"5. That no parole or probation be granted without suitable psychiatric examination.
"6. That in considering applications for pardons and commutation careful attention be given to reports of qualified experts showing the applicant's mental age and mental stability and that in drafting statutes determining or defining juvenile delinquency, mental age and mental stability, within reasonable limits, be regarded as of importance with the calendar age of the delinquent.
"In view of the foregoing and as an initial step towards the ends stated, the committee submits the following resolution and urges its immediate adoption:
"Resolved, That the several states be urged to make provision for the psychiatric examination, under conditions permitting prolonged observation when necessary, of all persons convicted of a felony, misdemeanor or other offense by properly qualified experts appointed to assist the court in reaching a decision as to the proper disposition and treatment of the offender."
The courts, the medical profession and the public have shown indications of a decided dissatisfaction with existing methods of determining criminal responsibility. This will certainly continue as long as the sole test of competency is the power of the accused to discriminate between a knowledge of right and wrong at the time when the act is committed. The conditions which lead to crime have been made the subject of scientific study by many. One of the early investigators in this field was Morel, who saw in the criminal a personification "of the various degenerations of the species." Much has been said of "moral insanity," a condition referred to by Abercromby as one "in which all the upright sentiments are eliminated while the intelligence presents no disorders." Lombroso advanced the theory that criminality is a form of atavism—a reversion of man to the primitive and savage type represented by his early ancestors. This theory was based on a careful study of the anatomical, physiological and psychological characteristics of primitive man. His classification included the occasional, the emotional, the born criminal, the moral insane, and the masked epileptic. Marro offered an anatomical basis for the degenerative theory in the form of nutritional defects in the central nervous system. Ferri distinguished between criminal lunatics and emotional criminals and held crime to be "a phenomenon of complex origin and the result of biological, physical and social conditions." "Habitual criminals," he says, "are the victims of a clear, evident and common mental alienation which causes the criminal activity," while the occasional offenders are to be explained by "the impulse of opportunities more than the innate tendency that determines the crime." The emotional criminal, according to Ferri, is a sane and moral individual overcome by momentary emotional paroxysms referred to as a "psychologic storm." Garofalo, on the other hand, looked upon crime as "an offense against the fundamental altruistic sentiments of pity and probity." From his point of view a criminal act was an indication of the loss of a proper sense of appreciation of the life or property of another—a moral anomaly. The Italian school of criminology was responsible also for the theory that criminal acts are only the expression of epileptic symptoms. Sociological workers have attributed crime to influences which overcome the natural resistance of the individual, a variation from which is merely an inability of the person to conform to the laws of environment. Max Nordau sees in human failings only an abnormality which he describes as "human parasitism." Others look upon crime as the natural product of a modern social and economic system. Colajanni ascribes alcoholism, vagrancy and prostitution to poverty, but crime, he says, is "due to necessity and to the degree and kind of education received." In the light of our present knowledge the conclusion would appear to be warranted that crime is the result of constitutional defects in the form of hereditary tendencies and arrested mental development, educational defects, a deterioration of habits as shown by alcoholism, etc., accidental influences such as environment and poverty, pathological conditions, including epilepsy and insanity, and precipitating factors in the form of emotional disturbances.
Criminality, alcoholism, poverty, prostitution and mental deficiency are closely correlated. A special committee appointed by the New York State Prison Commission has made an exceedingly interesting report[82] on the relation existing between mental disease and crime. Their investigation shows that 21.8 per cent of 608 cases at Sing Sing, thirty-five per cent of 459 men at Auburn, twenty-two per cent of three hundred men at the Massachusetts State Prison, twenty-eight per cent of forty-nine women at Joliet, twenty-five per cent of seventy-six women at Auburn, twenty-three per cent of one hundred cases at the Indiana State Prison and thirty per cent of 150 examined at San Quentin were found to be mentally defective. An average of 27.5 per cent has been found in the prison population as a whole. Thirty-one and four-tenths per cent of the inmates of reformatories, training schools, workhouses and penitentiaries were found to be feebleminded. From twenty-seven to twenty-nine per cent of the inmates of penal and correctional institutions of the country were said to be defective. About thirty per cent of the population of the penal institutions for women in New York were found to be feebleminded. A study of 502 selected cases at the Psychopathic Laboratory of the Police Department of New York City in 1917 showed that fifty-eight per cent were suffering from either nervous or mental abnormalities. Of one thousand offenders examined by the medical service of the Boston Municipal Court twenty-three per cent were feebleminded, 10.4 per cent, psychopathic, 3.17 per cent, epileptic and nine per cent, mentally diseased and deteriorated; 45.6 per cent in all showed abnormal mental conditions. It has been shown that one of the most important causes of recidivism is mental deficiency. The importance of this observation may be illustrated by the fact that of 133,047 persons admitted to the penal and correctional institutions of New York state sixty per cent had served previous terms. Of 25,820 persons received at institutions in Massachusetts during one year, 57.4 per cent were recidivits. Justice Roads is responsible for the statement that of 180,000 convictions in England in one year more than ten thousand represented persons convicted upwards of twenty times previously.
The mental condition of the cases committed to the Matteawan State Hospital is of great importance in a consideration of the relation of crime to the psychoses. Of 2,595 cases admitted between 1875 and 1907 heredity or congenital defects were shown as etiological factors in eight per cent of the total number. Of 793 admissions in which more definite and reliable information was available, hereditary factors were noted in either the paternal or maternal branches of the family or both in thirty-five per cent of the cases. In addition to this, heredity was found in collateral branches in sixteen per cent. Heredity of some kind was thus shown in 51.3 per cent of the whole number studied. Of 3,247 admissions, 46.9 per cent were noted as being intemperate in their habits. An analysis of 576 unconvicted cases in 1912[83] showed that 41.4 per cent were diagnosed as dementia praecox, 21.1 per cent as alcoholic psychoses, 6.9 per cent as paranoid conditions, 4.1 per cent as epileptic psychoses, 7.1 per cent as imbecility with excitements, 2.9 per cent as manic-depressive psychoses, 2.4 per cent as general paresis, 3.1 per cent as undifferentiated depressions, 6.7 per cent as constitutional inferiority and 2.2 per cent as not insane. An analysis of 925 cases committed as insane and charged with criminal offenses attributable to their mental condition shows the more common crimes as follows:—assault (all forms), 26.2 per cent, burglary, 7.8, grand larceny, 8.2, petit larceny, 1, manslaughter, 1.4, murder, 18.9, homicide (total), 22.4, rape, 3.2, and vagrancy, 4.2 per cent.
Nolan [84] has made an analysis of 646 first admissions to Matteawan during a period of six years (1912 to 1918). Forty-eight per cent of these were found to have been born in foreign countries. A striking observation was the large proportion of male cases born in Italy (10.8 per cent) and the female cases born in Ireland (11.7 per cent). Of the various races represented it was noted that the African, which was only responsible for 3.9 per cent of the admissions to civil hospitals, constituted 7.4 per cent of the Matteawan admissions. The races having the largest representation were the Irish (18.7 per cent), the Italian (12.4 per cent) and the Hebrew (10.8 per cent). The mixed races constituted 11.3 per cent of the admissions as compared with twenty-three per cent of the cases reported from civil institutions. Among the male cases 11.4 per cent were charged with disorderly conduct and 26.47 per cent with vagrancy. Of the women, eighteen per cent were charged with disorderly conduct, 16.4 with public intoxication and 39.8 per cent with vagrancy and prostitution. These three groups represent 74.2 per cent of all of the female cases admitted. Of the 646 criminal acts causing commitment, 34.1 per cent were classified from a legal point of view as felonies and 65.9 per cent as misdemeanors. Only 5.3 per cent were charged with murder, manslaughter, etc. Of the various psychoses represented by these cases 26.9 per cent were diagnosed as dementia praecox, seventeen per cent as alcoholic psychoses, 14.7 per cent as constitutional psychopathic inferiority, 7.3 as mental deficiency, 8.3 as manic-depressive psychoses, 11.3 as general paresis, 3.6 as senile psychoses, 2.0 as paranoia or paranoid conditions, 2.2 as epileptic psychoses, and 1.4 per cent as not insane. The alcoholic, constitutionally inferior and mentally defective group constituted thirty-eight per cent of the total. Of the 165 cases diagnosed as dementia praecox it is interesting to note that eleven were charged with homicide, ten with assault in the first degree, fifteen with burglary, thirteen with petit larceny, fourteen with disorderly conduct, and sixty-six with vagrancy or prostitution. Of the seventy-four cases of general paresis thirteen were charged with petit larceny, eleven with disorderly conduct, and twenty-nine with vagrancy or prostitution. The homicides and assaults were committed principally by the alcoholic, dementia praecox, constitutionally inferior and the defective cases. The burglaries and larcenies were committed largely by patients diagnosed as suffering from general paresis, dementia praecox and constitutional psychopathic inferiority.
The type of cases received at an institution exclusively for insane convicts is naturally quite different, as shown by the admissions to the Dannemora State Hospital in New York. Of 185 admissions covering a period of three years the principal psychoses represented were dementia praecox, forty-one per cent, constitutional psychopathic inferiority, nineteen per cent, manic-depressive psychoses, eight, mental deficiency, nine, alcoholic psychoses, five, paranoid conditions, four per cent, etc.