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time. We must not attempt too much and we must be very sure of our ground as we recommend and suggest.

The Judicial Council must approach the work in a broad spirit and with a real desire for improvement. Behind these must be a sympathetic attitude on the part of the judges and the lawyers of the State, and a realization on their part that occaisonal necessary changes mean a little inroad on old methods, practices and habits.

I shall be glad to have the fullest expression of view of all present before we attempt to formulate a plan of action.

ON THE DETERMINATION OF THE MENTAL
STATUS OF PERSONS ACCUSED OF CRIME.

WHITEFIELD N. THOMPSON, M. D.

MAX MAILHOUSE, M. D.

The purpose of this paper is to call attention to the inadequacy of the laws dealing with persons mentally ill or defective, accused of crime.

The reaction of the public to a plea of insanity as a defense is usually a protest, sometimes vigorous and bitter, often one of ridicule; nevertheless a person of unsound mind should not be treated as a criminal. Not alone may this be insisted on ethical grounds; it is against public policy and safety and is uneconomical.

Studies of prison and reformatory population by psychologists and psychiatrists have shown that not less than fifty per cent. are in some degree abnormal, defective or mentally diseased; that more than fifty per cent. are recidivists, and that the latter class is made up predominantly of those showing mental defect This must mean that prison and reformatory methods are ineffectual, as might with certainty have been predicted they would be for the main body of the defective group. Certain of these must be affected unfavorably by prison life and discipline, and they are therefore, when turned back into the community, a greater menace than before entering prison. To stem the flow of this class, representatives of which have from time to time. become nationally conspicuous in revolting crimes, is a present duty that can be neglected only with increasing peril.

Within the last decade or two traditional differences between the legal and medical profession on questions that relate to responsibility have been in a very considerable extent changed, and with increasing frequency in this state psychiatrists are

called upon to render an opinion prior to trial upon the mental condition of persons accused of crime.

In order to arrive at an apprecriation of the desirability, not to say the necessity, of making provision for routine mental examination of persons previously convicted of commission of crime, it may be worthwhile to examine the field as presented by prison psychiatrists.

The results of surveys are fairly uniform, showing only such slight variations as might be expected in different localities, and such as would arise from the condition of completeness or incompleteness of available records.

In a study of some six hundred consecutive admissions to Sing Sing Prison in a period of nine months it was found that two thirds of these had already served one or more terms in prisons or reformatories, and that "fifty-nine per cent. in addition to evincing various conduct disorders-the direct cause of their imprisonment-also exhibited some form of nervous or mental abnormality, which in one way or another had conditioned their behaviour. Twelve per cent, were insane or mentally deteriorated; twenty-eight and one-tenth per cent. were intellectually defective; while eighteen and nine-tenths per cent. were found to be psychopathic." Above eighty per cent. of the defectives had received one or more previous reformatory or prison sentences, and in the psychophatic group more than eighty-six per cent. were recidivists. In another group, made up of sexual offenders, the most to be feared on the whole as a menace to society, it was found that seventy per cent. were in some way mentally affected. The high percentage of mental cases in the vicious circle of recidivism is rather appalling in the suggestion it carries of potential danger to the community. From it appears an inferential criticism of the manner of dealing with this class, and, further, question is raised as to whether or not some members of this group might not have been turned into lives of usefulness, had their first enforced segregation from society been taken under hospital training, rather than in the adverse influence of the prison population.

1 "Concerning Prisoners"-Dr. Bernard Glueck.

The mentally defective criminal is in the extreme a social misfit. Even in the reformatory he interferes with its purposes, and advantage is too often taken of parole laws or rules to be rid of his presence. His return to the community is marked sooner or later, usually promptly, by conduct in conflict with the law.

Dr. Glueck emphasizes the problem of the mentally defective sexual offender by an illustration2 from which we quote in part, omitting the subject's school and early history up to the time when he was committed at the age of ten to the Brooklyn Disciplinary Training School, from which he was discharged on parole. He was returned at the age of twelve as incorrigible; was paroled after fifteen months, when he was at liberty two years. Was sent to the House of Refuge at the age of sixteen for sex assault; again paroled.

"When, less than six months later, he was again arrested for a particularly vicious sex assault upon a boy aged eight, and sentenced to twenty years in the New York State Reformatory at Elmira, his essential problem was not brought nearer to solution. It was the nature of his crime and not of his instinctive and mental makeup that had aroused the moral indignation of the judge who sentenced him. The institutional authorities in their turn, recognizing in him a defective incapable of being permanently benefitted by reformatory treatment, saw fit to release him after fourteen months, when he became eligible for parole. The Elmira authorities, in contrast to the agencies which had previously handled the boy more or less blindly, had means of knowing precisely what his future career was likely to be. To quote from their own records: 'A coarse type of mulatto; mental status poor; capacity poor; stability poor; moral appreciation poor; susceptibility to training poor.' And this is what they had to say concerning his future: 'Prognosis: A menace to society; permanent custodial care indicated.'

"Why, then, did they release him? This query immediately suggests its obverse: Why, being a reformatory, should they retain him? The facilities for permanent custodial care cannot be

2 "Concerning Prisoners”—Dr. Bernard Glueck.

provided by an institution designed either for punishment or for reformation.

"In view of the doctor's prediction, it is anything but a coincidence that less than four months after his discharge from Elmira, he was again convicted of a perverse sex assault upon a boy aged eleven. At the time of his arrest he admitted that he had used four other boys in a similar fashion. This time his case was administered by a judge who is notoriously skeptical of expert opinion, and who, accepting a plea of sodomy as a first offense, sentenced him to a term of ten years and six months in state prison, this notwithstanding the boy's known dangerously delinquent record.

"His industrial career has been extremely inefficient and on a par with his low capabilities. His average length of service in a place was three or four weeks. A psychometric examination gives him an age of eleven and five-tenths years."

This case, while it represents a somewhat extreme example, nevertheless is characteristic of the trend of certain of the defective or moron group-the "Defective Delinquent" class. Such persons are a handicap in a reformatory institution; they are out of place in a psychiatric hospital. Their requirements are for segregation under provisions especially designed to meet their needs.

There are two serious faults in the present method of handling the defective delinquent. They are not subjected routinely to mental examination on indictment and they are given sentences under which in general they may be paroled or discharged again into society.

At the last session of the General Assembly of this State a bill was introduced entitled "An Act concerning the care and segregation of male defective delinquents and vicious feeble-minded, as follows:

Section 1. There shall be established at the Connecticut Reformatory a department for the care of male defective delinquents and male vicious feebleminded. Such a department shall be known as "The Department for Defective Delinquents" of that institution.

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