Public health safety measures in the wake of COVID-19 have transformed health care into virtual medicine overnight. From psychiatry to surgery, all of the medical specialties have adapted technology-enabled virtual appointments. The support for health care providers has been pervasive in the past few weeks-from celebrity shout outs to presidential gratitude. It certainly is a daunting time to be a physician. As physicians remind themselves of their ethical duties enumerated in the Hippocratic oath, I reflect on our role as advocates for our patients and our communities. Treating the ill means advocating for our patients and promoting health and wellness in our communities. This includes the health and wellbeing of sexual offenders. Why would communities, especially in the setting of a pandemic, care about the wellbeing of sexual offenders? The answer is simple: Treating sexual offenders prevents sexual violence. And sexual violence is likely to increase, just as rates of domestic violence and child abuse increase, when individuals are confined without adequate resources.
Since the imposition of stay at home orders, sexual offender treatment groups have ceased. But unlike other patient populations, most sexual offenders are forbidden from accessing the internet as a condition of supervised release. As a result, virtual treatment groups are not an option for sexual offenders. In other words, sexual offenders are no longer receiving treatment in the community. The withdrawal of effective treatment and the addition of psychosocial stressors such as unemployment, financial strain, and isolation may contribute to sexual reoffending. Given the serious consequences of untreated sexual offenders, might the prohibition on internet access be re-visited?
To date, both probation and parole officers have been unwilling to adjust their approach to sexual offender management. Legally, offenders would need an amendment to their conditions of supervised release, which would allow for internet access for the sole purpose of treatment. This amendment could be sought individually though a probation or parole officer or by the sexual offender himself. This approach, in the time of a pandemic, is neither practical nor achievable as most courts are closed. But pandemics call for common sense interventions. Wouldn’t it make sense for agencies that supervise sexual offenders to adopt a “pandemic policy,” which would allow for treatment with the goal of preventing sexual abuse?
The notion that internet restrictions, alone, decrease sexual offending is not based on science. Many sexual offenders are restricted from internet access as a precautionary measure without empiric evidence to support this approach. Certainly, internet-facilitated sexual offenders may be at higher risk to re-offend if they have access to the internet, but this is all speculative. We simply do not know if access to the internet increases sexual offending.
Let’s not suffer more hardship then already incurred by COVID-19. Recognizing that both the psychosocial stressors arising from COVID-19 and the withdrawal of effective sexual offender treatment increase the risk of sexual violence, public safety demands that offenders have access to treatment. Without sexual offender treatment during COVID-19, we exchange one public health crisis for another.
Renée Sorrentino is a psychiatrist.
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