatment by a court 10 years ago after he served out his prison sentence for child molestation. At 63, his hair is white. He wears the khaki shirt and slacks that all individuals here wear.

CLARK: I'm continuing to relearn the German that I once spoke. And I paint in watercolors. I read a lot when I have time.

Clark spends much of his time in psychological treatment. 

CLARK: I truly do not want to ever impose myself on another victim, you know. Victimizing another person was not my idea to begin with. I mean, I didn't grow up thinking, "Gee, I'm going to become a sex offender." It’s just something I grew into. And growing out of it now is taking a little bit of effort, a little bit of intention and a lot of work.

Clinicians at the hospital are quick to admit that sex offenders can’t be cured. Instead, the treatment is more like learning to manage an addiction. It focuses on teaching individuals like Clark to manage their urges. That way, they can hopefully one day return to society and not reoffend.

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Coalinga patient Clark is taking part in the sex-offender treatment program at the hospital. He says he wants to learn to never molest a child again. But can sex offenders be cured?

Jude Joffe-Block has this report on the rehabilitation program, and why more than half of the patients want no part of it.

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JUDE JOFFE-BLOCK: Here at Coalinga State Hospital, rapists and child molesters learn to change their thinking and behavior over a five-phase program. 42-year-old LeRay is one of the patients committed here. He wants to be identified by his middle name.

LERAY: I've committed rape. And I've committed offenses against children.

LeRay is a slight man with dark hair and a large crucifix around his neck. He has been in mental hospitals for the past 11 years. He is now in Phase Three of treatment, where he is learning to identify the triggers that caused him to commit sex offenses. He must admit all of his crimes – even the ones he wasn’t convicted of. The hospital uses lie detector tests to see if he is being truthful. And that is just one of many tests he’s given.

Psychologist Marie Piccillo says she can tailor the treatment better with the help of a gadget, called a plethsymograph.

MARIE PICCILLO: And basically what it is is an instrument that measures sexual interest and sexual arousal. So it uses a band that looks a lot like a rubber band and it is filled with mercury.

Piccillo says that individuals are given privacy when they take this test.

PICCILLO: Basically they are asked to put that band onto the base of their penis and they are shown various sexual stimulus slides. It really kind of is what you think it is, it measures the arousal level and the rating to that and that gives us sort of a profile of what a sexual interest pattern is that we can use in treatment.

As for LeRay, he hopes to stick with his treatment regimen and become one of the few to progress to Phase Five.

LERAY: It's not a cure, but it's tools that we can use, that I can use. Rather than go back, I can use the tools to help me move forward. You know, and not create another victim.

If LeRay completes this level of treatment, he’ll go to Phase Four. Which means preparing to get out. Ernie Marshall is a clinician at Coalinga. He says the few who are released through this treatment program still face strict supervision in the community.

ERNIE MARSHALL: We are not recommending they get released unconditionally. We are recommending they get released conditionally into a very structured conditional, probably the most structured conditional release program, at least in the state of California.

It’s also possibly the smallest release program in the state. In 13 years, just 20 men out of 850 patients have advanced to the final treatment stage and been authorized by the hospital to go home. Another 200 or so have been released by the courts against the hospital’s recommendation.

For some, like LeRay, it takes time.

LERAY: I was very angry, so from 1999 up until 2005, I was angry. And I didn't get into sex offender specific treatment.

Ultimately, LeRay decided to give treatment a try. But the majority of individuals at Coalinga haven’t followed his example. Though everyone here is under a court order to get treatment, hospital clinician Ernie Marshall says that only 35% participate in the sex offender treatment program.

MARSHALL: We don’t try to persuade people. If an individual gets committed to the hospital, they have big choices ahead of them. What we do do is encourage them to weigh the pros and cons.

One of the cons is that what they divulge in treatment could be used against them in court and prevent them from ever getting out. Some attorneys advise their clients at the hospital to not participate. Michael St. Martin refuses to get involved because he says the treatment program is a sham.

MICHAEL ST. MARTIN: I'm not opposed to the treatment. I'm opposed to the fact that it's nothing more than a band-aid to detain me.

St. Martin spent 10 years in a prison for molesting boys in his neighborhood. And he’s been in a state mental hospital since 2002. In that time, he hasn’t seen many people leave.

ST. MARTIN: This is where I am. I’m here for the rest of my life unless the law changes at some point.

But it’s unlikely that the laws will change anytime soon. As far as the public is concerned, giving sexually violent predators a second chance is a tough bet to take.

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Over half of Coalinga’s patients choose not to participate in the hospital’s sex offender treatment program. But some of the hospital’s residents do try to make it through Coalinga’s rehab. It’s no easy feat – in 13 years, just 20 out of 850 patients have been authorized by the hospital to go home.

Reporter Amanda Dyer followed one of the few people who was allowed to leave Coalinga to complete his treatment on the outside. Here’s her report.

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AMANDA DYER: Today a man we’ll call Mr. G walks the streets of a Bay Area city on his way to his regular therapy appointment. We can’t tell you Mr. G’s real name or where he’s from because sex offenders have real enemies. Mr. G spent eight years in a state prison for molesting children. The state’s sex offender laws keep Mr. G in one of the worst areas in town, but he doesn’t seem to mind much.

MR. G: Well, where we’re at right now would be called the down-in-the-luck type neighborhoods.

AMANDA DYER: Still better than the hospital?

MR. G: Yes, anything’s better than being incarcerated.

After prison, Mr. G spent another 10 years in Coalinga State Hospital under California’s sexually violent predator laws. The law says that sex offenders at risk of committing new crimes must be detained in a state hospital after being released from prison. Patients at the hospital can undergo treatment for their disorders, but few opt to participate in it. And even those that do aren’t guaranteed release. In fact, Mr. G is one of the few people to ever be allowed to finished treatment outside the hospital.

MR. G: I honestly believe, and this is God's honest truth, that the treatment saved my life.

While Mr. G credits the treatment for his recovery, part of him wonders why he had to wait until after prison to get it.

MR. G: First off I asked for treatment back in 1987. I was told I did not meet the criteria. I didn’t have a problem. I wasted eight and a half years in prison just doing regular mainline prison time. I could have utilized those eight and a half years of my life in a treatment program.

Brendan Conroy is Mr. G’s attorney and represents several other patients at Coalinga State Hospital. Conroy believes Mr. G’s case points out a key flaw in the system.

BRENDAN CONROY: It does seem more than a little unfair that someone would be convicted, sent to do a prison term, and only at the end of that be declared to be someone suffering from a mental disorder that needs treatment.

ERNIE MARSHALL: What we do here is actually driven by the law, so it is the law, and that is what we do.

Ernie Marshall is a staff member at Coalinga State Hospital, the same hospital where Mr. G. was committed.

MARSHALL: I know that most of the individuals here would say this is a violation of my civil rights. The society has decided it is not. The premise is a basic commitment premise, that you have a mental illness that causes you to be dangerous to others.

The lawyer Conroy doubts that the state’s sexually violent predator laws were written to rehabilitate offenders.

CONROY: I believe that the law was not passed really with an eye toward treatment – I think it was passed as a cynical way of not releasing people and saying that it is not punishment. The people at Coalinga are being warehoused there.

Conroy says the system would be more efficient if more patients were allowed to complete treatment in the community. Right now, less than 20 out of the 850 patients at Coalinga are enrolled in outpatient treatment. Mr. G is one of them.

A year and a half after being released from Coalinga, Mr. G isn’t a completely free man. He wears a GPS tracking device, everywhere he goes, a security detail follows and he lives in a rundown area of town.

MR. G: (laughs) Oh you’ll see all kinds of things on the streets right here. I spent 12 years in a state mental hospital but I see more mental illness out here on the streets than I did in the hospital.

While Mr. G has abided by all his regulations since he’s been out several others have had their freedom revoked for violating the conditions of their release. The system for monitoring sex offenders is expensive, cumbersome and controversial, but unlikely to change.

Jude Joffe-Block and Amanda Dyer reported these stories from the U.C. Berkeley Graduate School of Journalism. Armand Emandjomeh and Helene Goupil also contributed to this report.

This series was produced as part of the News21 program, a public service reporting project sponsored by the Carnegie-Knight Initiative on the Future of Journalism. You can view the Berkeley News21 team’s package “Beyond the Bars: California’s Convict Cycle.”