The aggressive patient/inmate: beyond denial.

The public is no longer willing to tolerate being repeatedly victimized by a small group of sexually and/or physically aggressive predators. These predators may be found among much larger groups of non-predatory inpatients in psychiatric hospitals or inmates in prisons. These institutionalized people deserve to be treated or incarcerated without fear of being victimized, as well. The U.S. Supreme Court has recently recognized the principle of protecting the public from such predation, in its Kansas v Hendricks decision. This paper details the philosophy, management, unit construction, legislative changes, and intervention strategies necessary to contain such predators and to propel them toward rehabilitation-once we have given up our denial about the existence of such people.