Mental health workers offered mixed support for the treatment program. A rape crises advocate and support counselor suggested that diverting offenders out of the criminal justice system denied the victims the closure that they needed to move on with their lives. However, two psychiatrists indicated that they believe that treatment programs can be effective, and that treatment is the appropriate course for mentally ill offenders, rather than incarceration. In addition, because they work with mental commitments, they indicated that both of them have already participated in civil commitments for pedophilic child molesters who offended within the family group, and indicated their belief that the civil commitment process actually made it easier for the victim to begin the work to repair his or her life.
Finally, it is important to consider the criminals. More than in almost any other area, the idea of possibly indefinite civil commitment for those who sexually offend against children is terrifying. Some offenders suggest that the threat of indefinite civil commitment is cruel and unusual punishment, effectively giving them a life sentence for crimes that the legislature has determined should be punishable by smaller periods of incarceration. However, all three of the offenders surveyed indicated that they did not believe that they could get better without treatment and that, if they continued to have sexual urges towards children that they would eventually reoffend. One of the offenders discussed suicide as a possibility, and spoke of his attempts to have his family doctor castrate him when he first realized he was sexually attracted to his two-year-old niece. While it is easy to demonize sexual offenders, especially those that prey on children, the reality is that many of these people are deeply ashamed and horrified by their sexual urges. All three of them suggested that they would have turned themselves in after their first offense, if they had thought they had a reasonable chance at getting effective treatment rather than facing prosecution, conviction, and a horrific experience while in prison.
Divert all offenders accused of the sexual assault of a child into the civil commitment process for an emergency 72-hour hold to determine whether or not the offender is a pedophile and whether or not the offender poses a continuing danger to self or others.
For all offenders who are not determined to be pedophiles or suffering from another DMS-IV diagnosis that would cause them to sexually assault children, immediately divert them back into the criminal justice system.
For all offenders who are determined to be pedophiles and to pose a threat to self or others, seek a civil commitment at the end of the 72-hour hold to begin treatment for the pedophilia.
Keep the pedophile committed until his treating team determines that he is no longer a threat to self or others, but require hearings every six months so that a judge can rule on those determinations.
If a pedophile proves resistant to conventional treatments, give him the option of pursuing more radical treatments, such as castration or chemical castration, to reduce his sex drive, and thus reduce his likelihood of reoffending. Do not ever allow a judge or treating physician to order any type of castration without the patient's consent; the default is continued confinement.
Give the District Attorney the discretion to prosecute the pedophile for any acts of sexual assault, as well as any other crimes committed to further the sexual assault or hide the sexual assault. Any pedophile engaging in torture, aggravated assault, or murder would be subject to criminal prosecution for those crimes.
While conventional wisdom suggests that treatment for sexual offenses against children is ineffective, that simply is not the case. Pedophiles have a horrible disease. While that disease does not give them the right to victimize others, it like other mental illness, becomes more difficult to control when a person is experiencing "fear, lack of trust, low self-esteem, feelings of rejection, inadequate social skills, lack of empathy, isolation from others, and poor communications skills." (Freeman-Longo, 2001). Prison increases these feelings, making it unlikely that treatment in a prison setting would provide the same type of success as hospital-based treatment programs.
Furthermore, one-third of sexual offenses against children are committed by teenagers. (Chaffin, Bonner, & Pierce, 2003). Because many child molesters are, themselves, children, it stands to reason that there are many teenage child molesters who are pedophiles, though most adolescent sexual offenders do not meet the criteria for pedophilia. However, across the board, adolescent sex offenders are more responsive to treatment