Medicine: Psychiatry in Prison

"I'm grown up now and I've got to recognize it,'' said the wavy-haired, blue-eyed Irish type from Oxnard, Calif. "Next time out, I'm going to try to get a job in San Francisco instead of going home. I don't want to go back to the same old temptations. And I can't go on being dependent on my folks. I'm not a kid any more." At 35, he has spent half his adult years in prison.

A hawk-nosed alcoholic from northern California asked the Oxnard man what he was running away from. The answer: "I don't think it's running away. It's learning to live with yourself. Even after you get out, you're still an ex-con. They can't cure you of what you did that got you in here. You've got to live with that."

Separating Sinners. Last week the man from Oxnard was "talking it out" in a group psychotherapy session at the California Medical Facility in Vacaville, where he is now confined. With him were eight other convicted felons and Psychologist Gerald Berton. Most striking was the fact that Psychologist Berton, in charge of the twice-weekly, one-hour session, had the least to say.

The five-year-old Facility at Vacaville, a prison and mental hospital rolled into one, is virtually unique in the U.S.* Reason for its existence is the view, slowly spreading in the U.S. since the 1920s, that underlying most criminal conduct is emotional disturbance or outright mental illness. Carried to its logical extreme, this would mean abolishing prisons and putting all convicted criminals under psychiatric treatment. Society is far from ready for anything so visionary, and neither is organized psychiatry. As Kansas' famed Dr. Karl (Man Against Himself) Menninger puts it: "The sinners whose sins are inexplicable to laymen are officially labeled 'the insane'; those whom we think we understand ... are officially labeled 'criminals.' '' What has happened is that, largely under Dr. Menninger's prodding, U.S. criminologists and penologists are seeing more lawbreakers as mentally ill and fewer as "simply" criminal.

One end of the sprawling, ten-wing stucco structure outside Vacaville in Central Valley houses the reception-guidance center where all male felons convicted in California's northern 47 counties are studied for six to ten weeks. No treatment is given here, but all the men get exhaustive testing (IQ, aptitude, personality, "violence potential"). Mainly on the psychologists' advice, the state Department of Corrections then decides what prison to send them to—a maximum-security pen or a relatively open one.

The Broad Brush. The curative rather than punitive goal of the Medical Facility proper is proclaimed by the staff of Aesculapius over its main entrance. One-third or more of its 1,350 inmates are in for crimes involving violence—from robbery to rape and murder. Most of the rest are burglars, bad-check artists, or men caught up in the narcotics racket. Alcoholism is the commonest complicating factor, and a prison branch of A.A. offers help. By administrative fiat, but for no good psychiatric reason, all homosexuals rated as "effeminate" or "aggressive" are housed in a single cell block. These are among the least hopeful cases.