In 2006, amendments to the Missouri SVP Law took effect, lowering the state's burden of proof and changing the status under which rehabilitated individuals were permitted to rejoin society. These seemingly minor changes had enormous consequences, causing the constitutionality of the entire Missouri SVP scheme to be called into question. In the recent case, In re Care and Treatment of Van Orden, the Missouri Supreme Court addressed these concerns and found the amended scheme constitutional. However, in doing so, Missouri's highest court has effectively transformed what was once a remedial measure into a punitive sanction, under the veil of the Department of Mental Health, legitimizing indefinite restraint of personal liberty without due process of law.

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