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.

Says Superintendent William C. Keating Jr., 39, specialty-trained in administrative psychiatry at the Menninger Foundation: "Treating psychiatric patients as individuals is like painting cameos. I'm more of a muralist and like to work with a broader brush." With only six fulltime psychiatrists among the 14 M.D.s on his staff (plus 23 clinical psychologists and others equipped to lead group therapy), Dr. Keating can use only broad-stroke methods with the 700 patients rated as good treatment prospects. Chief Psychiatrist Knut H. Houck uses a variety of tranquilizing drugs for agitated patients and psychic energizers for the depressed. He hopes soon to try LSD-25 (TIME, March 28) to make psychotherapy more effective, especially in narcotic addiction and alcoholism.

Is prison psychiatry successful? Precise figures comparing crime-repeat rates after Medical Facility treatment and after ordinary imprisonment contain no pat answer, because of the way inmates are assigned and legal technicalities (e.g., a paroled felon is thrown back in the pen for committing a misdemeanor, though he may be close to "going straight"). A research program is under way to grade the expectations for a prisoner's future when he is committed, and test this prediction against his later performance.

In the occupational-therapy room last week, scores of prisoner-patients were making ceramics, doing woodwork and bookbinding, or putting their conflicts on canvas--some in the most modern nonobjective manner, others in representational styles recalling the tortured figures of Goya and the climbing workers of Rivera. From a low-fi record player came the inspirational strains of Beethoven's Eroica. The California Medical Facility is still a prison, but a prison with a difference.

* Founded earlier was the Medical Center for Federal Prisoners at Springfield. Mo., but overcrowding has defeated its purpose and led to inmate riots.

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