A group of men held at a northern Minnesota treatment center for sex offenders are entering their second week of an indefinite hunger strike that has led to the hospitalization of three of the men.

The hunger strike marks the second time this year that detainees at the center have gone without nourishment and has been organized to protest the historically low rate of release from the Minnesota Sex Offender Program (MSOP), which confines more than 740 men at prisonlike detention centers in Moose Lake and St. Peter. Some men have been held at the MSOP treatment centers for years or even decades after completing their prison terms — effectively turning the program into what detainees describe as a life sentence.

On Sunday, some family members of detainees participating in the hunger strike gathered for a protest outside the MSOP facility in Moose Lake, which is surrounded by fences topped with razor wire. A few said their loved ones inside the facility told them they were prepared to starve themselves to death. One woman, Tara Sam, broke down in tears upon learning that her brother, Jeremiah Johnson, among the hunger strikers, had just collapsed from fatigue. Three other hunger strikers have been taken to the hospital since Friday after falling unconscious, according to detainees and their relatives.

"This place is a due process catastrophe and needs to be shut down," said Daniel A. Wilson, a participant in the hunger strike and co-founder of OCEAN, a detainee advocacy group from inside the facility.

In a statement, Deputy Human Services Commissioner Chuck Johnson described the hunger strike as "disappointing," pointing to recent efforts by MSOP leaders and others to hold listening sessions with clients, families and their advocates since the last hunger strike in January. Those sessions will result in a report and recommendations that should be finalized in the coming weeks, he said.

"We never want clients to do anything that could endanger their health or become life-threatening. That's first and foremost," Johnson said.

The precise number of people participating in the strike is in dispute. The Department of Human Services, which oversees the MSOP, said "10 or fewer" clients reported they were participating in the hunger strike as of Monday, though detainees say the actual number of participants is closer to 30 because of differences in classifying who is on strike and because many men are not formally telling MSOP staff they are going without food or water.

The strike, which began on July 4, is the latest problem for a state civil commitment system that has lurched from one controversy to the next in recent years and has come under legal challenge. In February, a federal appeals court in St. Louis breathed new life into a protracted legal case challenging the constitutionality of the MSOP, after ruling that claims contesting the program's indefinite confinement could move forward.

In 2015, U.S. District Judge Donovan Frank in St. Paul declared the sex offender program unconstitutional, concluding that a program designed to treat offenders for sexual disorders had become punitive in nature, wrongly detaining people who could be treated in less-restrictive community settings.

Detainees and their advocates have pointed to statistics showing that people are more likely to die at the MSOP than be released. The DHS said that, according to its records, 72 clients have died at the MSOP over its 27-year history. Over the same period, 14 clients have been fully discharged from the program; 49 have been provisionally discharged, which means they were still under state supervision.

Jacob Flom, a detainee at Moose Lake and participant in the hunger strike, said he was among those taken by ambulance to the hospital. After going seven days without food or water, he felt dizzy and collapsed against the wall of his unit. Later, Flom said, he awoke to find himself in a hospital bed with an intravenous line stuck in his arm. Now he's back in custody at the Moose Lake facility, where he has resumed his hunger strike.

"We don't want to do this. I don't like starving myself," said Flom, who has been at Moose Lake for six years. "But I really feel like everything else has been tried, and we are adamant about getting out of here."

The latest action comes amid a year of unprecedented unrest at Minnesota's tightly controlled sex offender program.

After detainees held a 14-day hunger strike in January, Human Services Commissioner Jodi Harpstead agreed to hold a series of monthly meetings with strikers and their representatives in the community. Detainees presented a list of "barriers to release" and 17 corresponding demands. These demands included changing the name of the program to eliminate the term "sex offender"; defunding the MSOP and reallocating the money to victim advocacy; and evaluating the mental health of detainees to determine whether they still required treatment.

Yet hunger strikers say their primary demand — that Minnesota put detainees on a "clear pathway" toward release — has not been addressed. Now they are calling for the program to be shut down. "Millions of dollars are being spent on this program that's sucking the life out of people being forced to live here," said Russell Hatton, a hunger striker who was the first to be hospitalized last week for dehydration.

In a major study on recidivism, the U.S. Department of Justice analyzed the offending patterns of more than 20,000 prisoners who had been released from state prisons in 2005 after serving sentences for rape or sexual assault. The study found that 8% of these ex-prisoners were arrested for rape or sexual assault during the nine years after their release.

Chris Serres • 612-673-4308

Twitter: @chrisserres