From the outside, Sand Ridge Secure Treatment Center looks like a maximum security prison. Razor wire tops a double fence; the inner layer is electrified. The facility, about a mile from residential neighborhoods, is surrounded by fields, forests and an industrial park.
"That was part of the agreement with the town, before we built here," said Steve Schneider, the facility's security director. Sand Ridge opened in 2001 in Mauston, about 70 miles northwest of Madison. With 537 full time positions, it is one of the largest employers in the area.
The Wisconsin Center for Investigative Journalism and Wisconsin Public Radio were recently granted the first extensive media access to the facility since 2007.
Inside, the building has cream cinderblock walls and tiled floors with blue trim. Purchased and patient-made art decorate the hallways. It smells, like a hospital, of disinfectant and cafeteria food. Staff and patients -- persons committed as sexually violent -- move freely about some of the halls.
Patients wearing green shirts are involved in food service or janitorial work; others wear their own clothes. That is one advantage from when they served their criminal sentences before being involuntarily committed to the state in civil trials.
More than 300 men live at Sand Ridge, committed there by juries and judges throughout the state.
Sand Ridge residents are barred from using metal utensils, to keep them from hurting themselves or others.
Some residents say they had never been diagnosed as mentally ill before their commitment.
"It's beyond me that the state can do that," said Sand Ridge resident Clint, convicted of a sex crime in 1988 and committed in 2008. "Take a criminal case and make it a (mental illness) case," against someone who has already served their time.
Clint, 49, shared his views during an interview with six other Sand Ridge patients in November. Sand Ridge officials asked, as a condition of access, that the Center identify the offenders to whom it facilitated access by first name only, because they are considered patients, not prisoners.
During the past 10 years, the population of committed sex offenders has changed. As more men complete their treatment and return to the community, said Sand Ridge director Deborah McCulloch, the patients who remain have more serious mental illnesses or cognitive disabilities.
Ten percent of the facility's current patient population has a serious mental illness, such as schizophrenia or bipolar disorder, according to Sand Ridge data. Eighty-two percent have personality disorders; most are considered psychopathic in varying degrees. Nine percent are labeled "mentally retarded."
"In addition to mental illness, many of them have various learning disabilities, difficulties with memory, difficulties with executive functioning, difficulties processing, difficulties communicating," said R. Keith Ramsey, Sand Ridge treatment supervisor.
"We have a huge challenge here."
Boom and bust
The state's sexually violent persons law, passed in 1994, was designed for a smaller pool of offenders. It was later expanded to include persons who had committed less serious offenses.
Initially, the sexual offenders committed under the law were kept in existing state facilities for the mentally ill. But in 2001, the state built Sand Ridge, with 300 beds, at a cost of $39 million. The facility added a wing and 200 additional beds in 2009, but the population has declined since then.
The facility had a budget of $50.9 million in fiscal 2012, up from $37.3 million in fiscal 2007.
The Sand Ridge treatment program has four patient tracks, depending on the severity of their disorders.
David Thornton, Sand Ridge research director, said major mental disabilities complicate the treatment and release of sex offenders. Patients with traumatic brain injuries have trouble retaining information and patients with schizophrenia do not always respond well to medication.
"I think there are some patients who are easier to treat, because their problems are mainly sex offense-related problems, and they don't have other issues which get in the way of making changes in that area," Thornton said.
Poor work histories
At Sand Ridge, patients are encouraged to mingle and socialize, but are subject to strict rules, including a ban on sexual activity. Staff say the patient population is generally passive, but there are times when higher-functioning patients may not relate well with lower-functioning ones.
There have been six incidents of patient-against-patient physical assault since Sand Ridge began tracking this in mid-2011, but no incidents of sexual assault.
"We have to protect patients from each other," Ramsey said.
Sand Ridge also has a work program for patients who help staff the kitchens and complete janitorial work. They start at $2 an hour and can only receive wage increases as they progress in treatment.
"Many patients have very poor work and education histories," McCulloch said.
Some of the patients interviewed would like to see more vocational training. But there are no trade programs, such as construction or electrical training.
Clint, who works in the Sand Ridge kitchen, hopes to build his resume and leadership skills. While he likes some of the treatment, including group work on mindfulness and learning to slow his thinking to make better decisions, he finds some of the program repeats Department of Corrections material.
Still, he complies because he wants to qualify for supervised release.
"As far as the law goes, we're here for treatment," Clint said. "So it's helpful that way, to get significant progress in treatment."
The nonprofit Wisconsin Center for Investigative Journalism collaborates with Wisconsin Public Radio, Wisconsin Public Television, other news media and the UW-Madison School of Journalism and Mass Communication.
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