AMOS T. BAKER~ M. D, 465

We feel that a psychiatric clinic in a penal institution has a three- fold value.

First. To the prison authorities by taking care of those cases which do not properly belong in the prison on account of mental disorder or mental defect. To acquaint the prison authorities with the characteristics and make up of other abnormal characters who are found among the prison population.

Second. To be of value to the prisoners themselves by talking over their difficulties and helping them to make proper a~ljustments in prison and possibly proper adjustments on the outside.

Third. Research work. As a result of examinations and investi- gations to make some contribution to the causes of delinquency, if possible.

A case of a mental defect is mentioned to demonstrate the value financially of psychiatric work in connection with delinquents. This case was examined in a laboratory some ten years ago. At that time it was felt that he should be segregated. It was reported recently that this mental defective who was not segregated, set fire to some buildings, endangering the lives of a number of people and causing a property damage of $100,000. The cost of maintaining the laboratory was $18,000 a year.

RECENT TRENDS IN THE GIVING OF EXPERT TESTIMONY

BY LEO J . PALI~IER~ M. D.~ SUPERINTENDENT~ NEW YORK STATE

REFORMATORY FOR WOMEN~ BEDFORD HILLS

It would seem that the consensus of both professional and lay opinion is fast crystallizing with respect to the relationship of psy- chiatry to law and the criminal. In spite of sporadic tabloid dis- tortions of the alienist's features of some of the recent criminal cases, we do find that court room controversies between medical experts in matters of mental status are occurring less frequently. This, to some extent, is clue to the fact that quati- fled experts in mental disease retained by both prosecution and defense have made joint examinations and have satisfied themselves of the sanity or insanity of the prisoner previous to trial. In several recent instances, this occurrence of opinion has wholly eliminated the question of the legal responsibility of the prisoner from the trial and permitted the question of guilt to be determined solely on

466 REMARKS MADE AT HEARII~G OF N. Y. STATE CRIIVIE COMMISSION

the facts of the case. Both from the pecuniary value and that of the ends of justice, this is by far the more idealistic and practical procedure. Most of us have undergone the experience of opposing the opinions of so-called mental experts, who in fact were general practitioners or specialists in other fields of medicine, yet, on the strength of a previous connection in some criminal case and with the aid of a textbook on psychiatry, they have been able to qualify as mental experts. It is this type of expert who brings unfortunate and misdirected criticism to the specially trained group of mental experts and is instrumental in prolonging medico:legal cases indefinitely.

In spite of such necessarily brief discussion it should appear that to eliminate the appearance of partisanship when mental experts are called to oppose one another <luring court trial the mental status be determined previous to trial and to the satisfaction of a majority of at least three qualified psychiatrists. And furthermore, that definite steps either legislative or otherwise taken to determine who may qualify as experts in mental disease or as alienists.

In addition to the foregoing, it seems timely to entertain the thought of what is rapidly becoming the modern concept of the dis- position of the prisoner after his guilt has been determined. Those of us who have been engaged in psychiatry in the penal institutions of the State are only too familiar with the many prisoners showing mental aberration that are being regularly committed to our cor- rectional institutions with definite sentences--to be released uncon- ditionally at a definite time--regardless of their attitude toward society at that time. Many of these are our chronic offenders or habitual criminals. We do know that they will return but we dare not hazard a guess as to what they will do before they again fall into the hands of the law. I n passing, I might refer to this group as those who are definitely lacking in social intelligence; the neuro- pathic class made up of psychopaths, epileptics, psychoneurotics, etc., and the potentially psychotic. Statistics disclose that these groups constitute well over 50 per cent of our prison population.

The necessity for brevity in what could well be unlimited discus- sion brings us to the question of practical disposition of the prob- lem. Consensus of opinions of those engaged in criminological fields would indicate that solution lies essentially in the establish- ment of legislation providing for psychiatric classification of all

aOW~D C. S~LDO~ 467

convicted criminals, immediately following conviction and psychi- atric case studies at the disposal of our parole boards in whom would be invested the authority of recommending further segrega- tion for those prisoners who for behavioristic reasons are not adapt- able to extra institutional residence.

THE NEED FOR INDIVIDUAL GUIDANCE OF CHILDREN

BY ROWLAND C. SHELDON~ EXECUTIVE SECRETARY~ BIG BROTHER AND BIG

SISTER FEDERATION~ INC. , N E W YORK CITY

The Big Brother and Big Sister Federation endorses very heart- ily the use of capable psychiatrists in local case-work.

The federation by its studies has ~letermined that the most profit- able place and time to reach children with the idea o f preventing delinquency and later crime, is in the 5th, 6th and 7th grades of the public secondary schools among children in the pre-adolescent and adolescent ages.

The symptoms that would indicate to us the children needing attention are: irritability, anemia, mental retardation, physical defect and emotional instability.

We feel that if such children can be referred to a child guidance clinic for analysis, progzmsis and program, and if the child can then be referred to a competent Big Brother or Big Sister organi: zation with a trained experienced executive, and carefully chosen and trained volunteers, it will be possible during a three or four years' follow-up to carry out the recommendations of the psychiatrist.

We feel that the program is better confided to properly qualified and trained amateurs rather than to professionals, as the former are necessarily devoid of technique, both in vocabulary and manners.

We feel that approximately one per cent of the boy and girl popu- lation of a city having a population of 30,000 or over will be in need of individual, personal and intensive effort in order to avoid serious consequences.

Is it not possible that a child having the characteristics enumer- ated would become psychopathic, and is it not possible to prevent this condition by psychoanalysis, medication, dental, optical and surgical prescriptions and correction of parental attitt~de as well as a change in environment ?