FRANK L. CHRISTIAN~ M. D. 453

at present no satisfactory method of keeping them under proper supervision.

The management of E lmira reformatory causes the formulat ion of a " p s y c h o g r a m " of each inmate received at the institution, and furnishes each head of an insti tutional department , a summary of same, for his guidance in the assignment and adjus tment of all inmates coming under the jurisdict ion of his department . When an inmate is paroled, and before he is actually released upon such parole, a summary of this " p s y c h o g r a m " is sent to the parole offi- cer to whom he makes his monthly reports.

I t is considered that f rom 15 to 25 per cent of the population of the E lmi ra insti tution are definitely psychopathic; and in addit ion to these, there are other types of mental cases, so that one might classify near ly 60 per cent of our inmate populat ion as being mentally abnormal.

As has been before stated, segregation is to be recommended for the recidivist, as he is in all instances a mental case. Such care is as necessary for him as it is for the feebleminded or the insane criminal.

THE ELIMINATION FROM THE COMMUNITY OF THE PSYCHOPATAIC RECIDIVIST

BY GEORG1~ W. KIRCHWEY~ HEAD OF DEPARTI~IENT OF CRIIVIINOLOGY~

NEW YORK SCHOOL OF SOCIAL WORK~ N. Y. C.

I am no psychiatr is t and, at best, only an amateur psychologist but it is just possible that this lack of technical equipment may make my contribution to this discussion of more interest to you. I t is the story of a man groping through experience to a new unders tanding of an ancient problem.

I had scarcely become accustomed to my surroundings as the war- den of Sing Sing Pr ison in the winter of 1915-1916 when I was called upon to deal with a case of murderous assault made by one prisoner on another. I t was easy to know what to do with the vic- t im of the assault. He was taken to the prison hospital, examined and put under treatment. I t was not so easy to know what to do with the man who had committed the assault. The obvious thing to have done, and the thing that would usually be done in such a case, was to have refer red the case to the district a t torney of the

Om'.--l~lS--~,

454 REMARKS MADE AT HEARIl~G OF N. Y. STATE CRIME COMMISSION

county, with the certain result that the man would receive another sentence to Sing Sing in addition to the one he was then serving. That would, as the saying goes, have served the ends of justice, but it still left the man on my hands, with the same power and, pre- sumably, the same disposition that he had so dangerously displayed. So I took another course and invited the help of a .distinguished psychiatrist , the head of a State hospital for the insane, to visit the prison and make an examination of the culprit. He was good enough to do so, made a careful examination of the man and reported that he was insane. A fur ther official examination confirmed this diag~ nosis and the man was thereupon t ransfer red to the State hospital for the criminal insane. A few months later a similar occurrence took place. I followed the same procedure as before and again had the satisfaction of getting rid of a dangerous member of the prison community and get t ing him placed in an institution where his insane tendencies could be controlled and adequately treated.

Now, this seemed to me a very wasteful way of ascertaining what members of the S ing Sing community were unsafe to live with, and so I set myself to the task of devis ing a method of procedure whereby the madmen might be weeded out before they had exhib- ited their madness in killing or a t tempting to kill their fellow pris- oners. Out of this, with the wise and devoted cooperation of the late Dr. Thomas W. Salmon and other eminent psychiatrists, grew the first psychiatr ic clinic at Sing Sing.

In the meant ime my education had been going on apace. Th{~ prison population was upon the whole an orderly one, but there were occasional breaches of disciplinemfights, assaults and attempts to escape--and I soon discovered that though the acts were many the actors were few. The same men came up again and again for disci- pline. Again I consulted my psychiatr ic friends, only to discover that the major i ty of these offenders were not to be classified as insane but as constitutional bad-actors, apparent ly as incapable of profiting by experience or of controlling their emotional outbreaks as were the violent insane. I t was in this way that I discovered the psychopathic or demoralized personali ty as the real problem in prison discipline, far worse, much harder to deal with or to control than the occasional violent lunatic. I d idn ' t know how many of these there were but there were certainly enough of them to cause me constant uneasiness.

GEORGE W. KIRCHWEY 455

Then came the report of our psychiatric clinic, showing that something like 12 per cent of the population of the prison, some 200 in all, were definitely insane and another 18 per cent, that is to say 300 more, were irresponsible psychopaths--a total of 500 men out o a population of 1,500, who were to a greater or less degree, a men- ace to the peace and order of the prison community and many of them a positive danger to life and safety. But we didn't know who they were. The statistics in question were based on random sam- ples, current admissions to the prison. For the most part the indi- viduals which made up these dangerous classes remained unidenti- fied and continued to mingle as before with the general prison pop- ulation. To identify them would have been a useless formality. I had no way of segregating or treating them. The State had made no adequate provision, for the psychopaths no provision at all, for taking care of them elsewhere.

Then I sat in every month at the meetings of the Board of Parole. Man after man came up and pleaded his case for release. If he had behaved himself in prison he could generally count on being paroled at the expiration of his minimum sentence. If his prison record had been bad he might be detained a month or two longer. But the parole board knew nothing and could know nothing of the mental condition of the men apparently entitled to parole. So they were turned out--the sane and the insane, the normal and the psycho- pathic--to make their way as best they could in the world outside and then, after a few months or years, to come back again, perhaps more than ever a menace to the prison community and the plagu(~ of the prison administration.

I trust, Mr. Chairman and Gentlemen, that I shall not seem to exaggerate if I say that this is the most important issue that con- fronts you in your warfare against crime, and that the most vital blow that you can inflict on the enemy will be the elimination of thi~ dangerous and demoralizing element from the prisons and fro~: society. These are the true " repea te r s" , the real and, perhaps, the only "incorrigibles ", and if they are, indeed, ' ' irresponsible ' ', as many of them doubtless are, that is the best of all reasons for protecting the community against them. This can be effectually accomplished only by providing for a thorough study by competent psychiatrists of every person convicted of crime an.d by the provi-

456 REMARKS MADE AT HEARING OF N. Y. STATE CRIME COI~MISSION

sion of a State psychopathic hospital as well as enlarged facilities for the criminal insane.

In conclusion may I venture to urge your consideration of what has here been referred to as the Massachusetts plan or some practi- cable modification of that device for identifying and eliminating these dangerous personalities, whether insane, psychopathic or feebleminded, before trial. The sooner we can get rid of them and put them where they belong, the better, both from the point of view of safety and of public expense. The courts now have the power to do this, but the power is almost never exercised. Let us make it a matter of routine procedure and have it done.

THE IMPORTANCE OF KNOWING THE PERSONALITY MAKE-UP OF THE CRIMINAL

BY CHARLES ~I. BURDICK~ M. D.~ SUPERINTENDENT~

DANNEI~IORA STATE HOSPITAL

We are all interested in learning as much as possible about crhne and the criminal, especially the causes of crime, its prevention and the reformation of the criminal, if that be possible. In order to gain this knowledge, it seems to me we must of necessity approach the problem with a scientific mind and spirit. In order that less emphasis may be placed on punishment and more on reformation, I believe we should pay more attention to the criminal as such and not so much to the crime.

Some time ago the medical profession was criticised for paying too much attention to the disease and its nature and not enough attention to the patient and his nature. In recent years, I am glad to say, we have seen more emphasis placed on the patient, especially with reference to his make-up, his personality and his character, that which we speak of as the sum total of his internal and external characteristics. This has been brought about largely through the efforts of the National Committee for Mental Hygiene, the Ameri- can Psychiatric Association and other allied agencies.

As the result of the establishing of mental clinics, child guidance clinics and behavioristic clinics much has been learned as to the proper handling of many conduct disorders.