CHAPTER XVII
Psychiatry in the Army Correctional System
Ivan C. Berlien, M.D.
GENERAL CONSIDERATIONS
The problems posed by the delinquencies of soldiers were out of all proportion to the numbers of prisoners who were confined as a result of conviction by courts-martial. The psychiatrist was more or less involved from the time an offense was committed until the offender was separated from the Army or was restored to duty. If any suspicion existed before or at the time of trial that the accused was mentally irresponsible, the defense, the trial judge advocate, or the court could have requested psychiatric examination. In fact, in some commands, it was a standing operating procedure to have every accused soldier examined by a psychiatrist before trial. Many who were found to be mentally ill were sent to hospitals rather than to trial by courts-martial. If convicted, the prisoner soon met a psychiatrist at the rehabilitation center, disciplinary barracks, or Federal penitentiary to which he was sent. The primary function of these institutions has always been the restoration of prisoners to duty as soldiers. The role of the psychiatrist in military prisons has been recognized and enlarged since World War I. Indeed, the psychiatrist has become a 'key' figure in military correctional institutions.
ORGANIZATIONAL BACKGROUND
The authority to redesignate the U.S. Military Prison, Fort Leavenworth, Kans., to the U.S. Disciplinary Barracks, together with the statement of its mission, organization, and program, is contained in Sections 1451 to 1460 of Title X of the United States Code. With the exceptions of two sections, dealing with manufacture of supplies for the Army and donations to dishonorably discharged prisoners, these enactments became law on 4 March 1915 and governed the U.S. Disciplinary Barracks in World War II.
The U.S. Disciplinary Barracks at Fort Leavenworth was reestablished as a disciplinary barracks in November 1940, having been under lease to the Department of Justice for 10 years. Thus, with general mobilization, it was the only institution for general prisoners operated by the Army, the Atlantic Branch having been deactivated at about the same
492
time. (The Pacific Branch at Alcatraz, Calif., had been turned over to the Justice Department in June 1934 for use as a Federal penitentiary.) By V-J Day, there were in operation eight disciplinary barracks and five rehabilitation centers in the Zone of Interior. (This is in contrast to World War I, when there were only three disciplinary barracks and no rehabilitation centers.) Further, whereas, on 1 July 1918 (4? months before the defeat of Germany in World War I), there were 3,996 prisoners in confinement in the continental United States, there were 23,062 general prisoners in confinement as of 1 July 19451 (1? months before the defeat of Japan in World War II).2
Before 9 September 1944, the responsibility for the supervision of the various phases of the program for military offenders was distributed among a number of War Department agencies. On 9 September 1944, following recommendations to the Under Secretary of War by Mr. Austin H. MacCormick, Civilian Consultant to the Secretary of War, ASF (Army Service Forces) Circular No. 296 was issued, activating the Correction Division in the Adjutant General's Office. The supervision and functions pertaining to military prisoners were centralized in that office.
On 29 April 1944, an officer of the Neuropsychiatry Consultants Division, SGO (Surgeon General's Office), established liaison with Col. Marion Rushton, AGD (Adjutant General's Department), then the administrative officer who was handling matters of clemency for the Under Secretary of War and who had been, for some time, actively engaged in work on the problem. Colonel Rushton became director of the Correction Division upon its activation and remained in that capacity, developing a broad and efficient program, until he left the service in February 1946. From the beginning of the liaison, the Neuropsychiatry Consultants Division acted in a consultative capacity to the Correction Division on matters pertaining to neuropsychiatry in connection with military prisoners.
PSYCHIATRIC SERVICES
In October 1942, nine cadres of five officers each, detailed by the service commands, were ordered to the U.S. Disciplinary Barracks, at Fort Leavenworth, for an intensive course in orientation in the operation of that institution (fig. 46). These cadres later returned to their respective service commands and set up 'Service Command Detention and Rehabilitation Centers.' (On 16 February 1943, the names were changed to 'Rehabilitation Centers.') In each cadre, there was a neuropsychiatrist who received indoctrination in the methods employed by the Psychiatry and Sociology Board at Fort Leavenworth, which were then incorporated into each of the newly established centers.
1A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 30.
2This comparison suffers because of the marked difference in military strengths in the two wars.-I. C. B.
493
Functions
The basic authority and directions for the establishment and functions of the Division of Psychiatry and Sociology in disciplinary barracks were contained in AR (Army Regulations) 600-395, issued on 30 January 1930. Subsequent revisions of these regulations did not change the provisions of paragraph 13 pertaining to the Psychiatry and Sociology Division. These provisions are as follows:
13. Division of psychiatry and sociology.-a. To be maintained.-There will be maintained at each United States disciplinary barracks a division of psychiatry and sociology.
b. Personnel; assignment. The commandant will make such assignment of personnel to this division as will assure its proper functioning.
c. Office in hospital. Office space will be provided in hospital buildings, if available.
d.Duties of medical officer in charge.
(1)The medical officer in charge of this division will-
(a)Maintain a permanent psychiatric and sociological register of each general prisoner and also, when directed by the commandant of each garrison prisoner.
(b) Advise the commandant in the selection of prisoners for assignment to disciplinary companies, restoration to duty, clemency, vocational training and guidance, schooling and parole (both home and local).
(c)Prepare extracts and summaries of psychiatric and sociological registers for boards requiring them.
(d) Maintain a library on penology and related subjects.
494
(e)Make such routine research and experimentation as may be feasible and also such special research and experimentation as may from time to time be ordered by higher authority.
(f)Collaborate with agencies conducting intelligence and allied tests of applicants for enlistment and give instruction in the detailed methods of conducting such tests.
(2) He will also be available-
(a) For membership on parole, clemency, or restoration boards, and, when detailed as recorder thereof, will be the custodian of the board's records.
(b)For such other duties, medical or otherwise, as may be found desirable, provided they are not inconsistent with the nature of his work at the institution.
To assist in the administration of the functions just outlined, a board of psychiatry and sociology was established, consisting of two line officers, usually the supervisor of prisoners and the parole officer, and the psychiatrist, or other member of the Psychiatry and Sociology Division, who acted as recorder and custodian of the board's records. The senior member present presided at meetings of the board.
The Division of Psychiatry and Sociology was staffed, in addition to one or more psychiatrists, by psychiatric social workers, clinical psychologists, and the clerical help required. The ratio of psychiatric social workers to psychologists to psychiatrists was generally 4 or 5 : 2 : 1 or 2. There generally was, during the war, at least one Red Cross field director who worked closely with the division, chiefly by obtaining a social history on each prisoner, through local Red Cross chapters.
In general, one social worker interviewed each prisoner within a few hours after his arrival at the institution during which time the basic data were obtained upon which to get a complete history; that is, addresses of school, family, past employers, and the like. Request for social history was immediately forwarded to the local Red Cross, and questionnaires were sent to family members, schools, police superintendents, and so forth, so that by the time the prisoner came up for his complete clinical workup, this collaborative and background material usually had been received and already filed in the prisoner's permanent register.
Individual Case Study
For the regular, intensive clinical case study, the prisoner was first interviewed at length by a psychiatric social worker who integrated the material obtained through questionnaires, as well as from the patient himself, into a complete social history. He was next interviewed by a clinical psychologist who performed a psychological examination, including intelligence tests, Army general classification tests, and projective tests when indicated. Both social worker and psychologist usually gave their estimates of the prisoner's personality, stability, and restorability. Then, the prisoner was finally interviewed and examined by the psychiatrist who
495
finally integrated all the findings into a complete report, together with diagnosis, if warranted by a disorder of sufficient severity, and recommendations to the commandant through the Psychiatry and Sociology Board relative to restoration and clemency.
Diagnoses, except in clear-cut cases, were not made. Rather, the behavior pattern of the prisoner was stressed, pointing out strong and weak parts of his personality. The final case reports were couched in nontechnical language, with an effort to make unequivocal statements. To be helpful to boards and commanding officers, the reports had to contain information and findings which could aid in answering the questions: 'Is this prisoner restorable? Should he be granted clemency?" Obviously, a report in which there were inconsistencies between facts, opinions, and recommendations only served to confuse those correctional officers who had to work with the psychiatrists, especially those officers in higher headquarters who had no other knowledge concerning the prisoner and yet were responsible for, and made decisions relative to, restoration and clemency. Fortunately, such inconsistent reports were rare, and although some were better than others, by and large the individual case reports were of significant value. Obviously, the caseload per neuropsychiatrist in any par-
496
ticular institution at any given time largely determined the worthwhileness of reports. In circumstances where the staff was adequate and the workload of the psychiatrist did not exceed two or three cases a day (fig. 47), reports could be considered maturely and made quite complete. On the other hand, with an excessive caseload, the psychiatrist's reports were prepared rather hurriedly and represented a quick appraisal rather than a carefully considered study.
One of the early errors of some psychiatrists was the frequent tendency to diagnose constitutional psychopathic state. Thus, at one rehabilitation center, in 1944, 74 percent of the prisoners had been classified as 'psychopaths.' Also, great discrepancies often existed between rehabilitation centers in the reported proportions of other diagnostic categories. One center reported 1.5 percent as mentally deficient, whereas another reported 15 percent so diagnosed. It would appear that the largest cause of errors was the lack of adequate criteria for psychiatric diagnosis. Perhaps next important was the error of placing too much emphasis upon cross-sectional findings, rather than considering the longitudinal pattern of the life history of the person concerned. However, following a recommendation made by Col. (later Brig. Gen.) William C. Menninger, MC, at the Under Secretary of War Conference on the Rehabilitation of Military Prisoners, Fort Leavenworth, 14-16 November 1944, emphasis was removed from the extensive use of diagnostic labels. Instead, stress was placed upon delineating accurate descriptions of personality patterns and, from these data, rendering a prognostic opinion. Even with this change in policy, an analysis of 2,520 cases studied in the month of December 1944 revealed rather wide differences in the frequency of diagnostic categories among the various Army correctional institutions. Thus, for instance, 76.4 percent of the general prisoners in Disciplinary Barracks 'X' were diagnosed as constitutional psychopaths, whereas in Disciplinary Barracks 'Y' only 12 percent of the prisoners were so diagnosed. Barracks 'X' reported 0.6 percent of its prisoners as mentally deficient, compared with 15 percent of the prisoners so classified in Barracks 'Y.' Similarly, Rehabilitation Center 'A' reported 0.5 of its prisoners as constitutional psychopaths, as contrasted with 58.3 percent of the prisoners so diagnosed in Rehabilitation Center 'B.' (See table 49 for a distribution of all general prisoners by neuropsychiatric diagnosis.)
RESTORATION TO DUTY
Psychiatry and Sociology Board
Generally, to expedite Psychiatry and Sociology Board hearings for the purpose of restoration, carbon copies of the individual case reports were sent to all members of the board before the meeting, in order to acquaint each member with the cases to be heard. At the hearing, the
497
prisoner concerned presented himself before the board and was interviewed by the members. At the conclusion of the hearing, the board made its recommendations for restoration. As previously indicated, the psychiatrist usually served as Recorder and Custodian of Records for the board. The report of the board, together with its recommendations, was forwarded to the commandant of the correctional facility, for approval or disapproval. In either case, the report was then forwarded to the War Department for final consideration.
Disciplinary Company
The first step toward restoration3 to duty was to transfer the prisoner (later termed 'trainee') to the disciplinary company (sometimes called 'The Honor Company'). This transfer was usually ordered by the commandant upon recommendation by the Psychiatry and Sociology Board. For a time, commandants ordered the assignment of prisoners to the disciplinary company regardless of the Psychiatry and Sociology Board's recommendations. This, however, resulted in embarrassment when, later, the commandant's decisions were not approved by the War Department; for obvious reasons, therefore, this procedure was largely discontinued.
The reasons for assignment of prisoners to a disciplinary company by a commandant was understandable, for not being an experienced penologist, he would be guided by a prisoner's appearance, behavior and promises while in confinement, not realizing, for instance, that a forte of the 'psychopath' is the making of a good impression in order to accelerate his release. Also, that a confirmed alcohol addict, after 2 or 3 months of abstinence, with regular exercise, good food, and training can often appear much like a 'normal' man. An example was that of a prisoner with a long record of severe alcoholism and social and economic maladjustment being recommended by a line officer board president for restoration with the well-meant but trite and naive admonishment: 'Now it isn't that you shouldn't drink-just don't drink too much.'
In one rehabilitation center, such naive practices were slowly discouraged and almost entirely ended by the somewhat subtle method of maintaining, in the Psychiatry and Sociology Division, a 'score board' of prisoners received for restoration, showing their subsequent records. As the number of failures of 'psychopaths' and other unsuitable restorees mounted, the commandant showed more of a tendency to be guided by the recommendations of his Psychiatry and Sociology Board and less of a tendency to select men by a superficial impression gained after a brief interview. Of course, the never-ending informal educational campaign, conducted by the psychiatrists among their line officer confreres at the
3Sections 1456 and 1457 of Title X of the United States Code provide for military training and remission of unexecuted portions of the sentences of general prisoners considered suitable for honorable restoration to military service.
498
mess table, at board meetings, and in quarters, resulted in increased insight and broadened outlook on the part of the line officers and, as a consequence, enhanced prestige for the Psychiatry and Sociology Division.
Restoration process.-In general, all prisoners, found upon examination to be mentally and physically qualified for military service, whose civil and military records warranted consideration for restoration and who desired restoration, were assigned to the disciplinary company and were known as 'probationers.' Army Regulations No. 600-375, issued on 24 November 1942, provided that at any time after a probationer had served one-third of his sentence he could make written application for restoration. This requirement, however, was interpreted liberally beginning in the latter part of 1942 so as to give every prisoner considered suitable for restoration an opportunity to be returned to honorable duty, regardless of the portion of the sentence actually served.
Upon successful completion of the training program in the disciplinary company, the written application accompanied by a statement of the prisoner's civil and military record and statement of his mental and physical status, together with comments with regard to restoration, was forwarded to the Correction Division which acted for The Adjutant General. If the commandant's recommendation for restoration to duty was approved by the Correction Division, authorization was forwarded for the remission of the unexecuted portion of the prisoner's sentence and for his transfer to an appropriate service command for assignment to a military unit, based on his qualifications. Although these procedures were almost identical both in rehabilitation centers and in disciplinary barracks, the Commanding General, ASF, on 15 November 1943, directed that restoration to duty of all general prisoners from rehabilitation centers would be accomplished by suspension of the unexecuted portion of the sentence rather than by remission thereof. This action was motivated by the belief that a suspended sentence would provide a greater incentive to 'make good' than if the sentence were completely remitted. Although this concept would seem valid, whether or not actual results of such a policy represented a significant improvement are not known.
Nonrestorables
Shortly after the establishment of the rehabilitation centers, these centers began receiving incorrigible and nonrestorable prisoners of all types, although such prisoners belonged, more appropriately, in disciplinary barracks or in Federal penal and correctional institutions. Reviewing authorities had limited screening facilities, which included little more information than was contained in the record of trial, to assist them in selecting the type of institution considered most suitable for each prisoner. Giving rehabilitation centers the additional function of a screening agency seemed to be the only practicable solution at the time. Therefore, in
499
November 1943, an ASF communication4 stressed that rehabilitation centers screen out all prisoners not considered suitable for restoration, after a study of each prisoner's history and character, and transfer them to disciplinary barracks. This additional responsibility made necessary the addition of more psychologists, social workers, and psychiatrists, which personnel were already in critically short supply. The problem was solved, in part, at some rehabilitation centers by the utilization of trained enlisted and civilian personnel. By the end of the war (31 August 1945), 10,562 prisoners had been transferred from rehabilitation centers to various disciplinary barracks.5
However, by the spring of 1944, nonrestorable prisoners had accumulated in rehabilitation centers to such a marked extent that the psychiatry and sociology departments had developed serious backlogs in their psychiatric processing. In some instances, they were unable to interview and examine prisoners until 6 or 8 weeks after arrival. In an effort to alleviate this situation, the War Department, on 3 October 1944, issued Changes No. 7, AR 600-375, which charged reviewing authorities with the responsibility for screening all prisoners awaiting result of trial who might have serious psychiatric or neurological disorders in order not to send them to rehabilitation centers. In this connection, it is interesting to note that the Commanding General, Sixth Service Command, on 13 September 1943, wrote:
The records of general and garrison prisoners received for confinement at the Sixth Service Command Rehabilitation Center, Fort Custer, Mich., since it was established in December 1942, show a large number of cases involving both mental and physical disability. Many others, while mentally responsible for their actions, are inapt and do not possess the required degree of adaptability for the military service or give evidence of habits or traits of character which serve to render their retention in the service undesirable * * *. It is obvious that prisoners who are mentally or physically disqualified for service should not be sent to the Rehabilitation Center for the purpose of training them for further military service. Many of these prisoners should have been discharged and not brought to trial. Others, particularly garrison prisoners, might have been assigned to special training units for further military training.
On 6 June 1944, the Neuropsychiatry Consultant, Seventh Service Command, wrote: '* * * I would strongly recommend that a directive be issued from Washington to the effect that all soldiers to be tried by a general court-martial be examined by a qualified neuropsychiatrist prior to trial * * *" (Several commands did institute pretrial neuropsychiatric examinations.) However, it was decided that, for many reasons, the project was not feasible. Among such reasons was the fact that neuropsychiatric personnel in the Army were insufficient to meet the workload which would be created by such a change in regulations.
4Letter, The Adjutant General, Headquarters, Army Service Forces, to Commanding Generals, First to Ninth Service Commands, 15 Nov. 1943, subject: Operation of Rehabilitation Centers.
5A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph, op. cit., appendix XX, table 2.
500
MENTAL RESPONSIBILITY
Before and During Court-Martial
The provisions made in the 1928 Manual for Courts-Martial6 for the protection of the accused in connection with insanity were fairly explicit. In the first place, paragraph 30c (3) provided: 'No charge will ordinarily be referred for trial if he is satisfied that the accused is insane or was insane at the time of the offense charged.'
According to paragraph 35c:
An appointing authority may, in his discretion, suspend action on the charges pending consideration of the report of one or more medical officers, or the report of a board convened under AR 600-500 in a case where that regulation applies and it is practicable to convene such a board. The medical officers or board will be fully informed of the reasons for doubting the sanity of the accused and, in addition to other requirements, should ordinarily be required to include in the report a statement, in as nontechnical language as practicable, of the mental condition of the accused both at the time of the offense and at the time of the examination. The appointing authority may, in his discretion, attach the report to the charges if referred for trial or forwarded.
Paragraph 75a of the Manual further provided:
If at any time before the court announces an acquittal or imposes a sentence it appears to the court for any reason that additional evidence with respect to the accused's mental responsibility for an offense charged should be obtained in the interest of justice, the court will call for such additional evidence. The court may adjourn pending action on a request made by it to proper authority that the accused be examined by one or more medical officers and that such officer or officers be made available as witnesses. * * * A request, suggestion, or motion that additional evidence be called for by the court as contemplated herein may be made by any one of the personnel of the court, prosecution, or defense. The court may, in its discretion, give priority to evidence on such issue and may determine as an interlocutory question whether or not the accused was mentally responsible at the time of the commission of the alleged offense. * * * If the court determines that the accused was not mentally responsible, it will forthwith enter a finding of not guilty as the proper specification. Such priority should be given where the evidence on the matters set forth in the specification is voluminous or expensive to obtain and has little or no bearing on the issue of mental responsibility for such matters.
Also, as provided in paragraph 63:
The court will inquire into the existing mental condition of the accused whenever at any time while the case is before the court it appears to the court for any reason that such inquiry ought to be made in the interest of justice. Reasons for such action may include anything that would cause a reasonable man to question the accused's mental capacity either to understand the nature of the proceedings or intelligently to conduct or to cooperate in his defense. For instance, the actions and demeanor of the accused as observed by the court or the bare assertion from a reliable course that the accused is believed to be insane may be a sufficient reason. It should be remembered, however, that while a person who is insane to the extent indicated above should not be tried, nevertheless, until the contrary is shown, a person is presumed to be sane, and
6A Manual for Courts-Martial, U.S. Army. Washington: U.S. Government Printing Office, 1928.
501
the mere assertion that a person is insane is not necessarily and of itself enough to impose any burden of inquiry on the court.
* * * * * * *If the court finds that the accused is insane, the proceedings so far as had embodying the finding to that effect will be forwarded to the reviewing authority; otherwise the trial proceeds.
After Court-Martial
In addition to all these safeguards before and during trial by court-martial, a prisoner still had ample opportunity after conviction and sentence to gain justice if it was shown, even at a later date, that he was mentally not responsible at the time of the commission of the offense of which he was convicted. If, in the case of a general prisoner, it was found that he was not mentally responsible at the time of the commission of the offense of which he was convicted, his sentence could be remitted and he could be separated from the service honorably by the provisions of section II, AR 615-360, of 26 November 1942.
After consultation with various psychiatrists who dealt with this problem constantly, it appeared that, actually, it was a rarity to find a prisoner who was not mentally responsible at the time of the commission of the offense of which he was convicted. In those few cases that were discovered where the prisoner was later determined to have been mentally irresponsible at the time of the commission of the offense, it was doubtful that a psychiatric examination before trial would have satisfactorily settled the issue. Analyses of these cases indicated that, in the incipient stages of mental disorder, there existed insufficient symptomatology or objective findings which would have satisfied the court that the accused 'did not know the difference between right and wrong, and did not have the ability to adhere to the right.' Within these criteria for mental responsibility, it appeared that the accused would have to be obviously 'insane' in order to avoid trial by court-martial.
On 3 October 1944, Changes No. 7 to AR 600-375 read, in part, as follows:
* * * Whenever it appears to a reviewing authority that a prisoner awaiting result of trial may be suffering from serious mental or neurological disorder, he will, before designating the place of confinement, use all reasonably available facilities to determine whether such prisoner is suffering from any disorder listed in c (2) (d) * * * in order that prisoners suffering from such disorders will not be confined in a rehabilitation center.
The disorders listed were those which made restoration to duty unlikely for a soldier so afflicted. Although this change of the regulations was primarily intended to insure that nonrestorable prisoners would not be assigned to rehabilitation centers, it also provided, in essence, a post-trial examination which often resulted in a medical disposition rather than in affirmation of conviction.
502
CHANGES IN THE REHABILITATION PROCESS
Psychiatric Recommendations
On 16 November 1944, at the Under Secretary of War Conference on the Rehabilitation of Military Prisoners, Colonel Menninger, reporting on the group meeting of the psychiatrists of the conference, presented 12 suggestions, as follows:
Our first recommendation concerns the classification board. It is recommended that there be established an extension of functions and augmentations of the Psychiatry and Sociology Board or the creation of a classification board with chief function and purpose of planning and periodically reviewing the rehabilitation plan for each man. It is assumed that all members of this board would contribute to the prisoner program. The psychiatric contribution would include personality evaluation-perhaps more important suggestions regarding the rehabilitation of each offender. At the present time, and in some units, the psychiatrist's contribution is totally limited to psychiatric diagnosis and recommendations for disposition, whereas it is believed that his chief contribution should be advisory in planning and executing the rehabilitation program.
The second recommendation is relative to records. It is recommended that the standard P and S Board should maintain complete records on each man including both findings, claims, dispositions, recommendations, presumptions, accomplishments and that this record should accompany the prisoner if and when transferred to other corrective institutions.
The third recommendation has to do with nomenclature. It is agreed that diagnostic labels are often misused and more often misunderstood. Change 4 to AR 600-375 is too inflexible in the listing of diagnostic categories.
It is strongly recommended that consideration be given to some plan and necessary changes be made in existing directives and regulations which will eliminate the necessity of labeling each prisoner with a diagnostic term as such. In its stead the psychiatrist should furnish in simple and nontechnical language a concise, descriptive and dynamic formulation of psychoneurotic evaluations of the man including opinions as to salvageability, recommendations as to necessary security and suggestions relative to rehabilitation and disposition. Exceptions might include psychoses, mental deficiency, and neurological conditions. Further flexibility in the above-mentioned Army Regulation might be obtained if the board could rule that the soldier is not restorable at the present time with the implication that further training and rehabilitation would likely lead to restoration.
The fourth recommendation is on psychotherapy. On the basis of extensive clinical experience in psychoneurotic treatment methods, it is recommended that full utilization of group psychotherapy be developed in each rehabilitation center and disciplinary barracks by the psychiatrist or under his immediate supervision. Psychoneurotic experience indicates that it may be of definite benefit to the large percentage of the prisoners. Methods of presentation should be augmented by visual aids in the forms of charts, diagrams, movies, as well as simple propaganda techniques including printed material, newspapers, articles, etc.
The fifth recommendation is on clemency. It is recognized that certain specific types of psychoneurotic cases are special problems in the management of these individuals in rehabilitation centers and disciplinary barracks. This group includes the homosexual neurosis developed from combat, and men charged with misbehavior in front of the enemy, psychopaths with suicidal trends, epileptics with deterioration, the chronic alcoholics, the prepsychotic states, etc. It is recommended that a conference be held of a small number of the more experienced psychiatrists from these organiza?
503
tions for the purpose of developing recommendations and suggestions as to the best methods of management and disposition of these problem cases.
The sixth recommendation is followup system. On the basis of scientific experience we should know the degree of success and failure of our methods. This cannot be adequately judged merely on the basis of the number of men returned to duty or the status at the time of discharge from the disciplinary barracks or rehabilitation center. It is recommended that a followup system be developed whereby it might be possible to check our opinions and techniques in an individual case over a period of years as well as the results of our total efforts. Through such findings it might be possible to evaluate other procedures concerned with our work such as the methods of reassignment or of discharge and possible help to, and supervision of, the restored or discharged man. This latter responsibility should be recognized and used as part of our work.
The seventh recommendation is on neuropsychiatric personnel recognizing the importance of the psychiatric, psychological and the social contribution to the understanding of these problems. It is recommended that this group be implemented with adequate and trained personnel. Merely as a guide, the following suggestions are made on the basis of population of 1,500 and a turnover of 200 per month. We feel it should advisedly have 2 psychiatrists, 2 commissioned clinical psychologists, 10 enlisted men, 4 of whom at least should be psychiatric social workers in MOS 263 and 6 civilian stenographers.
The eighth recommendation is the selection and placement of personnel. On the basis that the proper selection and the placement of personnel working with the prisoners is of paramount importance, it is recommended that psychiatric and psychological help be requested relative to the selection and placement of such personnel. Furthermore it is suggested that certain basic requirements might be established for all guards including at least an eighth grade education, an AGCT score with a minimum of 85, a minimum age of 25 * * *.
The ninth recommendation is on a training program. It is believed essential that an organized training course covering this entire field should be presented to every member of the staff. Such a course should certainly include an outline of mental hygiene and psychiatry. It would appear possibly that three such courses might be necessary. First, a course for officers, to include perhaps 6 or 8 lectures in the field of mental hygiene or psychiatry. Second, courses for guards which we assume might have to run indefinitely for at least one hour a week. Third, a course for civilian employees.
The tenth recommendation is arrangements for the exchange of ideas and forms: It is recommended that for the psychiatrists and psychologists that machinery be established by which the forms developed in a particular unit might be available in exchange to the other units. This might be extended to include suggestions on experiences with various methods and techniques and very possibly the exchange of results.
The eleventh recommendation is provisions of a technical library: It is strongly recommended that a library dealing with criminology, penology, psychology and mental hygiene be established and be made readily available to all officers and enlisted men.
The twelfth and last recommendation-Prevention: It is recommended that a study be undertaken to determine whether our experience in these centers to date is capable of giving us some leads relative to the prevention of military offenses and the major problem concerned with the development and maintenance of morale in the Army.
Classification Board
In April 1945, the Correction Division suggested a procedure for classification in rehabilitation centers and disciplinary barracks which supplemented the recommendations offered by Colonel Menninger in that
504
it recommended the extension of functions and the enlargement of the membership of the then existing psychiatry and clemency boards. This was made effective by ASF Circular No. 260, issued on 6 July 1945, which established a 'Classification Board' and defined its duties, as follows:
3. Interviews and investigations. Study of each prisoner will include the following:
thru: | |
a. Establishing the criminal history | Interviewing, fingerprinting, and obtaining FBI and police reports |
b. Compiling the family and personal history | Interview by social worker (sociologist), review of military records, correspondence with sources of information and Red Cross investigation (ordinarily will be provided by the division of psychiatry and sociology at a disciplinary barracks) |
c. Determining the physical history and health status | Medical examination |
d. Determination of mental and emotional health, personality traits, intellectual level, academic achievement, and aptitudes and capabilities | Psychiatric and psychological examination, educational and vocational testing |
e. Study of the religious background and the influence of religion in the prisoner's life | Interview by chaplain |
f.Predicting the prisoner's apparent potentialities as a soldier and his adjustment as a prisoner | Observations and report of commanding officer of reception company and other sources listed above |
4. Classification summary. a. During the prisoner's last week in the reception company, a summary of the results of the study outlined above will be prepared by a classification officer for the use of the classification board on WD AGO Forms 95 and 95-1 (Classification Summary and Classification Summary Continuation Sheet). It will include all relevant and available data in concise form but will avoid repetition and irrelevant detail. Initial classification should not be delayed beyond 30 days. Data received following initial classification should be added to the summary prior to reclassification.
b. Automatic initial distribution of Forms 95 and 95-1 will be made to rehabilitation centers and disciplinary barracks during the period 15 July to 1 August 1945, after which additional supplies may be requisitioned in accordance with AR 310-200, as amended by WD Circular 264, 1944.
5. Classification Board-Composition. a. The Classification Board will consist of at least five officers appointed by the commandant. Its membership will represent both those who are responsible for examining and investigating the prisoner and those who are responsible for the supervision of major portions of the institutional program as they relate to the individual prisoner. In selecting the officers who are to be appointed to the Board, the commandant will exercise particular care to provide a balance between representatives of technical specialties (such as medicine, psychology, education, etc.) and officers with practical military experience. It is desirable that at least one member of the Board be an officer with troop experience, and one a member of the division of psychiatry and sociology. In addition to a classification officer as recorder, members of the Board may be chosen from among the following officers or their representatives:
505
Executive officer | Supervisor of education |
| Supervisor of prisoners | Chief medical officer |
Company commanders | Psychiatrists |
Training officers | Psychologist |
Parole officer | Chaplain |
Employment or vocational officer | Commanding officer of Reception Company |
Security officer |
It is desirable that the president of the Board be a senior officer with general military experience.
b. If the institution has an exceptionally large turnover or if temporarily it has an unusually large backlog of cases, two or more boards may be organized. With two boards, it is desirable to arrange for occasional exchange of members, so that both boards will employ the same standards.
6. Classification Board-Duties and responsibilities. With respect to each new prisoner the Classification Board will make determinations regarding the following:
a. Restoration: If the prisoner is recognized as being definitely nonrestorable that entry should be made. Otherwise, a tentative recommendation with respect to restoration should be made. It is not usually advisable to attempt to determine finally the question of restoration to duty at the time of first classification and if there is any basis for doubt the decision should be deferred.
b. Clemency. The Board's recommendation with respect to clemency will be entered for the information of the commandant in making his recommendation in accordance with paragraph 18, AR 600-375, to the Adjutant General or the commanding general of the service command.
c. Custody. The custody believed proper for the prisoner will be stated in terms of one of the four following degrees of custody: A, B, C, or D.
Custody D means that the prisoner should be transferred to a maximum security disciplinary barracks, such as at Fort Leavenworth or Green Haven; in the event it is impossible to effect such transfer immediately, he should be held in the meantime in the most secure housing facilities available and be eligible only for assignments and activities which provide constant supervision and the closest guard.
Custody C means that the prisoner may be placed in the ordinary housing facilities of a medium security disciplinary barracks or of a rehabilitation center and that he is eligible for assignments under normal supervision within the enclosure but must be closely guarded if detailed to work outside the enclosure.
Custody B means that the prisoner may be assigned to live in the less secure housing units within the enclosure of a medium security disciplinary barracks or of a rehabilitation center and that he may go from one place to another within the enclosure under parole, but if detailed to work outside the enclosure he must be under at least nominal guard or the supervision of overseers.
Custody A means that the prisoner is sufficiently trustworthy to be permitted to live outside the stockade as in the case of honor companies, or their equivalent, or that he may work outside the main enclosure without guard.
Subcategories under A, B, C, or D may be distinguished as required by the special needs or facilities of the institutions. Length of sentence should not be the sole criterion of degree of custody; the latter should be based on all observations which have been made of the prisoner and all known circumstances of his case (of which length of time remaining to serve is only one). In recommending local paroles, the Board will consider the prisoner's custodial classification as defined above.
d. Transfer. The question of transfer to another place of confinement will be considered in relation to recommendations under a andc above. The degree of security provided by Army correctional institutions are to be considered in relation to the degrees of custody distinguished above. The disciplinary barracks at Fort Leaven-
506
worth and Green Haven are maximum security institutions. Prisoners at other institutions who are recommended for custody D by the Classification Board should be considered as candidates for transfer to Fort Leavenworth or Green Haven. The remaining disciplinary barracks and rehabilitation centers, which have been activated to date, are medium security institutions. Prisoners at Fort Leavenworth or Green Haven, and prisoners at rehabilitation centers not deemed restorable, who have been recommended for custody less than D, are to be considered as candidates for transfer to one of the medium security disciplinary barracks.
e. Work assignment. If it appears that the prisoner's rehabilitation will be facilitated by assignment to a particular vocation or that he possesses skills that are of special value to the institution, the Classification Board will make a definite assignment to such vocation or occupation. In all other cases, they will classify the prisoner for general work assignment, specifying such limitations to his assignment as may be required on the basis of his physical or mental condition and his custodial classification.
f. Special program. This includes assignment to school, recommendations for special medical, psychiatric, or other treatment, recommendations for family casework to be arranged through the Red Cross, and other special measures. The name of the social worker (sociologist) who interviewed the prisoner during the reception period will be entered here as the counselor responsible for following the progress of special treatment measures, unless other provision is made therefor.
g. Reclassification date. A definite date will be set in each case for review of the prisoner's program. When he appears before the Classification Board, he will be informed that subject to the approval of the commandant, he will be called up again for reclassification on the stated date. If it is believed that he will be eligible for local parole or some other change in status on the date specified, provided he has made a proper adjustment in the meantime, notation regarding this will be entered in the record and he will be advised of the same so that he may have a definite goal.
TRAINING OF CORRECTIONAL PERSONNEL
Most of the personnel, both officers and enlisted men, of the disciplinary barracks and rehabilitation centers were inexperienced in penology and criminology. They, as most military personnel, were subject to being relieved and reassigned, so that there was a rather rapid turnover of personnel. Attempts were made to stabilize correction installation personnel without success.7
To meet the needs for training, the Second Service Command Rehabilitation Center and Disciplinary Barracks developed an inservice training course for its guard battalion, based on a schedule of 5 hours each week for a year, a total of 250 hours. Of this time, 107 hours were devoted to orientation and basic penology, and 17 hours were allotted to classification, medical, psychiatric, psychological, and educational services. After completion of background lectures, given to the battalion as a whole, the men were divided into departmental groups, in accordance with the duties to which they were assigned. Each group received 63 hours of practical training in the specific duty performed. Included in these groups was one
7An excellent presentation of this phase is contained in chapter IV of 'A Report of the Army's Program for Military Prisoners in the Continental United States During the Period September 1945 to December 1945.' Historical Monograph (Vol. II) of the Correction Division, Adjutant General's Office, War Department, Washington, D.C.
507
assigned to the Classification Unit. This group was made up of two subgroups of which one was assigned to the Psychiatry and Sociology Division.
Hopeful that the personnel situation would soon be stabilized, plans for a central training center were carried forward, and on 16 August 1945, the Correction Department of the Adjutant General's School at Fort Oglethorpe, Ga., began its correctional custodial personnel course. Provisions were made for the training of 600 enlisted men at a time and for the training of 50 officers a month. Seven hours and four hours for enlisted men and officers, respectively, were allotted for psychiatry and classification lectures.
Thus, after 3 years of frustration in the matter of personnel, it was not until the end of the war that a central training program was authorized and underway. That psychiatry had become a vital part of the Army's correctional system was recognized by its inclusion in the basic training course for enlisted men and officers.
GROUP THERAPY
Early Development
As the war progressed and psychiatric personnel became increasingly scarce, it was not possible to assign a sufficient number of psychiatrists to correctional institutions to provide adequate diagnostic, classification, and therapeutic services. Because the classification process was a basic requirement, little of the psychiatrist's time was left for therapy. It was obvious that individual therapy could not be carried out, although, exceptionally, a likely prisoner would receive a few hours of treatment. It became increasingly evident that only by dealing with prisoners in groups could any therapy be accomplished.
Most correctional installations made some attempts toward meeting therapy needs by such means as lectures, discussion groups, or orientation programs. However, too often, these efforts were confined to the evening hours when, after a grueling day of hard labor or rigid military training, the prisoners were too tired to absorb even this meager orientation. Also, it was the rule that other events, such as movies and amateur night, took precedence and that the hour of group orientation would be canceled in favor of some other activity. A noteworthy exception was the Fifth Service Command Rehabilitation Center at Fort Knox, Ky. At this center, an excellent group therapy program was organized and in operation, in 1944. Its apparent success was due, in great measure, to the stimulation and enthusiasm in the effort which stemmed from the commandant and personnel consultant in charge of the program. The therapy was largely on a superficial level but served as an excellent mental catharsis for prisoners. Capt. Joseph Abrahams, MC, the psychiatrist, and Lt. Lloyd W. McCorkle (now one of the directors of the New Jersey prison system)
508
were particularly effective as group leaders or therapists. Under the system at Fort Knox, the men themselves carried on the discussions and were effective in calling each others' failings to the attention of the group, so that group pressure for social adjustment was effectively employed.
Formal Program Established
At the Conference of Rehabilitation Center Commanders, Omaha, Nebr., 20-21 June 1944, a representative8 from the Neuropsychiatry Consultants Division, SGO, urged the commanders to adopt group therapy and to stimulate its use in all centers. The commandant of the Rehabilitation Center at Fort Knox also described, in glowing terms, the group therapy program conducted in his center and recommended its employment by all centers. However, MTP (Mobilization Troop Program) 22-1, which prescribed the military training program for rehabilitation centers, had not included provision for group therapy in the training schedule. Because of the interest and alertness of a member of the staff of the Military Training Division, ASF, who was present at the Omaha conference and who regularly inspected the training program in the various centers, this oversight was then remedied on 10 July 1944. Alert to the urgent need, and mindful of the success of group therapy at the Fort Knox Rehabilitation Center, the Military Training Division, ASF, included in its revised Mobilization Training Schedule, MTP 22-2, provisions for group therapy throughout the entire training period. This was the first time in the history of the War Department that the General Staff had agreed to the inclusion of group therapy as part of a training schedule for military personnel.
Colonel Menninger, later in 1944, at the Under Secretary of War Conference at Fort Leavenworth (p. 502), emphasized this modality of therapy, stating in part, as follows:
If we are to regard these men in the light of psychiatry as being maladjusted, this implies the provision of the most important element in any readjustment process-insight. By the term insight, psychiatrists refer to an understanding on the part of the patient, that first, he is maladjusted (which many patients and certainly military offenders do not know), second, of the nature, and insofar as possible, the reasons for maladjustment, and third, of what his own contribution to readjustment must be. In the clinical practice of psychiatry, this is largely accomplished through individual interviews with the patient, called psychotherapy. Unfortunately, time and manpower prevent this from being possible in our rehabilitation centers, desirable as it may be. We do have, however, the expedient substitute of group psychotherapy-the careful placement of men with similar problems in relatively small groups, with discussion and lecture by the psychiatrist. Group psychotherapy can be very helpful in giving the man a better understanding of his problem, but should not be confused with group 'gripe' sessions, which, while possibly very valuable in moulding opinion, do not necessarily provide insight.
8Berlien, I. C.: Rehabilitation Centers: Psychiatry and Group Therapy. J. Crim. Law and Criminol. 36: 249-255, November-December 1945.
509
Further Development
With these stimuli and its inclusion in the official training schedule, group therapy developed rapidly. At the close of the war, nearly every correctional institution in the Army was employing this method of therapy. Indeed, when one considers that, before the war, group therapy as such was either not employed at all in correctional institutions or at best only tolerated by those in authority, the forward strides made in the Army during the war are impressive to say the least. It is of interest to note that one of the first group therapy programs to be evolved in a civilian prison was that originated by a lay prisoner in the Auburn Prison, N. Y.9 Although several State and Federal prisons had evolved 'discussion groups' and group programs for selected types of prisoners (that is, constitutional psychopaths at Chillicothe, Ohio), it was not known whether group therapy, in the psychiatric sense, had been employed as an accepted or prescribed part of the rehabilitation program in civilian prisons.
Techniques
Techniques varied from one situation to another. The composition and size of groups varied, some being made up of prisoners with similar problems, as for instance, a group of illiterates. Some therapists worked with large groups and others with small ones. Some psychiatrists began their program with a lecture to a large group, followed by a discussion period. The large group was then divided into smaller components for which more frequent group therapy sessions were utilized. In general, experience in group therapy proved that better results and greater ease in management were obtained by using groups of not more than 30 to 35 (fig. 48).
As might have been expected, one difficulty encountered was that of the attempt at domination of the group by one or more 'psychopaths.' In fact, unless the therapist was unusually adept and exceptionally facile in his technique, it was found to be good practice to remove the more aggressive and resentful 'psychopaths' from the general groups. The therapist could then place 'psychopaths' together in a separate group, or could permit their inclusion in a group where there was some certainty of controlling the aggressions of the 'psychopath' and of thwarting his efforts to dominate and occupy the center of the stage at all times.
Fort Knox program.-At Fort Knox, the group therapy program was divided into three phases; namely, the 'preliminary,' the 'analytical,' and the 'synthetic.' The preliminary phase occupied the first 9 weeks and was largely devoted to imparting a working understanding of psychological principles and their relation to behavior to the individual, to orient?
9Personal communication from Mr. Austin H. MacCormick, Director, Osborne Foundation, Civilian Consultant to the Secretary of War.
510
ing him to the center, and to preparing him to consider his own problems. Among the topics presented and discussed in this phase were orientation talks, lectures with colored slides, 'Human Personality' and 'Personality Development,' and methods of escape from reality.
The second, or analytical, phase lasted 12 weeks and attempted, through group discussion, to analyze the various group members' problems. Topics for discussion, from time to time, included AWOL (absent without leave) and desertion, the role of authority and the manner in which different personalities respond to authority, the personality defects of the 'alcoholics,' and the effects of fear on behavior.
The last, or synthetic, phase concluded the prisoners' last 5 weeks at the Center and aimed at having each group member analyze changes in his attitudes and underlying reasons for such changes, as well as helping him to rid himself of any remaining resentments or hostilities. During this last phase, the group also examined problems which were likely to arise following restoration to duty. Among topics discussed in this final phase were 'profit by personal experience and experience of others,' 'adoption of patterns of expression which satisfy one and are acceptable in a social situation,' and 'adjustment to the new outfit.'
Alcoholics Anonymous.-In connection with group therapy, another significant innovation occurred in correctional institutions during the war.
511
This was the participation of AA (Alcoholics Anonymous) in the rehabilitation program in several institutions. The alcoholic prisoner's participation in AA was on a voluntary basis. The AA program was conducted mainly in those institutions located in or near the larger cities. Civilian members of local AA groups regularly came to the rehabilitation centers and worked with those alcoholic prisoners who desired their help.
Trends.-As the war ended, several definite trends in group therapy were detected. There was a tendency on the part of most therapists to work with smaller groups (fig. 48) because of obvious factors. In larger groups, there was insufficient opportunity for everyone to talk, and the men were less likely to develop group identification. It was also noted that there was a growing tendency to select groups of men with similar personality patterns, difficulties, and needs. This followed the realization that prisoners profited most by participation in discussions of problems similar to their own and progressed more rapidly in gaining insight if all members of the group were concerned with similar difficulties than if the discussions centered on other or dissimilar problems. Thus, groups of neurotics with predominantly psychosomatic symptoms were organized, while other groups would be made up of schizoid or inadequate personality types.
Effectiveness.-Evaluation of the effectiveness of group therapy was difficult, particularly as it was only one aspect of the total rehabilitation program. Certainly, if enthusiasm of both prisoners and correctional personnel can serve as an index, it was successful. Many commandants, prison officers, guards, and others voluntarily stated that group therapy alleviated friction, disciplinary problems, and resentment. Because there was no possibility of experimentally using control groups, scientific evaluation was not accomplished. However, the widespread employment of group therapy and its inclusion in the official training schedule are facts which bear testimony to its acceptance and to the belief by both medical and line personnel that it was beneficial.
PSYCHIATRY AND CLEMENCY
Throughout the war and following the termination of hostilities, psychiatrists connected with correctional work shared in the responsibility of deciding matters pertaining to clemency (fig. 49). The psychiatrists in the various correctional institutions were required by AR 600-395 to make recommendations to the commandant concerning clemency. The Neuropsychiatry Consultants Division, SGO, received large numbers of these cases for review, opinion, and recommendations concerning clemency from the Clemency Branch of the Correction Division, and was also called upon by that division to take active part in determining official policies concerning clemency.
512
FIGURE 49.-A disciplinary and adjustment board meeting at a U.S. disciplinary barracks.
Criteria for Clemency
Those men found to be essentially normal and who met the physical requirements for duty were recommended for restoration to duty. This type of prisoner constituted no great problem. Even those prisoners who had some psychopathic traits, not of serious degree, were usually given the benefit of the doubt and likewise presented no serious problem. Many of the offenses involved were military in nature, without counterpart in civilian life. Indeed, most prisoners were convicted of AWOL, desertion, disobedience of orders, disrespect for officers or noncommissioned officers, or violation of arrest or confinement.
Prisoners who did not meet requirements for military service constituted the major difficulty to clemency, for many had mental or physical defects which rendered their retention as prisoners a strain on both facilities and personnel. In such cases, the psychiatrist was often tempted,
513
as were his line officer confreres, to recommend clemency on the grounds that continued confinement would avail nothing of value either to the man or to the service and might even aggravate the existing condition and make necessary transfer to a hospital.
Frequently, the psychiatrist recommended, and classification boards and the commandant approved, clemency for prisoners with neuropsychiatric disorders on the basis that continued confinement might result in their becoming psychotic. The problem which emerged was: 'Is the prisoner's health the critical factor in determining clemency? Or should it be accepted, in the practice of penology, that offenders are not sent to prisons, disciplinary barracks, or rehabilitation centers for their health, and that it is presumed that confinement for violation of the law (Articles of War) is not conducive to improving one's mental well being?'
Morale factors.-In considering clemency for general prisoners, other factors also had to be considered. For instance, the effect upon troops of releasing prisoners while the war was raging had to be considered. To exert a deterrent effect, punishment for military offenses had to demonstrate to other soldiers that it was better to continue effective duty rather than to 'mess up.' To the man in a foxhole, risking his life hourly, day and night, in rain, in cold, or in jungle heat, 'getting out' of the Army even by receiving a dishonorable discharge seemed like a reward for wrong?doing as compared to a daily fare of shells, bombs, mud, poor or no food, and danger-the apparent reward for which was more of the same hazards and hardships. An illustration of this morale factor was the case of a prisoner from the Mediterranean theater who was found to have a severe psychoneurosis with only a marginal adjustment. Because it was believed that continued confinement might result in more serious mental disease, clemency was granted and the man was dishonorably discharged. However, information found its way back to this soldier's combat outfit to the effect that he had been released from prison and was now earning 'big money' in a war plant. The effect of this news on his former fellow soldiers' morale was definitely bad. Similarly, parents, relatives, and friends of combat soldiers demanded that military prisoners not be 'pampered' or released to make high wages in civil life while 'their boys,' because they were 'good soldiers,' were risking their very lives and sanity at the 'front.'
It may be understood, therefore, that psychiatrists and others concerned with matters of clemency were confronted with problems which further produced conflicts within themselves.
Policies
The policies of the War Department concerning clemency were evolved after a great deal of consideration and consultation. The Neuropsychiatry Consultants Division played an important role in this connection.
514
Mental deficiency
From the psychiatric standpoint, it was believed that there were certain classes of prisoners to be considered. In March 1945, the policy of clemency for the mentally deficient was established. For this type of prisoner, the following were held to be the important factors:
1. Civilian background before military service:
a. Social-economic history.
b. Habits.
c. Work record.
2.Military Record:
a. Type of offense.
b. Adjustment in confinement.
c. Psychometric test results.
d. Reason for maladjustment in Army.
e. Attitude.
It was decided that the following conditions were to be satisfied before recommending clemency:
1. Clean or negligible civilian record of arrest or confinement.
| Diagnosis | Number | Percent |
No diagnosis (essentially normal, no diagnostic label, no mental disease) | 9,345 | 40.5 |
Diagnosis deferred | 783 | 3.4 |
Constitutional psychopathy: | ||
| Unclassified | 5,495 | 23.8 |
| Alcoholism | 1,517 | 6.6 |
| Drug addiction | 124 | .5 |
| Inadequate personality | 892 | 3.8 |
| Emotional instability | 721 | 3.1 |
| Schizoid personality | 184 | .8 |
| Recidivist | 157 | .7 |
Mental deficiency | 1,570 | 6.8 |
Simple adult maladjustment | 701 | 3.0 |
Psychoneurosis | 449 | 1.9 |
Schizophrenia | 81 | .3 |
Other psychosis | 25 | .1 |
Epilepsy | 21 | .1 |
Other diagnosis | 1,078 | 4.6 |
| Total | 23,143 | 100.0 |
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office War Department, Washington, D.C., appendix XX, table 29 (modified).
515
Principal military offense | All institutions | Rehabilitation centers | Disciplinary barracks | Federal institutions | ||||
Number | Percent | Number | Percent | Number | Percent | Number | Percent | |
Absent without leave | 9,435 | 48.0 | 6,058 | 50.7 | 3,180 | 44.8 | 197 | 33.0 |
Desertion | 5,690 | 28.9 | 3,549 | 29.7 | 1,961 | 27.6 | 180 | 30.1 |
Mutiny or sedition | 119 | .6 | 28 | .2 | 45 | .6 | 46 | 7.7 |
Misbehavior before the enemy | 155 | .8 | 31 | .3 | 123 | 1.7 | 1 | .2 |
Discreditable conduct toward superior officer | 2,055 | 10.4 | 1,117 | 9.3 | 912 | 12.8 | 26 | 4.4 |
Misbehavior of sentinel | 269 | 1.4 | 195 | 1.6 | 71 | 1.0 | 3 | .5 |
Violation of arrest or confinement | 1,625 | 8.3 | 846 | 7.1 | 687 | 9.7 | 92 | 15.4 |
Committing depredation or riot | 103 | .5 | 41 | .3 | 59 | .8 | 3 | .5 |
Other | 211 | 1.1 | 93 | .8 | 69 | 1.0 | 49 | 8.2 |
| Total | 19,662 | 100.0 | 11,958 | 100.0 | 7,107 | 100.0 | 597 | 100.0 |
1Of the 24,289 prisoners for whom such reports were available, 4,627 were convicted of offenses of civil nature only.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 5 (modified).
Education attainment (grade completed) | All institutions | Rehabilitation centers | Disciplinary barracks | Federal institutions | ||||
Number | Percent | Number | Percent | Number | Percent | Number | Percent | |
Less than 4th grade | 1,324 | 5.7 | 745 | 5.6 | 478 | 5.8 | 101 | 6.3 |
4th to 8th grade | 12,493 | 53.7 | 7,085 | 53.1 | 4,542 | 54.7 | 866 | 54.1 |
1st to 2d year high school | 5,506 | 23.7 | 3,257 | 24.4 | 1,895 | 22.8 | 354 | 22.1 |
3d to 4th year high school | 3,439 | 14.8 | 2,046 | 15.3 | 1,168 | 14.1 | 225 | 14.1 |
Some college training | 439 | 1.9 | 200 | 1.5 | 190 | 2.3 | 49 | 3.1 |
College graduate | 41 | .2 | 11 | .1 | 25 | .3 | 5 | .3 |
| Total | 23,242 | 100.0 | 13,344 | 100.0 | 8,298 | 100.0 | 1,600 | 100.0 |
1Of the 1,085 unreported prisoners, 881 were in rehabilitation centers, 175 in disciplinary barracks, and 29 in Federal institutions.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 17 (modified).
516
2. No history of maladjustment due to alcoholism.
3. No history of nomadism.
4. Attachment to home and sense of responsibility toward it.
5. Reasonably good work record considering his intelligence level.
6. Not considered a problem in the community.
7. Not restorable to duty.
8. Good adjustment in the institution considering his intelligence.
9. Offense military or minor civil.
10. Psychometric tests and clinical observations indicate definite mental deficiency.
11. Inability to adjust in the Army because of or secondary to his mental deficiency.
12. Attitude good.
13. Reasonable assurance that the community will readily recognize his unfitness as a soldier and that he will assume a similar role in the community, home and on the job to that held before entering military service.
Psychosis
In deciding whether or not to recommend clemency for psychotic general prisoners, the following factors were considered:
1. Personality before becoming psychotic.-For instance, in the case of a constitutional 'psychopath' with criminality, it was recommended that he not be granted clemency, but that he be transferred to St. Elizabeths Hospital, Washington, D.C., allowing his sentence to stand, because, should his sentence to confinement have been remitted and his transfer to a State or private hospital been effected, upon his recovery from psychosis
Educational attainment (grade completed) | General prisoners1 | Enlisted men2 |
1st to 8th grade | 59.4 | 28.6 |
9th to 12th grade | 38.5 | 60.2 |
Some college training | 1.9 | 8.2 |
College graduate | .2 | 3.0 |
| Total | 100.0 | 100.0 |
1Based on reports for 23,242 general prisoners in confinement during the year 1945 at rehabilitation centers, disciplinary barracks, and Federal institutions.
2Based on a 2-percent personnel survey as of 30 June 1944.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 28 (modified).
517
he would be discharged, thus allowing a criminal 'psychopath' to return to society. On the other hand, in case the prisoner had a good record in civilian life and committed a military offense and was suffering an apparently chronic psychosis, clemency was recommended in order to permit his transfer to State or private hospital, if that were possible.
2. Nature of illness.-Early in the war, many recommendations for clemency were received in the War Department, for psychotic prisoners who, upon further investigation, were found to be exhibiting a 'Ganser' or 'prison' psychosis, from which they often spectacularly recovered when transferred to a general hospital, free from the prison atmosphere.
3. There was a tendency on the part of some psychiatrists, post surgeons, and commandants of disciplinary barracks to recommend clemency for 'psychopaths' who simply exhibited temper tantrums, aggressiveness, and destructiveness and who, in general, were great nuisances. It was obvious that such recommendations represented a half-conscious, half-unconscious desire to 'get rid' of them on the part of local authorities. A campaign of education resulted in markedly reducing such recommendations.
HOSPITALIZATION FOR PSYCHOTIC PRISONERS
Army Hospitals
At various times and at various places, the hospitalization of psychotic prisoners became a problem, complicated by the fact that, at times, various hospitals and rehabilitation centers were unsure as to which organization
Score | General prisoners1 | Enlisted men2 | ||
Number | Percent | Number | Percent | |
130-162, superior | 381 | 2.2 | 6,469 | 6.0 |
110-129, above average | 2,630 | 15.1 | 33,089 | 31.0 |
90-109, average | 5,276 | 30.2 | 33,320 | 31.2 |
60-89, below average | 7,637 | 43.8 | 28,989 | 27.1 |
42-59, inferior | 1,514 | 8.7 | 4,998 | 4.7 |
| Total | 17,438 | 100.0 | 106,865 | 100.0 |
1Based on reports of 17,438 of 24,327 general prisoners in confinement during the year 1945 at rehabilitation centers, disciplinary barracks, and Federal institutions.
2Based on a 1.54-percent personnel survey as of 31 March 1945.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 27 (modified).
518
should assume responsibility for clemency recommendations and as to the correct channels of command concerned. In the late summer and fall of 1944, there were so many psychotic prisoners at the Eastern Branch of the U.S. Disciplinary Barracks, Green Haven, N.Y., that a sizable number had to be transferred to Mason General Hospital, Brentwood, Long Island, N.Y. Careful investigation revealed that the great majority of these psychoses were psychosis with constitutional psychopathic state who
Age | General prisoners1 | 1944 mean strength of Army enlisted men2 | ||
Number | Percent | Number | Percent | |
Under 20 years | 1,478 | 6.4 | 521,441 | 7.5 |
20 to 24 years: | ||||
| 20 years | 2,028 | 8.7 | 478,813 | 6.9 |
| 21 years | 2,448 | 10.5 | 521,379 | 7.5 |
| 22 years | 2,593 | 11.2 | 562,028 | 8.0 |
| 23 years | 2,357 | 10.1 | 589,374 | 8.4 |
| 24 years | 2,058 | 8.9 | 552,748 | 7.9 |
| Total | 11,484 | 49.4 | 2,704,342 | 38.7 |
25 to 29 years: | ||||
| 25 years | 1,900 | 8.2 | 535,671 | 7.6 |
| 26 years | 1,541 | 6.6 | 479,308 | 6.9 |
| 27 years | 1,201 | 5.2 | 389,472 | 5.6 |
| 28 years | 937 | 4.0 | 334,408 | 4.8 |
| 29 years | 843 | 3.6 | 283,860 | 4.1 |
| Total | 6,422 | 27.6 | 2,022,719 | 29.0 |
30 to 34 years | 2,639 | 11.3 | 1,070,227 | 15.3 |
35 to 39 years | 1,065 | 4.6 | 577,186 | 8.3 |
40 years and over | 167 | 0.7 | 86,618 | 1.2 |
| Grand total | 23,255 | 100.0 | 6,982,533 | 100.0 |
1Based on reports for the general prisoners in confinement at rehabilitation centers, disciplinary barracks, and Federal institutions, in 1945. Age as of the time of sentence. (Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 25
(modified).)
2Percent distribution based on a sample tabulation, ATE-10. "Analysis of U.S. Army Personnel by Rank and Year of Birth as of 31 December 1944," Adjutant General's Office. These percentages were applied to the mean strength of Army enlisted men in 1944-for a numerical distribution by age.
Median Ages: General prisoners, 24.4 years; total Army enlisted men, 25.5 years.
519
Number of commitments | All institutions | Rehabilitation centers | Disciplinary | Federal institutions | ||||
Number | Percent | Number | Percent | Number | Percent | Number | Percent | |
None | 15,287 | 69.9 | 9,138 | 72.3 | 5,112 | 67.1 | 1,037 | 64.8 |
One | 3,671 | 16.8 | 1,988 | 15.7 | 1,372 | 18.0 | 311 | 19.4 |
Two | 1,584 | 7.3 | 826 | 6.5 | 627 | 8.2 | 131 | 8.2 |
Three | 697 | 3.2 | 372 | 2.9 | 266 | 3.5 | 59 | 3.7 |
Four | 336 | 1.5 | 170 | 1.3 | 130 | 1.7 | 36 | 2.2 |
Five | 125 | .6 | 60 | .5 | 55 | .7 | 10 | .6 |
Six | 70 | .3 | 36 | .3 | 29 | .4 | 5 | .3 |
Seven | 36 | .2 | 23 | .2 | 12 | .2 | 1 | .1 |
Eight | 29 | .1 | 15 | .1 | 8 | .1 | 6 | .4 |
Nine or more | 32 | .1 | 20 | .2 | 8 | .1 | 4 | .3 |
| Total | 21,867 | 100.0 | 12,648 | 100.0 | 7,619 | 100.0 | 1,600 | 100.0 |
1Of the 2,460 unreported prisoners, 1,577 were in rehabilitation centers, 854 in disciplinary barracks, and 29 in Federal institutions.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 22 (modified).
Courts-martial | All institutions | Rehabilitation centers | Disciplinary barracks | Federal institutions | ||||
Number | Percent | Number | Percent | Number | Percent | Number | Percent | |
None | 6,642 | 31.1 | 3,732 | 29.1 | 2,071 | 29.7 | 839 | 52.9 |
One | 5,012 | 23.4 | 3,122 | 24.4 | 1,534 | 22.0 | 356 | 22.4 |
Two | 4,030 | 18.8 | 2,479 | 19.3 | 1.364 | 19.6 | 187 | 11.8 |
Three | 2,689 | 12.6 | 1,669 | 13.0 | 920 | 13.2 | 100 | 6.3 |
Four | 1,508 | 7.0 | 935 | 7.3 | 522 | 7.5 | 51 | 3.2 |
Five | 850 | 4.0 | 519 | 4.0 | 296 | 4.2 | 35 | 2.2 |
Six | 319 | 1.5 | 192 | 1.5 | 117 | 1.7 | 10 | .6 |
Seven | 167 | .8 | 99 | .8 | 59 | .9 | 9 | .6 |
Eight | 84 | .4 | 48 | .4 | 36 | .5 | --- | 0 |
Nine or more | 75 | .4 | 29 | .2 | 46 | .7 | --- | 0 |
| Total | 21,376 | 100.0 | 12,824 | 100.0 | 6,965 | 100.0 | 1,587 | 100.0 |
1Of the 2,951 unreported prisoners, 1,401 were in rehabilitation centers, 1,508 in disciplinary barracks, and 42 in Federal institutions.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 19 (modified).
520
became violent and destructive in the Station Hospital at Green Haven, where the facilities were inadequate for their proper care. However, most of these prisoners improved rather well at Mason General Hospital, but became aggressive, often suicidal, at the suggestion of being returned to the Disciplinary Barracks to serve out their sentences. For these reasons, the Neuropsychiatry Consultants Division recommended that a small neuropsychiatric hospital be constructed at Green Haven in order to obviate transfer of psychotic prisoners to general hospitals and their subsequent severe reaction upon return to prison. Obviously, if such prisoners never left the Disciplinary Barracks, the issue of exacerbation of symptoms would not occur. However, for administrative reasons, this prison psychiatric hospital was never constructed.
Other Hospitals
Because the Federal Security Agency, according to AR 600-500,10 may be designated by the Secretary of War to receive psychotic military prisoners, the possibility of their transfer to hospitals of that agency was explored early in 1945. However, St. Elizabeths Hospital was found to be the only institution to which such psychotic prisoners could be transferred because all other beds available to the Federal Security Agency were in hospitals of the Federal Bureau of Prisons. The Judge Advocate General of the U.S. Army ruled that it was not legal to transfer Army patients
Courts-martial | All institutions | Rehabilitation centers | Disciplinary barracks | Federal institutions | ||||
Number | Percent | Number | Percent | Number | Percent | Number | Percent | |
None | 17,989 | 92.4 | 11,599 | 94.8 | 4,985 | 88.3 | 1,405 | 89.4 |
One | 1,320 | 6.8 | 602 | 4.9 | 577 | 10.2 | 141 | 8.9 |
Two | 136 | .7 | 39 | .3 | 74 | 1.3 | 23 | 1.5 |
Three or more | 16 | .1 | 1 | .0 | 12 | .2 | 3 | .2 |
| Total | 19,461 | 100.0 | 12,241 | 100.0 | 5,648 | 100.0 | 1,572 | 100.0 |
1Of the 4,866 unreported prisoners 1,984 were in rehabilitation centers, 2,825 in disciplinary barracks, and 57 in Federal institutions.
NOTE.-The entry .0 indicates a rate of more than zero but less than .05.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 20 (modified).
10Army Regulations No. 600-500, 20 Nov. 1939, with revisions of 7 Aug. 1942, 25 May 1944, and 4 Feb. 1946.
521
to any component of the Federal Bureau of Prisons unless a Federal prison had been specifically designated as the place of confinement in the court-martial sentence.
The question of transfer to a Veterans' Administration facility was likewise investigated. It was determined that the patient-prisoner or his legal representative would be obliged in each case to appeal to the Veterans' Administration for a ruling as to whether or not, in its opinion, the patient was or was not mentally responsible at the time of the commission of the offense of which he was convicted. If the Veterans' Administration ruled that he was not mentally responsible at the time of the offense, then the patient was entitled to care in its facilities, since a dishonorable discharge automatically canceled any benefits from the Federal Government.
Final Policy
On 29 October 1945, directions for the transfer, care, and disposition
TABLE 58.-Distribution of the general prisoners, by place of confinement and crimes committed, 19451
| Crimes | All institutions | Rehabilitation centers | Disciplinary barracks | Federal institutions | ||||
Number | Percent | Number | Percent | Number | Percent | Number | Percent | |
Murder | 6 | 0.2 | 3 | 0.2 | --- | 0.0 | 3 | 1.1 |
Rape | 27 | 1.0 | 13 | .9 | 10 | .9 | 4 | 1.4 |
Robbery | 259 | 9.4 | 148 | 10.6 | 97 | 9.1 | 14 | 5.0 |
Assault with intent to rob | 20 | .7 | 10 | .7 | 8 | .8 | 2 | .7 |
Manslaughter | 29 | 1.1 | 17 | 1.2 | 12 | 1.1 | --- | 0 |
Assault | 27 | 1.0 | 15 | 1.1 | 8 | .8 | 4 | 1.4 |
Burglary | 618 | 22.6 | 302 | 21.7 | 250 | 23.5 | 66 | 23.6 |
Larceny and auto theft | 1,127 | 41.2 | 572 | 41.1 | 433 | 40.6 | 122 | 43.6 |
Receiving stolen property | 19 | .7 | 6 | .4 | 10 | .9 | 3 | 1.1 |
Embezzlement and fraud | 20 | .7 | 12 | .9 | 3 | .3 | 5 | 1.8 |
Forgery | 223 | 8.1 | 113 | 8.1 | 84 | 7.9 | 26 | 9.3 |
Violating liquor or drug laws | 40 | 1.5 | 19 | 1.4 | 17 | 1.6 | 4 | 1.4 |
Other felonies | 323 | 11.8 | 163 | 11.7 | 133 | 12.5 | 27 | 9.6 |
| Total | 2,738 | 100.0 | 1,393 | 100.0 | 1,065 | 100.0 | 280 | 100.0 |
1Of the 24,327 general prisoners for whom reports were available, 2,344 were known to have been convicted of crimes which resulted in commitments to penitentiaries or reformatories for adults, and of these, the crimes in 40 cases were not reported. The maximum number of crimes tabulated for any one prisoner was 2.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 24 (modified).
522
of psychotic general prisoners were promulgated in ASF Circular No. 405. Seven Army hospitals, chosen for various reasons among which was their proximity to correctional institutions, were designated to receive such patients. It was directed that such prisoners be carried as absent, or sick in hospital, by the prison installation designated as his place of confinement. Further, instructions were given for the disposition of those prisoners requiring prolonged care. It was directed that recovered patients would be returned to their proper places of confinement.
STATISTICAL DATA
Various statistical data on Army general prisoners confined during 1945, pertaining to psychiatric diagnoses, type of crime committed, demographic information, and previous offenses are presented in the tables (49-59) throughout this chapter.
Number of arrests | All institutions | Rehabilitation centers | Disciplinary barracks | Federal institutions | ||||
Number | Percent | Number | Percent | Number | Percent | Number | Percent | |
None | 8,720 | 41.4 | 5,418 | 42.8 | 2,601 | 38.3 | 701 | 44.3 |
One | 2,575 | 12.2 | 2,145 | 16.9 | 140 | 2.1 | 290 | 18.3 |
Two | 2,772 | 13.2 | 1,568 | 12.4 | 1,006 | 14.8 | 198 | 12.5 |
Three | 2,042 | 9.7 | 1,01 0 | 8.0 | 879 | 12.9 | 153 | 9.7 |
Four | 1,380 | 6.5 | 697 | 5.5 | 598 | 8.8 | 85 | 5.4 |
Five | 984 | 4.7 | 516 | 4.1 | 417 | 6.1 | 51 | 3.2 |
Six | 627 | 3.0 | 330 | 2.6 | 266 | 4.0 | 31 | 1.9 |
Seven | 399 | 1.9 | 190 | 1.5 | 186 | 2.7 | 23 | 1.5 |
Eight | 329 | 1.6 | 170 | 1.3 | 146 | 2.1 | 13 | .8 |
Nine or more | 1,211 | 5.8 | 617 | 4.9 | 556 | 8.2 | 38 | 2.4 |
| Total | 21,039 | 100.0 | 12,661 | 100.0 | 6,795 | 100.0 | 1,583 | 100.0 |
1Of the 3,288 unreported prisoners, 1,564 were in rehabilitation centers, 1,678 in disciplinary barracks, and 46 in Federal institutions.
Source: A Report of the Army's Program for Military Prisoners in the Continental United States During the Period November 1940 to August 1945. Historical Monograph of the Correction Division, Adjutant General's Office, War Department, Washington, D.C., appendix XX, table 21 (modified).
