The Criminally Insane
A Community Follow-up of Mentally Ill Offenders
In 1971, 586 patients were released from a Pennsylvania maximum-security hospital for the criminally insane. They were not considered officially "cured," but a federal court held that their commitments had been unconstitutional. Through exhaustive examination of hospital and police records and interviews with hospital administrators and the subjects themselves, Thornberry and Jacoby assess the processes by which the patients had been retained in confinement, the impact of their release upon their communities, and their ability to adjust to the freedom of community life.
The authors demonstrate that the patients did not display a significant level of violent behavior during confinement, nor did they pose a major threat to society after release. In fact, their social and psychological adjustment to community life is shown to have been comparable to that of non-criminal mental patients. Yet despite these findings the subjects had been retained in maximum-security confinement for an average of fourteen years because they were predicted to be violent and "dangerous" to society. The authors explain this inaccuracy by a process called "political prediction," in which clinicians avoid any potential risks to the community, the reputation of their hospitals, and their careers by consistently overpredicting dangerous behavior.
The Criminally Insane will stimulate response from professionals in a wide variety of fields, including law, criminology, psychiatry, and sociology, and from anyone concerned with society's responsibility to the mentally ill offender.
1. The Criminally Insane in Pennsylvania
2. The Dixon Case: A Natural Experiment
3. Methodological Issues
4. The Dixon Patients: Characteristics and Backgrounds
5. The Farview Experience
6. The Dixon Patients in Civil Mental Hospitals
7. Discharge from the Transfer Hospital
8. The Dixon Patients in the Community
9. Recidivism and Dangerousness
10. The Impact of the Dixon Decision
Appendix 1 - Chronology of the Dixon Case
Appendix 2 - Dixon Case Record Summary
Appendix 3 - Transfer Hospital Record Summary
Appendix 4 - Violent Behavior Descriptions Derived from Hospital Ward Notes
Appendix 5 - Seriousness Scores by Offense Type
Appendix 6 - Subject Interview Schedule
Appendix 7 - Respondent Interview Schedule
Appendix 8 - Items in the Subscales of the Katz Adjustment Scale