Haxry Re Hoffa, Diveetor of the Behavior Clinte of the Criminal Court of Cook Countys — Dre Toffman suggested that + ide wes for certain pempblets and brochures thet you had written bearing upon the abnormal child behavior. I would appreciate it if you will write me giving .. cet have so that we may order from yous Darestor of Physical Bduoationy Apyil 12, 1558e tional wi Sook Director of Physical Edueation, QR 118 SM 7-36. UNDER THE SUPERVISION OF THE BOARD OF COMMISSIONERS OF Cook COUNTY HARRY R. HOFFMAN, M. D. . DIRECTOR HARRY A. PASKIND, M. D. ASSISTANT DIRECTOR A DIVISION OF THE COOK COUNTY BUREAU OF PUBLIC WELFARE EDITH KARLIN CHIEF OF SOCIAL SERVICE CRIMINAL COURT BUILDING 2600 S. CALIFORNIA AVE. PHONE CRAWFORD 7300 BEHAVIOR CLINIC OF THE CRIMINAL COURT OF COOK COUNTY CHICAGO April 7th, 1938, Mr. F. G. Allen, Director of Physical Education, University of Kansas, Lawrence, Kansas. My dear Mr. Allen: I am enclosing a pamphlet explaining the functions of the Behavior Clinic, as Peqnre ee in your letter of April 5th, 1938. If there is any other information you would like concerning the Clinic do not hesitate to call upon me. Very truly yours, Si tir VN (pf a Harry R. Hoffman, M.D. BRE: é encl. we Seen ee eee erica nner ceca cae ecccecccececacnceecaag ee EET Er ET ay TT ET ee ae eT PSYCHIATRY IN THE CRIMINAL COURTS OF COOK COUNTY®* BY Harry R. Horrman, M. D. Director, Behavior Clinic of the Criminal Court of Cook Cownty Report for the Fiscal Year, 1933 Organization—The Behavior Clinic of the Criminal Court of Cook County, which came into existence April 1, 1931, is essentially a diagnostic clinic, giving advisory psychiatric service to the Judges of the Criminal Court. The Clinic is disinterested in the legal aspect of the cases referred for examination. Its aim is the intensive study of the individual offender— his mental, physical and emotional make-up—his environment, and the in- teraction of that individual and that environment. It is hoped that such a scientific study will make for a better understanding of criminals and the forces motivating anti-social behavior and thus help to combat the menace of crime to society. Scope and Method.—A psychiatric examination may be availed for any offender whom the presiding judge sees fit to have examined. Requests for examinations are made for numerous reasons, the most frequent of which are: 1) to determine the sanity of the individual; 2) to determine his in- tellectual capacity; 3) to determine his suitability for probation. Every patient referred to the Behavior Clinic is given several types of examination: 1) a psychological examination by the psychologist to ascer- tain his mental ability and to determine what can be expected of him in terms of social and industrial adjustment; 2) a comprehensive social his- tory of the patient from relatives, friends, other agencies and individuals who have had contact with him, to learn all the pertinent facts concerning his family background, early life history, later experiences, and a detailed study of his environment in an effort to arrive at a more thorough under- standing of the patient in view of his background; 3) a physical examina- tion with special attention to constitutional and neurological defects when such an examination appears necessary; 4) a psychiatric examination by the psychiatrist: (a) to evaluate the personality manifestations of the person; (b) to coordinate all findings and from them make a report to the judge for use in determining the disposition of the case. Before the hearing copies of the psychiatric examination and conclu- sions are sent simultaneously to the presiding judge, State’s Attorney, and attorney for the defense. After legal disposition of the case copies of the psychiatric, psychological and social service reports are sent to the institu- tion to which the patient is committed or sentenced, or to the Adult Pro- bation Department should he be granted probation. Referrals.—Since the Clinic’s inception 790 cases have been referred for examination, of which 316 were referred during the fiscal year of 1933, an in- crease of 3 per cent over the number of referrals in 1932. Of these, 302 cases received the routine psychiatric and psychological examinations and * Presented before the Twenty-sixth Annual Meeting of the Illinois State Academy of Science, East St. Louis, Illinois, May 5, 1933. 3 2 intensive social service investigations; 2 were given physical examinations only upon order of the presiding judge; 10 either refused examination or were discharged before the psychiatrist could see them; 2 have not yet been examined. Diagnoses.—Sixteen per cent of those examined were found to be actively psychotic and were committed to hospitals for mental diseases. Ten per cent were found to be mentally defective to an extent warranting commit- ment to an institution for the feebleminded. An additional 6 per cent were mentally defective (borderline), but not sufficiently low for commitment. It happens that heretofore in the majority of these cases our findings of feeblemindedness have had necessarily to be disregarded by the Court be- cause of the danger of escape from a hospital for the feebleminded (such as Dixon or Lincoln), and the offender, if found guilty, sentenced to Pontiac or Joliet. However, since the establishment of an institution for the de- fective delinquents and the passage of new laws by the State Legislature permitting the commitment of such individuals to the Department of Public Welfare, the defective delinquents, so diagnosed by the Behavior Clinic, are being committed to the Department of Public Welfare at the Joliet Peni- tentiary and from there are transferred to the proper institution. Our findings obviously expedite matters for the Diagnostic Institute at Joliet, for the psychiatrists there accept our findings without further examination and dispose of the prisoners accordingly. About 8 per cent of those patients examined were found to be suffering from some mental or nervous disturbance or personality defect (psychopathic personality, drug addiction, neurosis, emotional instability, inebriety, epilepsy, ambulatory automatism), but not sufficiently serious to warrant commitment by the Court to a hospital for mental diseases. In most of the cases treatment has been recommended. The remainder were found to be negative, that is, no evidences of organic or functional nervous or mental disease were ascertained. Sources of Referral——The cooperation of the Judges and every division of the Criminal Court has not only continued but increased. Despite the change in the judges sitting in the Criminal Court, orders for examination originating directly from the judges has increased. In 1932 approximately 35 per cent of the cases referred to the Behavior Clinic for examination were requested by the judges themselves. In 1933 approximately 50 per cent were requested by the judges. Most of the judges sitting in the Felony Court have referred cases to the Behavior Clinic for examination, and several of the judges from the Boys’ Court. A judge of the South Chicago Court re- ferred a boy for examination who was being held in the County Jail await- ing trial in his court. The Public Defender’s office has requested examina- tions in approximately 16 per cent, and the State’s Attorney’s office about 5 per cent. The public at large seems to have become more aware of the Clinie’s service for 10 per cent of the private counsels for defense have re- ferred cases to us as against 5 per cent of last year. Referrals by members of the patient’s family, or friends, has shown a slight increase from 3 per eent of last year to 4 per cent of this year. The jail authorities (the Warden, Assistant Warden, and Jail physician) have referred 6 per cent; other social agencies, including the Bureau of Public Welfare, Criminal Court division, Rural Service and Veterans Service divisions, and the Juvenile Court, about 7 per cent; the Adult Probation Department 2 per cent. In one instance a Federal Probation Officer referred a female drug addict for ex- amination; the Parole Officer of Pontiac Reformatory asked for examinations of two boys on parole whom he had incarcerated in the County Jail for the purpose of examination. (In both instances the boys were found to be psychotic.) Os Charges.—Individuals charged with every type of offense from disorderly conduct and vagrancy to incest and murder, have been referred to us for ex- amination. Of the cases referred the largest number were those indicted on sex crimes (32 per cent), including rape (10 per cent of the total number referred), crime vs. children (14 per cent of the total number referred), crime vs. nature, incest, indecent liberties, and contributing to the delin- quency of minors. The next largest group were those charged with robbery, (17 per cent), 15 per cent of the cases referred were charged with murder, 13 per cent with burglary, 9 per cent with larceny and 4 per cent with “white collar crimes’, such as embezzlement, forgery and confidence game. Among the offenders referred for examination were individuals serving sen- tence at the County Jail for violation of the Municipal Code on such charges as disorderly conduct, soliciting, vagrancy and non-support. In five in- stances individuals held in the County Jail for safekeeping while awaiting transportation to Federal prison or other institutions were referred for examination. . Stage of Referral—Though it was intended that examinations by the Behavior Clinic be made after an individual was convicted of a crime, but not yet sentenced, the majority of the cases (80 per cent) have been re- ferred after indictment, but before conviction; 12 per cent were referred after arrest and before indictment; 3 per cent referred were already serving sentence in the County Jail. The remainder were in the County Jail either on habeas corpus writs, for safekeeping for parole officers, or were prose- cuting witnesses. Additional Services—The Behavior Clinic performs many services to the Court incidental to its work proper. Sometimes emergency physical ex- aminations have to be made and patients treated. On a few occasions the psychiatrist has had to make home or hospital visits to determine the fitness of an individual to appear in court. Occasionally the psychiatrist is called into court to answer questions involving psychological phenomena. (1) Expert Testimony.—The psychiatrist is called into court to testify regarding a patient’s mental condition in cases where a diagnosis of a psychosis (insanity) or feeblemindedness has been made warranting com- mitment to a State hospital. Thus the Court is saved the expense of paying outside psychiatrists for their testimony, and even more important, elimin- ates the so-called “battle of alienists”, for the findings of the Clinic are, in nearly every case, accepted by the State and the Defense as impartial un- biased conclusions. In many instances where a patient is found to be suffering from a mental disease he is committed at once to a State hospital upon testimony of the Clinic psychiatrist. Thus, not only are matters expedited, but the County is saved the expense of a trial, the impaneling of a criminal jury, the time of the judge, the prosecution and the defense. And the patient is spared the ordeal of a trial until his sanity is recovered. The psychiatrist has on several occasions been called by the State’s At- torney’s office to examine a suspect in a murder case at the time of the in- quest, especially where it is anticipated that insanity will be used as-a defense. (In the recent Wynekoop case Dr. Hoffman, besides making psychiatric examinations of the chief suspects, Dr. Alice Wynekoop and her son, was present during every interview with all the suspects in the case. During the initial investigation in the State’s Attorney’s office the psychiatrist was called in to make a psychiatric examination of the Touhy gangsters suspected in a pending kidnapping case). (2) Education.—Frequent informal conferences are held between the psychiatrist and judge or attorney concerning medico-legal problems. It is very encouraging to note the growing interest among the practitioners of 4 law in the causes of criminal behavior and its treatment, to note the veering away from the old conception of a set punishment for a set offense—a step, we feel, in the right direction. (3) Reform.—Just as after years of discussion in medical, legal and academic circles the Behavior Clinic finally emerged, so too, after much dis- cussion and finally through the concentrated efforts of the Behavior Clinic, an institution for defective delinquents and a radical change in the commit- ment of that type of offender, have been evolved. Though the need has been long standing, it was not until Dr. Harry R. Hoffman cohesed the general agitation into concrete meetings, committees and potent propaganda, that an amendment to “An Act to better provide for the care and detention of feebleminded persons”, was finally passed by the State Legislature. In Sep- tember, 1933, a theory became an actual reform. By this law defective de- linquents are committed directly to the State Department of Public Welfare who in turn, after receiving an intensive psychiatric study at the Diagnostic Depot in Joliet, are classified and committed to the proper institution. In those instances where a patient has been examined by the Behavior Clinic the findings of the Clinic are accepted without further examinations; thus the time and expense of the psychiatric group at the State Penitentiary are saved. Personnel—It is intended that all the members of the staff will even- tually be placed under Civil Service. Thus far only the supervising psychiatric social worker falls in this category. The psychiatrists were selected by the Chicago Institute of Medicine; the psychologist and medical stenographers were appointed by the Director of the Clinic. The staff as it was originally conceived, consisting of two half time psychiatrists, a full time psychologist, a resident physician, two psychiatric social workers and stenographic service, was barely adequate. With the depleted budget, effective since March, 1932, which eliminated entirely the services of the resident physician and one social worker, and cut the psychologist’s serv- ices to half time, the Clinic has been working under a handicap, despite which the case load has increased and the service widened, especially since the Courts have become acutely aware of its existence and dependent on its services. : The Behavior Clinic has now been in existence for 32 months. We feel that it has well justified its establishment not only for its work as an ad- visory psychiatric service to the Courts, nor as an economy measure effecting a savings to the County, but more important, for its inculcation into the spirit of the law and the philosophy of those practicing it, the conception of the offender as a mentally sick individual in need of study and treatment rather than a pariah to be punished according to the heinousness of his offense. June 8, 19586 is Douglas Rs Mille, University of T1tnoie, Champaign, Tilincise — Dear Pours 8 tan vary glad that you got Comets They will be a fine cards iow aenee lepine 0 tenties date in sfint'so Ghat we wilh Getintiaty Say 80 ant Sequthars I an quite suro thet wo cans With kbiest regards and best wishes, I an oe | Very eordialiy youre, Birootor of Fiyetoal Towetion, — Pe Se te vinta lad ©) eal ak een _ & Feciproval guarantee of $500.00, playing you either here eat Lewrence or at Urbema one year and the-next yoar — a Let me mow what you think PeCehe UNIVERSITY OF ILLINOIS ATHLETIG -ASSOCTATION CHAMPAIGN June 6, 19358 Mr. Forrest C. Allen Director of Physical Education University of Kansas Lawrence, Kansas Dear friend Allen: We arranged a clinic basketball game with Cornell of Ithaca, New York, ‘I am awfully sorry that you found it impossible to come out but please keep a tentative date in mind for the following year as ‘thd coaches in this section and myself in particular wovld like very much to have you with us in 1939, I'll take the initiative and write to you early next spring. / Sincere eas. DRM:dm D.cBs at Basketball Coach Again I would say that I recomend him withe Profeescr John Ise, Dear Johns 2 lave ecemecientad Sus taheainen te es tek Palkenstion, our financial secretary, regarding the rental on lumber spaces T am also looking imte the matter of disposing of the basketball goale This will be done in a very short wiiloe 16 ens ional tn Oks ae Ok a ek Whiles 4 My guecessor, Gwinn Henry, is now with the football teem on the way to Tucson, Arizonie He will arrive hone Monday morning, end I will have your letter on 3 | attentione Gwinn will be the new director of the Kansas Relays, end I am sure that you will hear f him in the very noay futures : 7 The other deal, on the possible rocoumeudation ofthe Ashele toward accepting the records of the Iowm Sprint Relay Team, will elso came to his attentiotie Riu igeghonerr te Cg wegaay 4%, but if I mention the AcAeU. at great length I am liable t& have en attack of hydrophobia, so I will let Gwinn handle thate 1 do went to ote Oe that in ali my year. .7¢. at the University as ‘of the Kensas Relays i deeply appreciate your wonderful support of these Relayse i want you; to imow that personally I value your sport very highly, and if at any time i can reciprocate by doing you a favor, please feel free to call upon mee : ith kindest personal regards, I am Very sincerely yours, — FOASAH : Director of Physical Edusations