A modern institution should be built on the cottage plan, well equipped, with small building units, and located in a rural community. Efficient officers and trained teachers who have studied the elements of psychiatry should be employed. Humanized discipline with no solitary confinement, a carefully prepared progressive merit system with a plan of withdrawing privileges for bad conduct, a supervised self-government system, and a complete survey of the inmates showing the mental age of each should be established in such institutions. In order to classify those assigned to school and the industries, intelligence quotients should be important factors in determining what is best.

The bloom of youth should not be tarnished by laborious indoor household duties for the entire time of the sentence. On the other hand, if he prefers it and the physical and mental condition of the offender justify this type of work, it would seem proper to fit him to become a trained chef, houseman, or waiter, if he is to have service in that line of work later on. All of the inmates should have a limited amount of training in household work, for this experience is valuable, after they leave the institution, in helping an invalid mother or father to keep a family together. The best time, in my opinion, for assigning inmates to this indoor duty is on their arrival at the institution, when homesickness is prevalent and when a woman's care and affection is needed. It would, however, not seem for their best interests to break up industrial education by assignment toward the end of their sentences to household duties, when an effort is being made to train these juveniles in the practical and vocational arts.

Home culture is very valuable in dealing with these unfortunates, so we should instruct them in table manners and household etiquette. The moral condition of a family is almost always indicated by the degree of happiness manifested by the inmates. If there is not harmony, it is evidence that there is something radically wrong that needs attention. It is good manners and thoughtful practices that form important transitions in everyday life.

Inmates should be taught to respect and love their parents, for after they return home it is the parents who will probably be the guiding stars for their destiny. Inmates should also be taught that their mothers should be properly cared for and comforted. This alone may be a starting point in improving conditions in homes of bad environment.

Love for animals should be inculcated in all, because if the inmates are kind-hearted they are more apt to succeed in life. A liberal attitude should be maintained in allowing dogs and animal pets at the institution, for this has a good psychological effect. So strong is the affection for pets manifested by inmates that they are often seen with their arms around dogs' necks, hugging them tightly, and calling them affectionate names. Why? It is because many of these unfortunates have been deprived, through no fault of their own, of a mother's and father's love. Many of them have no one in the world to love them or take an interest in them. This is food for thought for psychiatrists and institution administrators.

It is important, in the reclamation of offenders, and should be a basic rule in

psychiatry, to instruct offenders in Americanization and citizenship. For those from homes and foreign-born parents who retain old customs and native languages special emphasis should be laid on allegiance to the flag and our country. The offender should first be instructed to obey officers, to respect constituted authority, and to have pride in the institution. Without this training and discipline no institution can be successfully managed. There should be constant supervision by the officers to prevent loafing and idleness, which invariably leads to carelessness and immorality. The management should stand firmly behind every officer who protects himself in line of duty if he is assaulted or if there is impending danger of being injured by an inmate. Self-preservation is one of the first laws of nature, and no institution for delinquents can endure without this understanding. Inmates should be carefully supervised to prevent fighting. Kindness, with strict discipline prevailing at all times, prevents a great many problems from arising in an institution.

There should be a segregation of the inmates by age, mental grade, first offenders, and sex offenders, so that special treatment and training may be had for each case.

Inmates should not be overburdened with heavy labor, but good wholesome outdoor work, in my judgment, is one of the best psychiatric medicines of all. It expends surplus energy and takes care of the exuberance of youth.

Good health, of course, is the most important factor in every institution. There should be a competent physician, a surgeon, a dentist, and other specialists to correct physical defects. Adenoids, tonsils, and eyes should receive special attention.

Play is one of the innate tendencies of the human, therefore there must be an abundance of amusement and recreation, for "All work and no play makes Jack a dull boy." Playgrounds, baseball diamonds, and athletic fields should be provided. Honor inmates should have a camp in the woods, where they can learn to love nature with its beautiful trees, streams, birds, and animals. They should be allowed the "big outdoor life" prescribed for the Boy Scouts. Wholesome motion pictures and theatrical shows, both professional and amateur, should be provided. Occasionally it is wise to introduce a home talent circus, with old-fashioned sawdust rings, horses, clowns, peanuts, red lemonade, and everything boys like. For amusement, also education, a zoo for wild animals and birds can be provided without much initial cost, and with but little expense for upkeep. Another form of recreation is music. This form of instruction is valuable because it instils in the hearts of the young sentiment and love.

After-care of paroled inmates is important, and a sufficient number of parole officers should be employed. Unless this is done, much of the good work of an institution will be ineffective. The institution should be provided with ample funds to finance boys going out on parole. Oftentimes if these boys are not financed for the first week's board or so, and if they are not properly clothed like other boys, they drift back to reformatories.

While the institution of which I am in charge has not entirely attained the

ideals expressed herein, we have an abiding faith that, through psychiatry, conditions will be better as time goes on.

In concluding, the words of Mr. Briggs, the cartoonist, seem appropriate"Oh, Skin-nay, come on over" to St. Charles, Illinois, where we have 750 redblooded boys all ready to extend you a hearty welcome.

PSYCHIATRY AND THE PRISONER

Karl A. Menninger, M.D., Professor of Criminology, Washburn
College, Topeka

Time was when there were but two recognized types of human behavior, good and bad. The "good" included the pious, the proper, the fatuous, the harmless, the conventional, and the inconsequential. The “bad” included the heretic, the delirious, the anarchic, the antisocial, the not-understood, the nonconformist. There were Alexanders and Cotton Mathers and St. Pauls among the former, and Galileos and Neros and Guiteaus among the latter.

Ultimately such heterogeny shocked popular logic into further partitions, and the "bad" became subdivided into at least two groups. Those of one group did inexplicable things, profitless evil, gratuitous social damage, and withal much pointless and purposeless miscellany which seemed capable of gratifying no ordinary desires or impulses of the average man. It was incidentally discovered, too, that certain drugs would abate some of these aberrancies of behavior. And so because they were inexplicable and esoteric and exotic and mysterious, and because some seemed to benefit from medicines, and because the prophets (sociologists) kept lashing the inhumanity of continuing to punish the members of this group, they were relegated to the doctors, who were told to do what they would and could with them. Then, to legally wash their hands of them, the lawyers labeled them "the insane."

The remainder of the "bad" did more understandable things. They took what they wanted without paying; they killed their enemies; they pleased themselves regardless of society. In short, they did what all members of the race had always instinctively desired to do, without regard to the restrictions and taboos which experience and tradition and religion had laid down for the conventional acceptance of adult society. These fellows did forbidden things, abnormal things, and very understandable things-understandable to the "good" man struggling against yielding to the same temptation, and painfully reminiscent to his juvenile offenses in the same directions. These folks escaped relegation to the doctors, for a great host of avengers arose to clamor for their blood. Every man desired to crush in another what he was so fiercely struggling against in his own soul. A play (Rain), which vividly pictured this projection of punishment with an ultimate switchback, attracted enormous crowds the past few years. In other words, the sinners whose deeds are inexplicable to the

laymen are officially "the insane." Those whom we think we understand, judging intuitively by our own struggles, we have labeled "criminals," and we have insisted upon punishing them for our own satisfaction, regardless of cumulative evidence of its futility.

Now science is constitutionally and notoriously opposed to accepting social and traditional verdicts and classifications. And psychiatry, which is the branch of science concerned with aberrant behavior, has officially no respect for such stratifications of human behavior as "good" and "bad," or "criminal" and "insane." Once it was sufficient to diagnose an illness as "the fever"; now medical science knows scores of fevers, each of different causes, courses, concomitants, and complications. Similarly the scientist, the psychiatrist, cannot regard "theft" or "murderer" as a diagnosis; these are symptoms appearing in a variety of syndromes.

Originally, it is true, the psychiatrists were chiefly concerned with those types of misbehavior which had been garnered in by the lawyers and labeled insane. To this task they had been assigned. But when they had studied this material according to the scientific method of collecting and correlating data and constructing laws to fit, they discovered no such partitions between the "insane" and the "criminal" as the lawyers had (at the instigation of the herd) erected. They found that the types and trends of abnormal psychology extended far out from the "asylum" into the courtroom, the school, the home. They found their task as definitely defined in the terror-ridden child as in the impulse-driven youth, as much in the melancholy and suicidal mother as in the unstable and homicidal man. They found their experience and technique as applicable to the irascible employee as to the retarded school child, and to the unhappy, suspicious husband as to the deluded and hallucinated wife. ncreasingly the psychiatrist found himself faced with many popular and legal parti. tions of the misbehaved, without any technical interest or general agreement with these partitions. As a scientist he is concerned with the unpropitious trends of human character-socially and individually adverse acts, thoughts, emotions, instincts, and adaptations.

This scientific (psychiatric) attitude must sooner or later totally displace the existing legal method. Time was when doctors treated patients, not by applied intelligence, but by the precedents established by Hippocrates, Paracelsus, and Galen. But while they have now left this method one hundred years behind them, the lawyers continue solemnly to apply medieval stupidities in the name of "established precedent," "public policy," and other mouthy elaborations of an indefensible archaicism. There are, of course, intelligent lawyers who are earnestly striving to better this situation. But there are yet more who stoutly defend their crumbling kingdom. They declaim in public and private about the travesties upon justice which result from the introduction of the psychiatric method into court. And nothing better illustrates the conflict between the old point of view and the new. What science or scientist is inter

ested in justice? Is pneumonia "just"? Or cancer, or gravity, or the expansion of steam? What criteria of justice can be applied to a broken arm or a weak mind? And to what good end? The scientist is seeking amelioration of an unhappy situation, the greatest good for the greatest number. This can be secured only if the scientific laws of the situation can be discovered and complied with, and not by philosophical concepts of equity based on primitive theology.

This brings up also the conception of "responsibility," with which the psychiatrist is also unconcerned. He has no idea of what it means, although he is constantly asked to testify concerning it. The psychiatrist asks, not "Is he responsible?" but "Of what is he capable (or incapable)?"

Finally, the scientist must disavow any interest in "punishment” except to observe how it gratifies the cravings of the crowd for vicarious suffering. The doctor may regret his patient's folly, but he treats his wounds without prejudice. Accordingly the psychiatrist seeks treatment, rather than punishment, for his patients. Opening a boil or setting a fracture may be painful, and the psychiatrist, too, may prescribe painful treatment, but it is always treatment, never punishment. The difference is nineteen centuries of intellectual evolution.

The advantages seem too obvious to elaborate. With every prison in the land half full of recidivists, the failure of the antiquated methods of crime prevention has no need of the current newspaper alarms over "the crime problem.” So long as offenders are sentenced according to a book instead of studied according to principles the results will continue to be as inadequate as if doctors prescribed twenty days for every case of appendicitis, six months of castor oil for every cancer, five years for every imbecile.

The first step in the program is the change of public opinion in regard to the aims and methods of science in regard to the prisoner. This is being rapidly accomplished by psychiatric clinics operating in association with municipal and criminal courts in various cities, and also by the ardent work of many agencies: the National Committee for Mental Hygiene, the Committee on Prevention of Delinquency, the Commonwealth Fund's Child Guidance Clinics, etc.

The next step is the alteration of the laws governing criminal procedure. The American Psychiatric Association and the American Bar Association are both at work on this problem. Meanwhile the trend of progress is evident. Jails will slowly evolve into scientifically managed institutions. The modern surgical operating amphitheater developed out of dirty public barber shops. The physicians took surgery away from the barbers a century ago; now they are taking criminology and penology away from politicians, wardens, and lawyers.

Ultimately there will be no important administrative distinction between "asylums" and "jails." Both will have lost those atrocious names. Both will be institutions, under state jurisdiction and under expert medical management and direction, for the care of individuals committed to them by the state because of behavior inepititudes, failures, and incapacities. A "sentence" will be as unthinkable for a murderer as it now is for a melancholiac. Unkindness will be as