The English Prison System

by Sir Evelyn Ruggles-Brise

When the Act came into force there were no State Institutions, and the accommodation in Certified Institutions was totally inadequate to meet the needs of the situation. A State Institution was secured towards the end of 1914, but was almost immediately handed over to the War Office. Little, or nothing, could be done in the way of provision of further accommodation, State or otherwise, during the continuance of the Great War, and, as a result, very few criminal defectives could be dealt with. Since the termination of hostilities, a State Institution for male and female defectives has been established, and further institutional accommodation provided, and it is hoped that in the near future full provision will be made for dealing with all defectives, guilty of criminal offences, who are certifiable under the Act.

From 1st April 1914 to 31st March 1919, 871 cases were certified under the Act, the total receptions into local prisons for this period being 376,000, i.e., 2·3 per 1,000 receptions. The prisoners certified in prison do not comprise the whole number of cases of criminal defectives dealt with, as Courts have power under the Act to send such defectives direct to Institutions, instead of to prison, and, as the working of the Act becomes more stabilised, advantage is taken of this power to an increasing extent.

But even so, there is a considerable discrepancy between the defectives dealt with under the Act and the official ante-Act estimate, which was considerably greater, and this is mainly due to the strict requirement of the Act that the defect must have existed from birth or from early age. Here at once a large number of prisoners regarded as mentally defective, forming 30 per cent. of the whole, were excluded from the operation of the Act owing to the fact that the mental defect from which they were suffering, e.g., senility, alcoholism, arose from causes operating later in life. Again, of the number of prisoners whose mental defect was regarded as of congenital origin, 77 per cent. were over 25 years of age, thus making it difficult to obtain proof of the existence of the defect from early age, without which a certificate cannot be given.

But the Mental Deficiency Act, limited as it is in its scope, and disappointing in its results, is a pioneer piece of legislation of considerable importance. Many Voluntary Associations and other bodies in this country interested in its administration are advocating an extension of its provisions, and I think we can anticipate with every confidence the time, to which the prison reformer has so long looked forward, when those unhappy persons, who through mental affliction drift inevitably into criminal courses, are removed from prison surroundings to the more appropriate atmosphere of institutions where they can remain under proper care and control.

The operation of the Mental Deficiency Act, 1913, and the discharge from Naval and Military Hospitals of numbers of men suffering from mental and physical disabilities arising out of the war, have accentuated the already growing interest shown by Justices, and others engaged in the administration of the Criminal Law, as to whether the means hitherto taken for dealing with persons committing offences are the best and most humane which could be adopted. The opinion has been growing in intensity for some years that mental and physical disabilities may largely contribute to the commission of crime, and that it is the duty of the community to investigate thoroughly such causes, when they exist, to determine whether they are beyond the ability of the individual to control, whether they do not limit wholly, or in part, the responsibility for the commission of the offence, and to what extent they should be taken into account in determining the question of punishment: and whether some form of treatment, rather than punishment, by imprisonment, cannot be devised, which shall be more scientific, efficacious and humane.

The Justices of the City of Birmingham, early in 1919, took action and approached the Prison Commissioners in the matter and asked that a whole-time Medical Officer might be appointed to the Prison, and that portions of the hospitals, on both the male and female side, might be entirely partitioned off from the rest of the Prison and adapted for the reception of persons on remand whose mental condition appeared such as to require investigation.

Effect has been given to the recommendations of the Justices and, at the time of writing, the scheme has been in operation for some 12 months with valuable results. The Medical Officer of the Prison works in the closest co-operation with the Justices and no person, in whose case there is any suspected mental element, is sentenced to imprisonment until after full investigation of his condition of mind and all other avenues of dealing with the case have been exploited. The "Birmingham" experiment, as it is termed, has aroused great interest throughout the country and an extention to other centres, in a modified form, has already resulted.

The institution of the Borstal System has given a new and additional importance to the rôle of the Medical Officer, who plays an important part in the daily administration of these Institutions. From the medical point of view, the system commends itself more particularly by its insistence on the influences which promote sound physical development. Special inquiries made by the Medical Staff in 1903 and 1907 furnish positive proof of the physical inferiority of the adolescent criminal, 16-21, relatively to the free population, notably in height and weight. These inquiries furnish a striking argument in favour of the soundness of the principles on which the Borstal System, as explained in a previous chapter, has been established.

The foregoing observations merely indicate generally the direction in which the manifold activities of the Medical Prison Service are exercised. I have laid stress on the part played in the discernment and investigation of mental disorder. That the question of guilt is identical with the question of mental soundness is a commonplace not only with those who seek to analyse by scientific inquiry the mysterious and subtle working of the human mind, but with those who, working in the name of humanity, are forced by personal observation, unaided by science, to the conclusion that many whom the law strikes are not fully responsible for their actions, and are not justly punished. In the United States of America, where science and humanity march hand-in-hand in exploring prisons and places of punishment, and in surveying the whole field of crime, we find that practical steps have been taken by the establishment of criminal laboratories, as at Chicago and Boston, to classify offenders, especially the young, according to the nature and degree of their mental capacity for distinguishing right from wrong. There is nothing so elaborate as this in England, but this is not because public opinion is not keenly alive to the importance of the medical aspect of cases, but because it would not be disposed to admit that the causes of a criminal act are discoverable by physical observation, or by the precise research of a criminal or clinical laboratory. It would be the duty, and the pride, of any civilized State to maintain a high standard of medical work in Prisons: it is a question whether the establishment of criminal laboratories does more than illustrate the practical benefits to be derived from good and thorough medical work in prisons, and whether experimental psychology, with its instruments of precision for testing the human mind, is a really effective auxiliary for the Court of Law in deciding guilt. It may be of value, as a supplementary aid to such diagnosis as a conscientious Medical Officer would apply, and it could be used as a means to support and justify opinion, but it cannot, by itself, be a substitute for other methods of observation. Though public opinion in England is increasingly sensitive to degrees of responsibility, as affecting punishment of crime, it would be more disposed to place its faith in a medical man having experience of mental disease than in the conclusions drawn from the employment of the precise methods of experimental psychology alone. It is disposed to take the view expressed by no less an authority than Dr. Binet, which is to the effect that the complex phenomena of human action cannot be expressed in a few terse formulas,—"c'est de la littérature: ce n'est pas de la science." He inclines to the view that the essential characteristic of normal man is in the direction of choice. The want of direction is due to a disordered moral nature. Of this moral degeneracy little is known. The subjective valuation of the alienist cannot in practical life be the test of responsibility—the Judge, as representing 'common sense,' must decide.

At the same time, it recognizes the enormous value of preventive medicine in relation to the detection of mental disorder in its earliest stages. Sir George Newman, in his recent work "An Outline of the Practice of Preventive Medicine" lays great stress upon this point. He states: "Here, as elsewhere, we must seek to begin at the beginning. An understanding of eugenic principles and practice, a new aptitude and alertness in the physician, a new type of clinic, special hospital and institution—"early treatment centres"—a system of "voluntary boarders" in approved homes and institutions, a wider education of the public in what causes and constitutes mental incapacity, a larger apprehension of the meaning of self-control—all this is necessary if we would prevent mental disease. It is obvious that such a policy raises many questions of science, law and administration. But the experience of the war and of our colleagues in America (at the Phipps clinic at Baltimore and the psychiatric hospital at Boston) all points in one direction, namely, the practicability of establishing suitable psychiatric clinics in this country for dealing with early cases of mental and nervous disorder."