Report of Inspection of !'!ental Health Care Facilities

Report of Inspection of !'!ental Health Care Facilities

and

Therapeutic Communities in

Canada, Denmark, The Netherlands,

England and Scotland •

•

David M. Schwartz, Ph.D. and

John C. Horton New South ~Jales Department

of Corrective Services

July~ 1980.

TABLE OP CONTENTS

CHAPTER PAGE -I.. IN~PHODUCTION ..... ., ... ., ..... ., .......... ., .................. o....... .. .. 2

II. DATA COLLECTION AND CHECK LIST OF ISSUES 7 EXPLOHED AT INcl'L'ITUTIONS VISITED ••••••••••••

III. SITE VISI'l'S, SECTION ONJ·;: 13 PHISONS WHICH FUNCTION AS HOSPITALS ••••••

1. Regional Psychiatric Centre (Ontario) 15 Kingston, Ontario, CANADA •••••••••••

2. Anstalten ved Herstedvester 25 Herstcdvester, DENMJiHK ........................ .

IV. SITE VISITS, SECTION T~IO: 38 DPECIAL HOSPITAI.S .... ,. ................................... ..

1. lJroadmoor Hospital 41 Crowthorne, Ber~shire, ENGLAND •••••

2. .Moss Side Hospital 43 .Maghull, Liverpool, ENGL\ND ••••••••

3. Park:' Lane Hospital, 45 .Maghull, Liverpool, ENGLAND ••••••••

4. Hegional Psychiatric Centre (Pacific) 47 Abbotsford, British Columbia, CANADA

V. SI'J.'E VISITS, SECTION THREE: Trllii~PEUTIC COMMUNITIES •••••••••••••••••• 60

1. Dr. Henri van der Hoeven Kliniek 69 Utrecht, THE NETillmLANDS ••••••••••

and Pieter Baan Centrum 64 Utrecht, THE NETHEHI.ANDS ••••••••••

2. H.l"'. Prison Grendon 79 Aylesbury, Buckinghamshire, ENGLAND

3. Special Unit, H • .M. Prison: B.arlinnie 88 Riddrie., Glasgow, SCOTLAND , •• , ••••

VI. SU!'li"'ARY OF NON-INSTITUTIONAL l'lEETINGS ••••• , • 100

VII.. RECOMMENDATIONS .. & ........................................ " .... e- 108 • i

.APPENDIX

l.

2. List of individuals contacted during the planning and execution of the trip ··•·•••·•••

3. Herstedvester 1978/79 - Danish text and English translation

Lars Nielsen ••••••••••.•.•••.••••••.•••••

4. The English Special Hospital System Dr. ]:JoG... McGrath.~ • " ., o .................... o ..... ., ...

Cuc:tody and release of dangerous offenders •••

6. Broadmoor Ins and Outs: 1960 - 1977 --- Dr.. D.:. 'llidmarsh ..... o .......... o ••• ., .... o .... .

7. A five-year follow-up ~;tudy of male patients discb1rged from Broadmoor Hospital --- D.A. Black •••••••••••••••••••••••••••••••

8. J'1o;;s Side Hospital: Guidelines for management of violent patients oooooooooooooeoooooooooooo

9. PR.rk Lane Hospital -Phase I Preview •••••••••

10. Regional Psychiatric Centre (Pacific): Nova \Jard induction booklet --- The Admission Team·, Nova \Jard •••••••••••• ..

11. Ilegional Psychiatric Centre (PAC): Directions and regulations ---Dr. C. Roy •.•••••••..•.••••••.••••••••.••

12. II.P.C.: Regional Psychiatric Centre ---Solicitor General of Canada ••••••••••••••

13. Detention R.t the government's pleasure: 'l'reatment of criminal psychopaths in 'l'he Netherlands

Central Recruitment and Training Institute of the Prison Service and the Care of

PAGE

114

116

120

128

140

147

163

186

191

192

202

206

Criminal Psychopath Service •••••••••••••• 214

14. The Dr. Henri van der Hoeven Kliniek: Background and treatment credo

P.A .. M .. Hendricks .... ~., ........................ .

15. 'l'he Dr. Henri van der Hoeven Clinic, Utrecht, The Netherlands: The new building and the ideas which underlie it --- A .:rvi. Roosenburg, Director ......... o ••••••••

16. 'L're:1tment results at the Dr. Henri van der Hoeven Clinic, Utrecht, The Netherlands --- J. "I .• Jessen &_ A .J1. Roosenburg o •••• o ••• o ••

17. Butler report references to Grendon --- B.J. Barrett •••••••••·············•••••••

18. Criteria for treatment at Grendon --- B.J. Barrett •••••••••••••••••••••••••••••

19. Criteria for treatment in adult wings at Grendon

1~ :r u r) ....

223

229

240

251

256

APPENDIX PAGE

20. The group of people we trent at Grendon are those with personality disorders

B.J. Barrett ooooooooooooeooooeooooooooo 259

28.

''9 L •

"B" wing constitution v ............... ., •. e............ 260

Aims and methods of treatment on 'A' wing,.. 264

Notes on treatment in 'B' wing ................... "'

Barlinnie information booklet . .,. ................ .. cipecial Unit: Barlinnie ---Scottish Information Office .............. .

Barlinnie Special Unit - 'I> group' system ••

'J'he Special Unit: Some central issues ---D. Webster ooooooooooooooeoooooooooooooo

Secretary of f) tate's instructions on the operation of the Special Unit at Barlinnie Prison (21st February, 1978) •••••

Fact Sheet 18: The Scott~sh penal system ---Scottish Information Office ••••••••••••

267

272

280

287

289

294

298

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Introduction.

'l'he population of the prison system in New South

Wales is extremely varied, consisting of individuals with

widely differing backgrounds and an enormous range of problems,

requiring a wide variety of treatment programmes. While the

Department of Corrective Services has taken a number of initiatives

in remediation of education skills deficits (numeracy and literacy,

trades training, etc.) little has been done for those prisoners

suffering from psychological illnesses of both the episodic and

chronic variety.

To date, mentally;.ill inmates have languished in an

intermediate "no-man's land" marked out as the responsibility

of the Department of Corrective Services and/or the Health

Commission. Truth to tell, neither organisation has done

much to generate, develop and implement treatment programmes .. for these inmates. Lack of initiatives in the Department of

Corrective Services has been due to limited resources and

expertise in the field of health care delivery, a traditionally

narrow view of its contribution to the mental welfare of prisoners

and a long history of departmental deference to the wisdom and

authority of the Health Commission to, care for this sector of

the prisoner population. In the case of the Health Commission,

there seems (particularly of late) to be a concerted policy

of not-so-benign neglect of the mental health needs of prisoners

that, in recent months, has been nothing short of criminal.

(One might cite, for example, the recent return to imprisonment

of more than forty individuals designated as "G.P.'s" who were

beinrs cared for by the Health Commission as a case of this policy)

If, in fact, recent events reflect an attitude of certain highly

placed bureaucrats in that organisation to relinquish responsi

bility for the care of convicted individuals, alternative

arrangements must be explored by the Government.

Mr. Justice Nagle, the Royal Commissioner, noted

the discouraging lack of treatment programmes and facilities

in the Prison Syntem. He was emphatic in recommending that

the only mental health facility under control of the

Department - the Observation Section (OBS) of the Central

Industrial Prison in the Malabar Complex of Prisons - should

be closed immediately. The facilities of the OBS are

antiquated, inhumane and inadequate ("Dickensian" was the

description applied by Nagle.) Moreover, there is no

attempt to carry out a treatment programme there. In

response to this pressing need for a proper mental health

facility within the prison system, the Department of Corrective

Services set up a committee to explore the range of treatment

possibil:ities. This group ultimately arrived at the concept

of the Special Care Unit.

The Special Care Unit was devised not only to meet .. the recommendation of Mr. Justice Nagle to close the OBS and

provide a suitable treatment alternative for those prisoners

who were "in psychological crisis," but also to provide a

mechanism by which custodial officers could taken on increased

responsibilities for the care of prisoners. It was thought

th<1t the therapeutic community concept advocated by Dr.l"laxwell

Jones offered the most appropriate model for such a unit

in that it allowed custodial staff an equal role on a multi

disciplinary treatment teani. It was hoped that prison officers,

having served a period of time in the Special Care Unit, would

then move back into the mainstream prison system and continue

to exercise these newly acquired therapeutic skills. In

short, both prisoners and prison officers would profit from

placement in this experimental treatment facility.

Initially, the Special Care Unit was conceived to be

a multi-disciplinary venture (medical, psychiatric, custodial,

psychological), but the Health Commission, after considerable

reached the rather parochial decision that any treatment

facility is, by definition~a health facility under the

auspices of the Health Commission. It was felt by us that

such a solution was short-sighted. Under a medical regime,

custodial staff would have no part in the treatment regime,

thus defeating one of the purposes for the Unit. The Corrective

Services Commission decided to staff and manage the facility

without on-site medical backup.

Having elected to run the therapeutic community

without the active support of medical practitioners meant

that we had to more carefully define the sorts of mental

problems that we could properly treat. Clearly, inmates with

chronic mental illness would not be suitable for such a treatment

regime, inasmuch as drug intervention is often essential for

them. In addition, we had do~bts, based on our reading of the

literature, that manipulative psychopaths would be suitable

candidates for the Special Care Unit • .. However, this issue of

who and what such a unit could best treat constituted but one

of a number of outstanding questions that could only be answered

by travelling abroad on a fact-finding/study mission.

The body of this report contains our systematic

observation of a number of sites in Canada, Denmark, The

Netherlands, England and Scotland. We chose to analyse these

facilities in terms of five broad areas in order to gain

information that would be crucial to the establishment of

the Special Care Unit.

1. Organisation of Unit 2. Personnel: staffing, selection and training 3. Security considerations 4. Regime of Unit 5. Daily functioning of Unit.

It would be irresponsible to say that these other facilities

provided us with definitive answers to the many questions

we set out to investigate. However, the observations provided

us with support for what previously had been a philosophical

conviction of what was possible, given the sincere dedication

of custodial staff, in the area of therapeutic programming

in a penal institution.

This report is organised around the body of information

gathered during the trip with the aid of a rather detailed

checklist (included in the next section along with a note

on our method of collecting data).

grouped under three major headings:

The various sites are

1. Prisons which function as hospitals 2. Special hospitals 3. Therapeutic communities

-- REFER TO THE ATTACHED MATERIAL FOH DE'l'AILS OF OUR ITINERAHY AS WELL AS THE INDIVIDUALS CONTACTED DUHING THl; PREPARATION AND EXECUTION OF THIS TRIP INCI,UDED AS APPENDICES 1 & 2 --

Following a summary of matters discussed at

non-institutional meetings held during the trip, there .. is a brief set of recommendations relating to observations

made during the trip. To conclude the report, a set of

appendices has been included to amplify and clarify

information discussed in the body of the report.

•

•

SNOI\LllJiiJiSNI JiV U3:1J01dX3: SciDG;;r .ii:O Mll'I }!03:!!0 GNV NOIJiO~>ITIOO VJiVG • II

Data Collection.

For this trip, we developed a check list to explore a large number of issues, some of which incorporated material of a sensitive nature, as well as a considerable amount of qualitative data that could only be gained after a degree of rapport had been established. Because our itinerary was "rather tight", we developed a strategy for collecting the most information in shortest amount of time with-out appearing to "grill" our institutional hosts. been warned beforehand that some of these individuals

Having might

tend to "get uptight" if we came to institutions "with notebooks and pens poised", we tried to make the interviews as conversational as possible. T,YPtcally, we would introduce ourselves and explain the terms of our mission (i.e., factfinding in order to set up the Special Care Unit) as briefly as possible. Then, .. Dr. Schwartz would lead the host (medical superintendent, psychiatrist, prison governor, etc.) through the various points of the check list without referring to the check list in an obvious fashion, while Mr. Horton took notes unobtrusively. With this initial information, we would then go off in separate directions: Schwartz meeting with the psychiatrists and psychologists; Horton talking to custodial and nursing staff. Attempts were als~ made by both of us to speak with inmates.

In the evening after each visit, we would compare notes and prepare a composite briefing on the information gathered at each site, On those occasions when we were able to return to the institution on another day, we would also prepare a set of questions for greater depth of coverage or cla:t~ification of conflicting information. Because this method involved a great deal of confidence on the part of • our sources, we gave assurances that nobody would be quoted in any official report. In this manner, we collected a great deal of information in a very brief .period of time. Furthermore, by dividing responsibility, we were able to compare staff/professional perceptions of an institution's functioning.

CHECK LIST OF ISSUES EXPLORED AT

INSTITUTIONS VISITED.

A. OHGANISATION OF UNIT.

1. Objectives of Unit.

a. Stated objectives.

b. Types of individuals being treated ("target population").

c. Generalised perception of success by personnel/custodial staff.

2. Hules and Principles by which Unit is run.

a. Stated management principles (if any)

b. Perception of management style by investigators Horton and Schwartz.

3. Helation of Unit to prison system to which it is connected.

a. Phys~cal location.

b. Formal relationship.

4. Custodial involvement in Unit.

a. How extensive?

b. Perception by Horton and Schwartz of custodial effectiveness in Unit (based on conversations with them).

5. Number of individuals in Unit.

a. Patients

b. Staff

(l) Custodial

(2) Medical

(3) Psychological

(4) Ancillary

f ' i ' ' i ! ' ' f ' ' r

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B. PERSONNEL: STAFFING, SELECTION AND TRAINING.

1. Staffing of Unit.

a. Unit model adopted

b. Service period required in Unit for staff.

(1) Provision of a probationary period?

(2) Specified length of service in Unit.

2. Selection of staff.

a. Custodial component.

b.

c.

d.

(1) Vocational background.

(a) Previous experience required.>

(b) Prior training suggested?

(2) Method of selection (by application, secondment, draft etc.).

(3) Selection procedure (panel, interview, etc.)

(4) Criteria used •

.. Medical Staff ~

staff)

~ Psychological

Ancillary staff

same information as above for custodial selection.

3. Training of staff.

a. Objectives

b. Length of training programme

c. Methods used (lectures, discussion, site visits etc.).

d. Materials used.

e. Provision for "refresher" training ?

f. Ongoing evaluation of staff e,ffectiveness:

I

C. SECURITY CONSIDERATIONS.

1.

2.

3.

4.

Around perimeter of Unit.

Within the Unit.

Access to Unit by "outsiders" (see "public access to Unit").

Generalised impression by investigators Horton and Schwartz of the "dangerousness message" given by the Unit in general.

D. REGIME OF UNIT.

1. Entry and discharge of patients.

a. Channels of referral (self-referral, medical, custodial, etc.).

b. Selection and acceptance of patients.

(1) Use of formal case presentations?

(2) Selection panel or administrative decision?

c.

(3) Criteria for acceptance of patients • .. (4) Length of stay in Unit specified?

(a) Provision of formal guidelines

(b) Average length of treatment.

Discharge of patients.

(1) Who makes the decision?

(2) Criteria for discharge of patients.

2. Pro vramme in Unit •

a. Goals of programming (adjustment to imprisonment, self-knowledge, crisis intervention etc.).

b. What range of programmes is provided?

c. How is programme selected for the patient?

d. Participation of prisoner in programme selection?

(

3. Medical regime of Unit.

a. Availability of psychiatrists.

b. Availability of psychiatric nursing staff.

c. Use of drugs for treatment.

4. Communication between patients and professionals.

a. Access to contents of reports?

b. Use to which reports are put in decision making.

c. Generalised perception of "openness of patient/ staff interaction" as perceived by investigators Horton and Schwartz.

E. DAILY FUNCTIONING OF UNIT.

1. " Induction procedures for patients entering the Unit (formal presentation, "buddy" system, etc.

2. Routine of Unit • .. a. Scheduling: structured vs. unstructured

b. Provisions for meetings of staff.

c. Availability of feedback options for staff and/or patients' problems.

d. Crafts/hobbies provided.

e. Interaction of staff and patients at meals?

f. Input of parole officers.

g. Provisions for clergy

Public access to Unit.

a.

b.

c.

d.

e.

How do visitors gain access (written and/or verbal application?).

Who makes the decision for access?

What grounds for refusal of access?

Provisions made for visits by relatives and friends of patients.

Ease of access to Unit by interested parties (media, citizens' committees etc.).

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F. OTHER ISSUES (not specifically dealt with in the check list.) (

III· SITE VISITS, SECTION ONE:

Prisons which function as hospitals • .. Regional Psychiatric Centre (Ontario) Anstalten ved Herstedvester.

•

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................... .._ ......... .,....,., Section One: Prisons which function as hospitals.

Institutions Visited:

l. chiatric Centre Ontario)

2, Anstalten ved Herstedvester, Herstedvester, DENMARK.

In this section, we shall review our experiences and

impressions gathered at two institutions which were primarily

characterised by those who worked in them as prisons, despite

the fact that their primary function was as hospitals carinr;

for prisoners who display varying degrees of mental illness.

In the case of the Regional Psychiatric Centre (Ontario), the

primarily custodial function may be due more to the environmental

constraints of the ancient facility in which it is housed than

to a conscious decision on the part of those bureaucrats who • are entrusted with decisions relating to health care delivery.

Perhaps all this will change when the new facility is built.

Certainly, the briefing documents that were so graciously

given (and sent) to us bode well for this project. However,

as it now functions, this institution is little more than a

containment unit for a number of prisoners, a large percentage

of whom are not mentally ill (e.g., troublemakers, protection

cases), staffed by a dispirited group.of professionals and

secured by custodial staff whose attitude to the inmates

within its walls ranges from benign neglect to outright

disdain. The case of Herstedvester is rather different.

Prior to 1973, it served as a treatment centre for individuals

on indeterminate sentences, including a large number of sex

offenders who participated in a well-publicised programme of

voluntary castration. Since the decision was made to 'do

away with indeterminate sentencing, the particular function

of this institution does not seem to have been defined.

Unlike the Canadian facility included in this section,

Herstedvester impressed us. Its physical plant was

clean and reasonably modern and the staff appeared to care for

the prisoners with whom they were dealing. In addition, we

had the good fortune to be briefed by a psychiatrist who does

empirical research and seems genuinely excited by his work •

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REGIONAL PSYCHIATRIC CENTRE- KINGSTON, ONTARIO, CANADA.

A. Orsanisation of the Unit.

1. Objectives of the Unit.

a. Stated Objectives.

The stated objective of this Unit was summed up

for us in one word: Security.

b. Tarset Population.

Any prisoner who is "troublesome" in other

institutions within the province is sent to the Unit.

people were variously described as:

- protection cases - "difficult" prisoners - troublemakers - sex offenders - psychiatric cases - psychotics

These

We attempted to draw from various members of staff more specific

criteria for their "target population", but were unable to

"pin them down" to anything more definitive.

c. Perception of success b~ personnel custodial staff.

In terms of the stated objective -- security

the staff felt that they were successful.

2. Rules/principles by which the Unit is run.

Though we attempted, on a number of occasions, to get

this information, the staff was unable (or unwilling) to supply •

this information. The Principal Psychologist, Mrs. Sharon

Williams, felt that the Unit existed to "isolate sick people

and contain them." Our perception of management style could

best be summed up as "laissez faire." In other words, doctors,

psychiatrists and nursing staff all seem to be "doing their own

thing." The principal psychologist voiced some concern about

this issue, particularly with regard to the establishment of

consistent programming for prisoners. It seems that custodial

pressure has been exerted to over-rule the medical Superintendent

on a number of occasions.

3. Relationship to the Prison System.

a. Physical Location.

The Regional Psychiatric Centre at Kingston is

housed in a very old wing which is situated within th.e walls of

an antiquated (130 year old) maximum security prison complex.

Little has been done to update the structure of this old wing;

toilet facilities consist of "honey buckets" and the cells have

open grill fronts affording no privacy at all.


The control of the Unit rests in the hands of .. a medical director who is theoretically independent to administer

the facility. However, it was evident that the responsibility

for the Unit's functioning was in the hands of the superintendent

of the main prison; he exercised ultimate control over the Unit.

4. Custodial involvement in the Unit.

There was no custodial involvement in the functional

life of the Unit. During the two days of our visit,

staff did no more than open ·and close gates. What's

the custodial I more, they

f made it plain that they were not at all interested in what we;nt o;n 1 ' there. There were, however, two officers who indicated that they I f

would like to be more involved and had volunteered to hel.p the I principal psychologist with testing for the sex offenders programme

€

(as control subjects for the eXPerimental design of the study), but I they were most concerned that other officers not be aware of this.

Perhaps the general custodial attitude was best summed up by the

senior officer in charge of custodial staff who said, "The main

thing in this place is to keep it clean, and that's an uphill

! It I I I I_

5. Number of individuals in the Unit.

a. Patients.

Currently there are 85 patients in the Unit.

There is overcrowding due to the difficulty in discharging

inmates back into the prison setting.

b. Staff.

(1) Custodial

(2) Medical

(3) Psychological

( 4) Ancillary

26

45

2 plus 2 clinical psychologists serving internships from Queen' University.

11

In addition to these individuals, there is a social

work section and a research section which are.not housed in the

Unit. Theoretically, they may be called upon to provide services

to the Unit, but it seems that their impact on the daily functionin. '

of the Unit is virtually nil. These staff figures are not included

in the above staffing for that reason • ...

B. Personnel: Staffing, Selection and Training.

1. Staffing of the Unit.

a. Unit model adopted.

The Unit is a prison disguised as a medical

facility. It is theoretically a hospital and all the inmates

are considered to be "sick", but the validity of this statement

is questionable when one considers the wide range of categories

of inmates who are sent to, and housed in, the Unit (i.e.,,., ... nr."'

cases certainly do not seem to fit into an illness typology).

b. Service period reguired in Unit for staff .•

There is no provision for a probationary period

of service in the Unit, nor is there any upper limit to the length

of period of service in this location.

(



Custodial officers employed within the Unit have

the same background as custodial officers in any other gaol in

this province, They have completed basic prison officer training

requirements. Selection of custodial staff is made by the

personnel division. Thus, placement of officers in this Unit

does not differ from that in any other gaol in the system. When

pressed to provide criteria used to assess suitability, senior

unit staff stressed experience with inmates, flexibility and

(preferably) some nursing background. One senior officer's view

was that he wanted, "someone who won't start a riot in an empty

room."

:. b. Other staff.

No information was forthcoming on the issue of

selection of non-custodial staff.


No further training was given to any member of the

Unit staff following placement. There was some mention of an

"induction", but this seems to be an!!£ hoc and somewhat haphazzard

process inasmuch as nobody seemed able to explain how the procedure

worked and what it entailed.

4. Other Staffing Issues.

There appeared to ·be considerable role confusion amongst

the staff in the Unit. The senior custodial officer for the Unit

occupies an office situated outside of the main prison complex in

which the Unit is sited. His team of base grade officers had

no senior member to whom they could appeal for advice. In the

most immediate sense, security decisions are taken by the Medical

Director or, during the night shift, by the nurse on duty.

These decisions are passed to custodial staff, in the form of

directions by these individuals. Of course, this organisational

structure leads to considerable resentment by prison officers.

c. Security Considerations.

The perimeter of the Unit has no additional security because

of its placement within a maximum security gaol. Entry to the

Unit is via a locked double "air-lock" arrangement of doors.

Once inside the living area of the Unit, one has the uneasy

"feel" of a maximum security unit which is "on edge", in a

volatile state. There appeared to be some reluctance and

embarrassment about showing us around this area. Comments on our

tour around this area included a number of the following:

- "Don't walk down that corr:idor because the guy in 5 cell is liable to toss his honey bucket at you."

- "Don't wake up the man in the 'Chinese cell' because he's liable to spit at you." ..

As we have previously noted, the cells date from ca. 1850.

The regime in our view is worse than that in operation in the

O.B.S. Section at Long Bay Complex. Stripped cells appeared to

be the norm and closed circuit television cameras are focused

into each cell. Three (3) prisoners are given the "run of the

wing" each night to cope with "problems" that might arise with

other inmates. Needless to say, such an arrangement would be

questionable in a regular prison regime; the spectre of

inmate-inmate victimisation was very palpable, particularly

when one considered that a number of the prisoners in the Unit

were psychologically unstable and/or defenceless.

Officer morale and standards of dress were apparently •

at a low ebb. Obviously work-interest and job satisfaction

are lacking. In part, this must be due to the lack of custodial

involvement in the functional running of the Unit. The Principal

Psychologist supplied corroborative detail to support our

of officer malaise: instances of sick leave among officers is

frequent in the Unit.

D. Regime of the Unit.

1. Entry and Discharge of Patients.

Inmates are referred to the Unit by the doctor Of the

prison in which they are currently housed. They are then seen

by a psychiatrist and, if suitable, are admitted to the Unit.

That, at least, is the theory of admission; in practice, it is

obvious, given the wide range of inmate categories in the Unit,

that the superintendent of the Kingston Penitentiary determines

admissions.

Discharges from the Unit theoretically take place when

the inmate is cleared by the psychiatrist for return to his gaol

of classification, In practice, everyone to whom we spoke

mentioned considerable difficulty in discharging inmates and the

resultant overcrowd1ng problems.

2. Programmes in the Unit.

Programmes seem to be provided by a few members of

staff who have retained an interest include;

- an intensive (17 hours per week for 4 months) sex · offenders treatment programme.

- transactional analysis self help/living skills programme.

As you can see, the programmes are psychological in orientation

and are run by the two psychologists (both with doctorates) on

staff as well as 2 university students (clinical interns) from

nearby Queen's University. The psychiatric and nursing staff

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were, for the most part, dismissive, condescending and patronising ! l •

when discussing these programmes.

3. Medical Regime of the Unit.

Full-time psychiatrists and psychiatric nursing staff

are part of the staff complement for the Unit. The use of drugs

(

for treatment is determined by the psychiatrist in the case of

each inmate. Although no specific information was given, our

perception of drug usage for treatment is that it is considerable.


There is no access to reports by inmates under any

circumstances. It was not possible to obtain information about

the use to which reports are put in decision-making. In spite

of asking the question a number of times in a number of different

ways, a direct answer was never forthcoming. Our perception of

the "openness of patient/staff interaction" can best be summed

up in one word: Closed.

E. Daily functioning of Unit.·

1. Induction Procedure • .. There is no formal induction procedure for the Unit.

There are formal written rules which are enforced within the

Unit, but we were told that these rules are precisely the same

as in any gaol (i.e., "straight from the book").

2. Routine of Unit.

The routine of the Unit is much the same as any other

closed gaol. Work is provided for some inmates in internal

workshops in such areas as: Spray painting and furniture repair, j including staining, varnishing and upholstery. The works officer

impresses as a dedicated man with a desire to help the prisoners in I some vaguely rehabilitative fashion in spite of the very -limited

facilities at his disposal. Other inmates (i.e., those not in

the shop) are involved in psychological programmes (described

above), but the majority sit around, read books available from a

somewhat limited library in the Unit, or sleep. At the time

of our visit a rather innovative programme was in the process

of being established: the installation of an internal radio

station to be manned by inmates. In addition, a well-equipped

gymnasium was availble for use by residents.

There are no provisions for meetings of staff, nor was there

any formal structure whereby inmates and staff could meet. No

informal interaction occurs between inmates and staff due to the

physical separation of staff and living facilities in the building.

Also, there seems to be an unwritten rule that~most of the

inmates are violent and untrustworthy, particularly in their own

living quarters~(a message, incidentally, that is reinforced by

the open bar arrangements of the cells).

inmates on a one-to-one basis, typically.

Therefore, staff see

Because of the fact

that the Unit is situated within the confines of the main gaol,

its routine is tied to that of the larger surrounding institution.

Therefore"", the Unit closes from 11.00 am. to 1.00 pm. each day

and all inmates are locked in their cells for lunch. During the

summer months, there is a provision for an 11.00 pm. lock-in at ..

which time the inmates may use the outside exercize yard and

gymnasium (incidentally, the exercize yard is not available for

use by inmates because of a shortage of custodial staff to

supervise activities in that location. Lock-in during the

winter months occurs at 4.45 pm. In addition, films are shown

in the gymnasium on weekends and public ~olidays.

3. Public Access to the Unit.

There is virtually no public access to the Unit.

Representatives of the media or other interested parties can

seek permission from the Regional Director to visit the facility,

but we were assured that this would occur very rarely. !n fact,

no staff member to whom we spoke could recall a visit of this type. I t

Visitors to prisoners must be registered on an approved

list; they are allowed in the. normal visiting facilities in the

main prison. We were advised that they would be allowed to

visit in the Unit "in exceptional circumstances, by very special

arrangement." Again, no staff could recall such an extraordinary

occurrence.

F. Other Issues,

1. It may appear that we have been unduly critical of the

Regional Psychiatric Centre at Kingston. However, this critical

stance must be understood in the context of our itinerary. Our

previous stop had been to the Regional ?sychiatric Centre at

Abbotsford. Naturally, we drew comparisons between these two

Canadian institutions. Upon reflection, we feel that the

contrast between Kingston and Abbotsford -(which appeared in

so many ways to be such a positive experience for us) may be

related to two different reasons:

- a complete lack of interest, innovativeness, managerial expertise and willingness to make decisions at the local level. ..

- the difficult and antiquated surroundings in which the Unit is forced to operate.

2. In complete contrast to the attitudes of local

management were those of the Senior Administration at the Ontario

Regional Headquarters. In particular, mention must be made of

Ross Duff, Regional Manager, Security. Whilst acknowledging the

difficulties inherent in operating old establishments, the

difficulty in obtaining the_necessary finance to build a new

psychiatric unit and the planning delays, Mr. Duff retained an

enthusiasm and hope for the future that was not evident in his

subordinates at the institutional level. He was also much more

open in his discussions of those difficulties and very prepared

to provide information to us and the Corrective Services vc>mmtls:s

of New South Wales. To that end, he has sent us a complete set of

briefing materials and specifications for the new psychiatric unit.

Mr. Duff also arranged for us to visit the Ontario Correctional

Staff College. This visit will be discussed elsewhere in this

report (Section VI),

•

ANSTALTEN VED HERSTEDVESTER - HER..STEDVESTER, DENMARK.

A. Organisation of the Unit.



The objectives of the institution have not been

defined since 1973. It is perceived as an institution for

mentally disturbed inmates.

REFER .'l'O THE ATTACHED MATERIAl, ENTITLED "HERSTEDVESTER 1978/79" (DANISH ORIGINAL AND ENGLISH TRANSIJ,TION) INCLUDED AS APPENDIX 3 --

b. Target population.

Those inmates with behavioural problems were

said to be the target population at this institution. Many

are psychopathic or borderline psychopathic/neurotics (800fo)

but there are a number of psychotics (15-200fo) as well. A

large number of these men have alcohol-associated problems • .. Drug addicts are not accepted, unless there are exceptional

circumstances. 10%-15% are dangerous offenders who have

repeated convictions and are serving indeterminate sentences

mainly sex offenders and some pyromaniacs.

c. Perception of success by personnel/custodial staff.

Staff believe that they are successful in

relieving the pressure on the main prison system, although

they noted an increasing incidence of violence within the

institution during the last two (2) years.

The programme of voluntary castration for sex

offenders, for which Herstedvester was best known in criminological

circles3 was discussed. Between 1929 - 1959, 900 males were

castrated, 738 of whom were criminal sex offenders. It was

stated that recidivism rates among this'speciai" group of men

was only 1%-~~. as opposed to 30o/~50% for other categories. Though

this programme of surgical castration was suspended in 1972, an

alternative treatment consisting of "chemical castration" is

presently in the early stages. This treatment consists of

the administration of a chemical that blocks the effects of

endogenous male hormones (androgens), resulting in a lowering

of sex drive. Though dosage levels required for this outcome

are still in the process of being determined and there still

seems to be some concern about the acceptance of such a

programme by legal authorities, the chemical treatment of sex

offenders seems far more humane than the surgical procedure

previously carried out at Herstedvester because the chemically

induced i~potence is reversible when the administration of the

drug is stopped. Dr. J~rgen Ortmann, the psychiatrist involved

in this programme, suggested that this treatment seems to be

the only alternati~ for treatment of sex offenders inasmuch

as aversion therapy (the other treatment often used for these

offenders) and surgical castration are inhumane.

2. Rules/Principles by which the Unit is run.

A formal hierarchy exists within the prison, but

there is considerable openness between staff and the institution

was said to function on a democratic basis. Our perception of

management style was one of an egalitarian community.

Meetings of the professional staff are held daily,

chaired by the senior psychiatrist. Each officer is required to

report on inmates within his unit, followed by an unstructured

discussion. In addition, there is a weekly meeting at which •

the following topics may be discussed:

- Releases: inmates may be released after they have served between 1/2 and 2/3 of their sentence.

- Weekend Leave: available to all inmates as a r • 8 e eVerY third WP.AkAnt'l "f'i-on 1 /Jt ~<- ;.\.,~

Returns to other prisons: in this case, a determination is made of whether the inmate is suitable or unsuitable for return to another institution.

3. Relationship to the prison system.

a. Physical location.

This is a separate, self-contained institution.

b. Formal Relationship.

This institution is considered a prison, rather

than a hospital, and is an integral part of the Danish penal

system.


~The custodial staff are fully involved in the

operation and programming of the institution. We were advised

that this involvement is much greater than in any other Danish ..

penal institution. The psychiatrist (Dr. Ortmann) stated

that information and opinions of custodial staff are highly

valued because of the close contact that these individuals

have with inmates.

5. Numbers of individuals in the Unit.

a. Patients.

The Unit has a capacity of 140 beds. However,

one section is closed due to lack of funds for maintenance

and provision of staff. Currently the institution holds

117 inmates.

b. Staff

(1) Custodial

(2) Medical

(3) Psychological

( 4) Ancillary

lif'l •

11 (5 psychiatrists, 2 doctors,! 4 nurses)

7

5 teachers, 1 interpreter (part-time)

28 admi

B. Personnel: staffing, selection and training.



The institution is considered to be a prison.

A great deal of emphasis was placed by all staff on the fact that

it is a prison and prison rules must be obeyed. The institution

is run by a custodial superintendent, on a daily routine basis,

who is legally empowered as the head of the institution. However,

the Medical Superintendent, Dr. Marianne Schi¢ler, is, in reality,

the ultimate authority within the institution. Therefore one

might make a case that this is a hospital disguised as a prison.

b. Service period required in unit for staff.

No provision exists for a probationary period • • Staff generally serve for at least two (2) years, but there is

no upper limit to the service period and some staff have worked

in the Unit for more than six (6) years.



Custodial staff have completed an initial training

period of 5~ months ?nd a secondary tra~ning course of ~ months.

In addition, they have had 2 years of experience as prison

Selection is by interview which is held in response to formal

application by the prison officer who seeks selection. All

custodial staff are paid an allowance of 10% of salary for

work at Herstedvester.

The morale of the staff was generally high, but

it was clear from talking to junior staff that the strain of

working in such close contact with inmates takes its toll.

Indeed, it was suggested that junior staff typically leave

for other institutions after two years because of the strain.

It is worthwhile to note that female custodial staff are

regularly employed at Herstedvester without any difficulty.

In fact, male staff seemed surprised that we should question

the utilisation of female staff in custodial roles in a

male prison.

b. Other staff.

Selection is on the same basis as for psychiatric

hospitals in Denmark. There is some interchange between the

two systems. Research is currently being undertaken in Denmark

which suggests that psychiatric and penal systems share a

considerable portion of their clientele -- nearly 70% of

psychiatric admissions are on record as committing criminal

offences, according to Dr. Ortmann.


Additional training is confined to custodial staff.

Prison Officers selected to work in the institution are given

three (3) months of psychiatric training in a psychiatric

hospital. In addition, "in-house" training is being given

by psychologists and psychiatrists to custodial staff. These

sessions of two (2) hours per day in a one (1) week block are

extremely popular.

paid working time.

' Staff attend these sessions during normal

c. Security considerations.

Herstedvester is surrounded by a high masonry wall and

the perimeter is monitored by closed circuit television cameras

from which images are transmitted to a 9 screen array lucated

in a central control room that is, in turnlsituated in the

Administration Building.

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Internally, security is fairly standard with manually

locked doors fitted for wings, grill gates to corridors and

solid doors for cells. Custodial staff indicated that their

most serious security problems are the ~esult of drugs brought

into the institution from outside.

Electric shavers are used at Herstedvester because razors

are not allowed, for obvious reasons.

Each of the buildings at Herstedvester has an alarm button

which, when activated, sets off a flashing red light on a map

of the institution that is located in the control room of the

Administration Building. This map and its lights are duplicated

in all other locations, enabling each officer to see where the

problem exists. Additionally, each unit officer carries a radio

which is ~onitored by the staff in the Administration Building.

With the exception of the Jsolation Unit (which consists

of a number of bare cells with restraining devices secured to

cots that are, in wrn, secured to the floor), the "feel"

of the institution was positive although some inmates indicated

that they felt stigmatized (labelled as "crazy") by being at

Herstedvester.

Visiting arrangements reflect the concern of staff with

regard to smuggling in of contraband drugs. Inmates on visits

may be required to change into visiting clothes. By the same

token, visitors may have their bags searched and be given a

body search. The visits take place in a private room, out of

sight and hearing of staff and are available to inmates for

one (1) hour per day. When questioned aj)out the likelihood

of sexual contact during these visits, staff indicated that it

was officially forbidden, but probably occurred. •

Telephone calls are allowed by inmates. There is no limit

to the number of calls allowed, but they must be approved at

the daily staff meeting. Generally, one call per week is

allowed. However, this arrangement applies only to outgoing

calls; incoming calls are not a art of this scheme. Also

{

calls from prisoners are randomly monitored.

There is no limit on the number of letters an inmate

may send or receive. There is no censorship, although the

police or a court may direct that a particular inmate's mail

be read. As a general rule, inmates show the letter and

accompanying envelope to their wing officer; if the letter

is outgoing, it is sealed in the presence of the officer.

When staff were queried about prisoners' needs and

grievance committees, they stated that such organisations

no longer functioned at Herstedvester, although they seem to

exist in all other Danish prisons.


1. Entry and Discharge of Patients • •

This institution receives 100-150 new inmates per

annum. Between 1933-1973, Herstedvester was an institution ..

that dealt solely with criminal psychopaths who were serving

indeterminate sentences. These people were sent there for

treatment, rather than punishment. In the wake of the

political decision to abandon this special function, Herstedvester

differs very little from other Danish penal institutions, save

in two respects:

- the courts may direct inmates to an institution that deals with criminal psychopaths. Though Herstedvester is not named, it is the only location in the Danish penal system which has facilities to cater for such individuals.

There is, however, no structured referral procedure. Prisoners

may be simply classified to Herstedvester because the facility •

is regarded as a prison; in some cases this option is exercised

because this gaol is viewed as the "last resort", an option to

be taken when all else has seemed to fail.

There are no formal provisions to return inmates to

other institutions. In those cases when return seems indicated,

{

the decision is made following case discussion at the daily meeting,

When a prisoner is received, he typically comes to stay until

released. The average length of time spent at Herstedvester

is 7-8 years, but one inmate has been resident there for 27 years.


There are no well-defined programmes at this institution,

although there was a general consensus among staff that better

defined programmes and more staff would enable the institution

to have greater impact on the prison system generally. Dr. Ortmanx

said, "I personally believe that there is little that can be achievE

by treatment, except for sex offenders, other than to provide

humane treatment." He went on to add that the effectiveness of

most psychological treatment was dependent upon the expertise

possessed by prison officers in the area of man management. '

Indeed, he stressed the need for additional training for prison

officers and the appointment of more female officers to the .. institution.

The therapeutic benefits of pre-release leave into

the community is recognized. Prisoners are allowed to leave

the institution on escorted leave with an officer or psychologist.

Non-escorted weekend leave is also used extensively. In the

event that an inmate retur·ns latf) from leave or fails to return

for a day or so, he is automatically given two (2) additional

weeks' sentence and no further leave for three (3) months.

Of course, this is the case only if no further crimes have been

committed whilst on leave: criminal acts would require judicial

procedure. If the prisoner repeatedly abuses the leave

privilege, total loss of leave may result. •

Prisoners are encouraged to decorate their own cells.

Indeed, one entire wing is self-managed by prisoners who are

nearing the completion of their sentences. In this Unit, the

10-12 inmates maintain their own garden, cook their own food

and formulate the rules for their community, including the

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determination of which outsiders will be allowed to enter

the Wing itself. Staff do]£! enter without permission or

invitation.

Group therapy and workshop options are available at

the institution. The groups are run by the medical superintendent

and, sometimes, a psychologist. A full range of work is

available in such areas as:

- carpentry/joinery - bookbinding - laundry - tailoring - leatherwork

All inmates are required to work. Any who do not work do not

get paid, However, provision is made for a psychiatrist to

recommend a "sick" inmate for a "pension." The wages from

work are paid weekly and may be spent in the canteen.

' In addition, educational programmes and a library

are provided.


Full-time psychiatrists are available, as are nurses,

though not necessarily psychiatric nurses. Pharmacological

intervention is carried out with psychotics, but the general

philosophy of the institution seems to favour the avoidance of

drugs, particularly addictive drugs. In fact, staff insisted

that fewer drugs, per head of population, are used at Hersted-

vester than at other Danish penal institutions. Drugs are

ordered by the doctor and dispensed by the nurse to the prison

officer who, in turn, issues.the drug to the inmate. It is

of interest to note that the officer is liable to prosecution

if medication is given to an inmate against his will.

Other problems discussed in relation to medical

regime included: transfer of actively psychotic patients to regional psychiatric hospitals is very diff:Leult to achieve; even in those cases when this is accomplished, they are often returned to prison within a few days. Clearly the "instant cure" is more

nrH

•

psychotic inmates are often remanded there prior to sentencing after which they may be sent to psychiatric hospitals

- manipulative psychopaths who disrupt the running of the institution pose the usual difficulties

Alas, no real solutions were offered to these vexing problems

which are probably as common in New South Wales as they are

in Denmark.


All staff have access to ~ reports, but concern

was expressed about notes/reports leaving the institution.

Communication was said to be good with inmates, particularly

at the prison officer level. There is no formal access by

inmates to reports which are used at staff meetings to discuss

such issues as release, leave, etc. Also, some staff admitted

to maintaining "pr;l.vate" note's on individuals to which there

is no access by staff in other institutions.

E. Daily functioning of the Unit.

1. Induction procedure.

No formal induction procedure exists, but all inmates

are received into a reception wing and infor~ed formally of the

requirements of the institution by a prison officer; informally

by another inmate. Some inmates may be received directly into

the Isolation Unit and, after a few days (maximum stay: two weeks)

be placed into an appropriate ward.

2. Routine of Unit.

As stated above, provision exists for daily siaff

meetings which are attended by custodial staff representatives.

Decisions made at these meetings are communicated by prison

to the inmates. Any inmate may request an interview with the

superintendent if he has a grievance either by making a verbal

request through his wing officer or by written application. Any

forwarded to "head office."

A football oval is available within the secured

perimeter of the institution. Staff engage in all forms of

sport and activities with inmates. An auditorium is used for

weight training and other exercises after working hours. A

film is shown every two (2) weeks and outside bands visit the

institution occasionally.

separately.

Staff and inmates take their meals

A number of professionals from outside the institution

visit prisoners. Parole officers are welcome, but in the view

of some staff they are not seen at Herstedvester frequently

enough. There is a full-time chaplain on the staff (who is a

trained psychologist), but other clergy are welcomed as visitors

or as requested by particular inmates.

3. Public a~cess to the Unit.

Anybody is welcome to visit Herstedvester, with the

exception of some former inmates. Visiting procedure requires

the prisoner to place the names of his visitors on a list that

is then vetted for approval by staff at the daily meeting. We

were informed that this is now a formality and all lists are

generally approved, with the sole proviso that the inmate must

supply the name and address of the proposed visitor. In the

event that a visitor is denied access to a prisoner, the facts

of the decision are explained to the inmate by his wing officer.

If there is further disagreement, the superintendent is empowered I to make the final decision. As previously noted, visits are

for one (1) hour per day and are conducted in absolute p~ivacy.

I The media and local citizens are encouraged to visit, ~

but the staff indicated that this opportunity is seldom exercised. I

F. Other Issues,

The perception of crime in Denmark by both custodial

and psychiatric staff is as follows:

the "crime rate" is rising rapidly

- approximately 7,200 convicted persons should be in custody, but present conditions in penal institutions allow for a capacity of only 3,300. Considerable numbers of units of cell accommodation are presently "shut down" as an economy measure.

- the prisoner population at Herstedvester seems to be "hardening" and becoming more difficult to manage with strategies currently in practice •

..

IV. SITE VISITS, SECTION T\VO:

Special Hospitals.

Broadmoor Hospital Moss Side Hospital Parle Lane Hospital Hegional Psychiatric Centre (Pacific)

•

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f l I E g i I I

Site Visits, Section Two: Special Hospitals.

Institutions Visited:

1. Broadmoor Hospital Crowthorne, Berkshire, ENGLAND.

2. Moss Side Hospital Maghull, Liverpool, ENGLAND.

3. Park Lane Hospital Maghull, Liverpool, ENGLAND.

4. Regional Psychiatric Centre (Pacific) Abbotsford, British Columbia, CANADA.

The Special Hospital System (in England)

represents a type of solution to the problems that have recently

occurred in New South Wales between the Health Commission and

the Department of Corrective Services. In such a system, firm

guidelines are provided for the care of prisoners who have

serious mental illness, as well as those individuals adjudged

to be "not guilty" who are serving indeterminate sentences

"at the pleasure of the governor.'' We have included two

papers that explain the structure of this system in England.

REFER TO ~!.'HE ATTACHED MATERIAL ENTITLED "THE ENGLISH SPECIAL HOSPITAL SYSTEM" AND "CUSTODY AND IlELEASE OF DANGEROUS m'FENDERS" INCLUDED AS APPENDICES 4 & 5

As the reader may note, such a system also allows for the

transfer of inmates who are certifiably insane. We believe

that the introduction of such a system in New South Wales

would provide for a facility that would specificallJ cater for

imprisoned individuals, both male and female, within the con-

fines of a secured establishment. Until such time as such a

facility is established, the haphazzard and inhumane treatment

of mental illness will continue to be in the hands of individuals

who are less than enthusiastic about the full and caring

responsibility of convicts. Clearly, this was the broader

issue alluded to by Mr. Justice Nagle when he recommended the

I

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f 1-, I '

closure of the Observation Section at Long Bay.

We believe that the Special Hospital System,

were it to be set up in New South Wales, could also take over

the functions of a psychiatric assessment unit for court referrals.

The model for such a unit would be the Pieter Baan Centrum.

We have included in this section the Regional

Psychiatric Centre (Pacific) because of its functional resemblance

to the English establishments. The primary difference between

it and the English Special Hospital lies in the use of custodial

staff in the Canadian institution for maintaining security.

This seems preferable to the arrangement in England where nursing

officers perform the dual role of custody and treatment, resulting

in some potential conflict of goals. Because the Canadian facility

presents the more potentially u~eful model for New South Wales,

we have presented information from that site in considerable

detail. Information from the three English sites will be .. presented in a briefer and more impressionistic manner.

At the present time, the English Special Hospital

System is under considerable fire from the press because of the

recent release of several individuals (from Broadmoor and Hampton)

who have re-offended. As a consequence, a great deal of pressure ' has been brought to bear on the authorities in control of these

institutions to be far more conservative in the exercise of criteria

for releasing individuals from custody. As if this political

situation did not present enough difficulty for these institutions,

yet another obstacle is preventing the Special Hospitals from

discharging individuals to regular psychiatric hospitals: the

militant nursing union which refuses to accept responsibility

for the charge of mentally ill ex-offenders. Thus, the Special

Hospitals are caught "'between the rock and the hard place," unable

to easily discharge people into the community or to alternative

facilities. At the same time, the courts continue to commit cases

to the Special Hospital System. It seems certain that this

impossible situation cannot continue for much longer. Not even

the completion of the Park Lane Hospital, due to open to full

capacity in 1984-85 will appreciably alleviate the problem of

over-population. Because of the turmoil resulting from these

pressures, Rampton Hospital was eliminated from our itinerary.

On the basis of telephone contacts, it was evident that the

authorities running the institution were very anxious about

having to host an official visit. Therefore, we decided to

see ££ih Moss Side and Park Lane Hospitals in the time now

made available, though we had initially planned to see only

one of these sites.

•

BROADMOOH HOSPITAL - CROWTHORNE, BEHKSHIHE, ENGLAND.

A. Activities of visit.

1. Interview with Dr. P.G. McGrath, who related the history of the institution, the proposed re-development prop;ramme, description of facilities, etc.

2. Tour of Reception and Adolescent Units.

3. Meeting with D.A. Black, Consultant Psychologist

4. Lunch with the senior medical staff

5. Attendance at a case conference, chaired by Dr. D. Tidmarsh.

B. Issues raised during the visit.

1. Broadrnoor is a vast complex of buildings dating,

for the"most part, from 1863. The following is indicative

of the size of the institution:

- Lf00+ psychiatric nurses 9 psychologists 9 ~ocial workers

a large number of doctors, psychiatrists, and consultants

workshop managers (with therapeutic training) 811 patients (692 males and 119 females)

In a breakdown of cases sent to Broadmoor, Dr. McGrath said

that 90% of patients were sentenced there and 10% were from

the prisons: 75% of individuals were actively psychotic,

25% sufrered from personality disorders. The majority of

individuals had committed homicides (Lf5",.0).

HEFER TO T\,10 ATTACHED PAPERS ENTITLED "BROADMOOR INS AND OUTS: 1960-1977" AND "A FIVE-YEAR FOLLOW-UP STUDY OF l"IALE PATIENTS DISCHAHGED FROM BROADMOOR HOSPITAL" FOH ADDITIONAL INFOHMA'l'ION, INCLUDED AS APPENDICES 6 & 7 --

•

2. The problem of releasing individuals detained at

Broadrnoor was discussed throughout the day. This institution

is feeling considerable pressure because of the recent release

of a violent rapist who subsequently re-offended, murdering

his victim in the course of the offence. What was remarkable

about this dischari':e was that it was ordered by the Deputy

Director of the Hospital without the benefit of a psychological

assessment. Clearly, such an assessment was in order since

a previous psychological report (done in 1976) stated that

the prognosis for this man's safe release into the community

was not p;ood.

3. Following from the issue raised in point 2, it

seemed that the psychiatrists do not treat the psychological

staff in a collegial manner, in spite of the fact that several

of the staff psychologists have done very respectable research

at Broadmoor Hospital. We were left with the impression that

considerable professional resources were "going to waste". "

At the present time, with Dr. McGrath's retirement imminent,

the psychological staff are lobbying for a change in the

management structure of the institution demanding greater participation. ~

4. He felt privileged to be able to sit in on a case

conference, but were more than a bit concerned with the e~ents

that transpired: due to the heavy bias in favor of psychiatry

at the conference, members of staff seemed overly anxious to

"label" an individual without having sufficiently researched

the man's case or listened to the facts that the patient was

openly disclosing. As a function of this experience, we were

more convinced than ever before that a multi-disciplinary

staffing model must be achieved for the Special Care Unit.

What's more, we feel that considerable thought and attention

should be given to the staff organisation of the new Hospital

Facility before the Government turns this facility ovet to the

Health Commission. As stated in the recommendations, we feel

that such an institution should become a Special Hospital,

governed by individuals from 12.Q.!h the Health Commission and

Corrective Services.

t

MOSS SIDE HWPITAL - MAGHUI,L, LIVERPOOl,, ENGIJ\.ND.

A. Activities of visit.

l. Meeting with various heads of departments (Social work, industries, psychology, nursing and administration of hospital) at which the programmes of the institution were outlined by Dr. M.P. Neill and her staff.

2. Tour around workshops, classroom and living facilities on the part of the complex near Park Lane Hospital.

4.

5.

6.

Lunch with heads of departments. Tour of women's wings and other male living units. John Horton tours administration and security faci David Schwartz meets with psychologists from Moss Side

and Park Lane Hospitals Final meeting with Dr. Neill' Sheila Scott (socia.l

and J. Eric Postles \Administrator fgrbpth Moss Side and Park Lane) //''' ' 2' >,,


1. At present, Moss Side Hospital has a large complement

of intellectually sub-normal patients as well as individuals

with average inoolligence. However, there is a fear among the

staff of the hospital that this institution will handle only

sub-normals after Park Lane Hospital is fully operational.

Thus, Moss Side would cater for the same sort of individuals

in the north of England that Hampton Hospital serves in the

lower part of the country. Staff would not be happy to see

this development because they believe it is beneficial to

staff to have the opportunity to work with both normal and

sub-normal patients.

2. Moss Side is apparently losing members of its staff

to Park Lane as that new facility becomes fully operational.

This has generated some bad feelings.

3. We were very impressed with the various workshops

at the institution as well as the security arrangements present

in each location. Of particular interest is the use of

procedures structured as craft activities that were used for the

4. Educational facilities and instructional programmes

were of interest, Though the man in charge of these facilities

is employed by the local council, he is a full-time member

of the Moss Side staff.

5. Once again we had the impression that psychologists

felt isolated from the rest of professional staff. However, to

counteract this, they have organised a regular series of staff

seminars on a broad range of topics. Their plight is not nearly

as serious as seen at Broadmoor Hospital.

6. Because of the nature of the population at Moss Side

Hospital, a set of guidelines have been printed for the handling

of viol~nt patients. We feel that this material is of interest

and have included it in the Appendices.

-- HE~'ER TO THE ATTACHED DOCUMENT ENTITLED "MOSS SIDl': HOSPITAL: GUIDEI,INES F'OH 'PRE MANAGEMENT OF VIOLENT PATIENTS" INCLUDED AS APPENDIX 8 --

PARK LANE HOSPITAL - MAGHULL, LIVERPOOL, ENGLAND.

A. Activities of Visit

1. Tour of facilities (old living units, gymnasium, etc.)

2. Meeting with Dr. Malcolm MacCulloch (Medical Director), and two senior nursing officers about plans for the institution when it is completed, as well as procedures currently in operation.

3. Lunch with Dr. l"lacCulloch, l"lr. J. Eric Postles and the other senior staff.

4. A visit to the two units scheduled to be opened in late June.


1. We were most impressed by the new units that we were

allowed to see(even before a number of members of staff), While

some chqnces have been taken in the design of the living units

(each of which has a private toilet), the attempt to provide

an environment that is both aesthetically pleasing and humane

is highly commendable. We told the Senior Nursing Officer

Norman Pearce that we would like a "progress report" in twelve

to eighteen months to see what problems have been discovered in

these housing units.

-- REFER TO THE ATTACHED DOCUMENT EN'l'ITLED 11 PARK LANE HOSPITAL - PHASE I PREVIEI¥"

INCLUDED AS APPENDIX 9 ~-

2. The senior staff were very helpful in sharing

with us on the following procedures:

- incident reporting relating to unusual events of patient's behaviour

- seclusion procedures when a patient is exhibiting irresponsible or disturbing behaviour or behaviour that may harm the patient or others

- admission procedure - patient's tempora17 absence for treatment procedure - sick noticing procedure - dying in hospital procedure - recording procedure for goods received from

visitors and relatives -accidents to staff, patients or visitors

(procedure) - procedure for taking specimens of blood - induction of new staff into ward environment - various security procedures (movement of patients,

spot checks, personal search of patients, missing tools e · ·

3. The Medical Director seems intent on operating a

very open hospital with much more staff participation in the

management of wings than we saw in the other special hospitals.

It is perhaps indicative of change that the nurses in this

institution did not wear standard uniforms; they wore civilian

clothing.

4. In order to maintain professionalism and a

"fresh" approach, Dr. MacCulloc h has established professional

contacts with major hospital and university facilities in the

region. It is his intention to avoid "staff staleness"

by continually giving them contact with professional personnel

who are not connected with the Special Hospit~l System.

5. The psychologists at this institution do not feel

as alienated here as was the case at Broadmoor. The Medical

Director has statQd in the Policy Station (on file at Long

Say, along with the Policy Statement for Moss Side and the

Joint Policy Statement for the two hospitals) that he has

no objection to turning over the running of a wing to

psychologists. Given the context of this system, that is,

indeed, a radical departure from tradition.

(

REGIONAL PSYCHIATRIC CENTRE (PACIFIC) 1 ABBOTSFORD, BRITISH COLUMBIA CANADA.


The Unit was opened in May 1972, following the tabling in

Parliament of a report entitled "The General Progra.lllllle for the

Development of Psychiatric Services in Federal Correctional

Services in Canada", more generally referred to as "The Chalke

Report". The Unit is administered by Dr. c. Roy, a psychiatrist.

This report led to the creation of Regional Psychiatric

Centres throughout Canada. Initially there was a considerable

amount of criticism and opposition to setting up these units.

Generally this criticism following the argument that prisons as ~

a reform or rehabilitative measure had failed and considerable

pressure was applied to gain acceptance for the "Just Desserts

Model" of sentencing • .. 1. Objectives of the Unit.


The rendering of professional health care to

Federal inmates (all inmates sentenced to 2 years or more),

approximately 10,000 in number, primarily. from British Columbia.

The Unit is accredited as a hospital and serves as a teaching

Unit for the University of British Columbia.


The present population of the Unit consists of the

following groups:

25% Mentally Ill -"Psychotic"

10% Sex Offenders

65% "Behavioural Problems"


The staff of the Unit 'believe' that they are

successful in terms of their stated objectives. However, 48% of

inmates who have served periods in the Unit are subsequently re

admitted for further periods.

One thing we noted however, was the attitudes of

custodial staff. From discussion with the custodial staff,~ it is

apparent that the regime of the Unit is in some way, and to some

degree, responsible for more positive custodial attitudes. No

attempts have been made to measure these changes.

2. , Rules(Principles by which the Unit is run.

Although no formal principles of management style were

stated, it was obv~us to us that the Unit reflects the personality

of the Director, Dr. C. Roy. He tends to push the staff in the

direction which he wants to go, by persuasion, discussion and

concensus seeking, rather than by direction.

his style is that of a "Benevolent Dictator".

In our perception

It is appuent

from discussion that if persuasion fails, then he is prepared to •

use direction. He is, however, well thought of and, in general

liked by staff from all groups and at all levels.

3. Relationship to the prison system.

(a) Physical location.

Regional Psychiatric Centre (Pacific) is located

at the end of a cul-de-sac which also contains the Matsqui Medium·

Security Prison. It is, however, physically quite separate from

this institution. It is administered and staffed separately,

although some limited, informal contact takes place between

both groups of staff. The contact is limited at the custodial

The Regional Psychiatric Centre was not purposeqbuilt.

The Centre was previously used as a female institution and had

lain empty for four (4) years before being re-opened b. its

present form.


The Unit is primarily a provincial or state unit,

although it has been called upon to deal with offenders from

other provinces. The Director reports to senior administrators

within the province, or through them to Federal Officers in Ottawa.

4. Custodial involvement in Unit.

The custodial involvement in the Unit is mainly that of

traditional prison officers; that is, they are not directly

involved in programing and provide the security for the Unit.

However, it became apparent as we moved around the living units

that the custodial~personnel have good rapport with inmates and

are sympathetic and in some cases, empathetic to inmates' problems.


a. Patients

The Unit has a capacity of 138 beds. It is a •

policy of the unit to maintain 10 - 15% of the beds vacant as

a contingency plan. On the day of our visit the Unit contained

113 inmates.

i b. Staff.

(1) Custodial 71 (2) Medical 94- (6 psychiatr~sts,

88 nurses)

(3) Psychological 5 (4) Ancillary 15

\

1. Staffing of Unit.


The Unit is run as a medical facility and is, in

fact, an accredited hospital; inmates are sent there because

they are 'sick'. There is considerable use of such terms as

patients, rooms and wards in lieu of inmates, cells and wings.

It was noted, however, that some custodial staff lapsed into the

more familiar custodial terms on some occasions.

The Unit operates as a teaching facility for

overseas Correctional Psychiatrists.

b. Service period reguired in Unit for staff.

There is no provision for a probationary period

of service within the Unit, nor is any upper limit applied to

length of service within the Unit. Indeed it was noted that

some staff in almost all groups had worked there since the Unit .. had opened.

2. Selection of Staff.


The previous background of the custodial staff was

indicated to be the same as that of any other officer in any other

prison. He would have completed his normal entry and progress-

ional courses and his refresher course. It is mandatory for all

officers to complete forty (40) hours of refresher training per

annum.

Officers are selected by a panel selection

after submission of a written application. Posting to the Unit •

is much sought after and a number of officers to whom we spoke

had dropped one or two ranking levels in order to obtain placement

there. The Unit Director's view was that suitable custodial

staff were vital to the effective running of the Unit. The

qualities which were sought, he indicated, were similar to those

required to function in a medium, or open, security institution

{ \

Personality (positive and open)

Leadership ability

Credibility (with their peer group and in the community).

b. Other Staff.

]'rom lengthy discussions with the Unit Director,

it is apparent that he endeavours to attract the staff he considers

to be most suitable from other similar institutions. He indicated

that those qualities he desired in his custodial staff were

equally important in other staff within the Unit. He placed

considerable emphasis on the need to publish frequently the

results of individual research projects carried out by staff.

In addition, he spoke of encouraging staff to continue professional

work outside of their work in the Unit.

3. Training of all staff •

.. Additional training has been primarily confined to

custodial staff. The initial intake of staff was given some

weeks of lectures and discussions in the following:

- the purpose of the Unit.

- the types of inmates for which it would cater.

- the background of types of i~ates.

- recognition of types of mental illness, unusual behaviour, etc.

- methods of treatment.

This ''training" is reinforced by staff meetings held

two (2) weeks. It seems that these meetings also provided a means

by which the Director could continually assess the interest and •

involvement of the custodial staff in the work of the Unit. A

device has been adopted in the Unit to encourage custodial

interest in daily changes observed in patients' appearance and

behaviour, that consists of a log which is kept in the muster ruurn

A scan of the log revealed that it is used frequently by the

officers.

c. Security Considerations.

The security of the Unit is totally in the hands

of the custodial staff of the Federal Penitentiary Service. The

level of security around the perimeter of the Unit was described

as "ultra-maximum." The perimeter exterior and an internal

"no man's land" is constantly scanned by a number of closed

circuit television cameras. Images from these locations rotate

sequentially every ten seconds. There is provision to "fix"

any single camera onto a second screen in the event of problems.

Taping facilities are provided to produce a visual record of any

incident. In addition, there is another camera fixed high above

the Unit which can be adjusted for size of field observed. This

camera was trained on the external entrance during our visit, but

the officers demonstrated how it is controlled from the control

room (focus and changes in the 'observed field of vision); images

from this camera appeared on a third monitor in the control room.

Internally, the level of security was described as medium.

the following features must be noted:

1. All external doorways and internal door,_,ays in the Administration Building and Admissions Unit (Nova Ward) are hydraulically controlled and oversighted by closed circuit television monitors.

2. Each ward, room or work area contains an alarm button, monitored by central control.

3. Each member of staff carries a personal alarm which is monitored by central control.

4. The cell and room doors are hydraulically opened by an officer isolated in a mini-control unit in each ward/wing. Cell and room doors can be manually closed by staff or inmates.

5. Corridor grill doors are controlled, both as to opening and closing, by an officer in the wing/ward control unit.

6. All parcels are X-rayed before being opened ana. patients' mail is both opened and read.

The Director placed great emphasis on what he termed "dynamic

security", consisting of personal knowledge by staff on the

inmate/patient. He expressed a personal dislike of the use

of "razor wire" on the gaol perimeter saying that he would

on the wire. There are a number of points during the day

when an inmate's location is checked and all patients are

accounted for. This "count" takes place eight (8) times

a day, during which all inmates are required to "stand to."

Control of keys and weapons within the Unit was excellent.

Three (3) separate keyboards are maintained. Of the two (2)

boards within the Central Security Zone, one (1) must always

l:eintact. The third set of keys is located on the perimeter

at the main gate. Keys are issued only on the production of

an identity tag which is placed on the board in lieu of the

keys. Weapons were maintained in a central perimeter armory,

with the exception of two (2) revolvers and batons which are

on issue to Central Control Staff. Officers on duty in the

Unit and not stationed in the Central Control area ma~ not carry

any weapons, in accordance with 'the policy of the Director.

It was interesting to note the recent acquisition by the Canadian

Service of Australi .. an "saflock" handcufifs which are used for

prisoners' escorts in conjunction with a light 5-chamber .38

calibre Smith & Wesson revolver and leg-chains.

In spite of the very detailed security measures,both

around and within the Unit, there was no impression given to

us of the "dangerous message." The "fee;t." of the Institution

was comfortable, even in the living units. We particularly

noted the number of women freely moving about the institution

and subsequently found that·over 60% of non-custodial staff are

female, although the inmate population is totally male.

Allied with the issue of security is the usage of illicit

alcohol in the form of "home brew." We inquired about this •

problem area, but were informed that the incidence of "brews"

is virtually nil because of a very simple solution: all sugar

and sugar concentrate items are not issued to inmates in bulk.

Tea and coffee is served sweetened or unsweetened and cordials

are likewise available in mixed form.

Officer morale and standards of work and dress (a most

reliable behavioural indicator of the quality of custodial

standard) was described and observed to be high. Clearly,

these outcomes are the positive result of eight years• good

management of the Unit. The following information was given

as a brief resume of "disturbances":

- one suicide

- one escape

- one murder

- numerous hostage-takings (which seem to be a feature of the Canadian system).

- "riots" were referred to by some officers, but the Director said that these incidents were usually disturbances involving fewer than twenty patients. As Dr. Roy said "I'm from Calcutta, so I think of ten thousand people demonstrating violently as a riot. Anything less than that is a disturbance."

incidents of physical aggression have been infrequent; raised hand gestures are not tolerated by the Director, whereas verbal aggression is encouraged as part of the therapeutic process • ..


1. Entry and discharge of patients.

Inmates are referred to the Unit by the Director of

the prison in which he is currently housed• or by other members

of staff, including members of the National Parole Service,

via the prison doctor or consultant psychiatrist at that

institution. The decision to accept or reject a particular

inmate is the responsibility of the Director, although Dr. Roy I '

indicated that he uses a "team approach" to make the determination. !

The average length of stay in the Unit is 160 days,

[

t ' I

I Discharges are determined in the same manner, with Dr. Roy as the

• individual who is ultimately responsible for the decision.

with the majority of inmates/patients remaining for less than

six months. Some are cleared after thirty days, while some I [

men have been in the Unit for some years, however. ~

As previously I !:

st tsrl t e ate 4

(


Programming at Abbotsford is of a purely medical/

psychiatric nature and was said to have a single objective:

to return the inmate/patient to his gaol of classification

in a more healthy state than he enjoyed prior to admission.

Staff were very keen to point out that there was no experi

mentation carried out at the Unit and that the inmrlte/patient

was there on a purely voluntary basis. Thus, he could return

to the institution from which he was received at any time.


Full-time psychiatrists and psychiatric nurses are

part of the Unit's staff. Drugs are used and the type and

level of drug dosage is determined by each individual psychiatrist.

The Unit has an excellent drug.accounting record system, providing

the Director and other medical staff the following information:

- level of dr~g usage in a particular ward/wing

- number and type of drugs issued to a particular patient.

- breakdown of drugs being prescribed by particular do~tors.

- a costing for each drug on a continuous basis.

All this is very up-to-date, being available on a daily print-out.

It seems that such information is used for a variety of purposes, •

the least of which is cost accountability. According to Dr. Roy,

the "team" of the Unit is free to query treatment prescribed by

colleagues during staff mee~ings. In addition, the information

on the printout may serve to alert a doctor that he is habitually

using a particular drug or possibly over-prescribing for a patient.

4. Communication between Patients and Profession&ls.

There is no absolute right of patients/inmates to be

given access to reports which are written about them. Hov~ever,

each staff member has the personal freedom to discuss such matters

with inmates and/or allow them to read reports if the staff agree

to such a procedure. Reports are generally used only as a basis

(

for transfer from the Unit to other institutions. Our perception

was that patient/staff interaction was reasonably free and open.

E. Daily functioning of Unit.


A formal admission/induction procedure is carried out

over a number of days. Each patient/inmate is interviewed,

assessed and tested within an admission unit (Nova Ward) and

his placement within the Institution is determined. Patients/

inmates are given a booklet to read during their time in the

admission wing/ward which they sign and return to staff when

they leave for formal placement. In addition he is supplied

with a set of "Directions and RegulRtions".

-- REFER TO THE ATTACHED MATERIAL ENTITLED "REGIONAL PSYCHIATRIC CEN'l'IIE (PACIFIC): NOVA WARD INDUCTION BOOKLET" AND"THE REGIONAL PSYCHIATRIC CENTRE (PAC.): DilillCTIONS AND lillGULA'.riONS" INCLUDED AS APPENDICES 10 & 11 --

2. Routine of Unit.

The routine of the Unit appeared to. be relatively

unstructured. Inmate/patients were seen in the living units,

at school, in the library, in group sessions, working in the

canteen/dining room. Crafts and hobbies are available

and decoration of one's personal cell is permitted, although

the cell layout ~ conform to one of three alternatives.

A stereo/music room is provided. Staff and inmates dine in

adjacent dining rooms, but the food provided-is the same for

both groups. A well-equipped gymnasium is also available.

In addition to all of these amenities, a chapel is provided

for the use ob both staff and inmates and both groups are

encouraged to worship together. Visiting clergy officiate

at services.

l

The normal day extends from 7.00 am. to 11.00 pm.

although it is possible for inmates to remain in the television/ I K

recreation room (in a locked-in situation) until 2.00 or 3.00 am.

on weekends. During the night, should an inmate need to use the

toilet facility, he presses a call button and communicates his

desire to officer in the wing control room who then releases

the lock on the man's door. When the man returns to his room,

he pulls his door shut and the locking mechanism is activated.


Inmates/patients must place the names of visitors on

their visiting lists for approval. In addition, provision is

made for inmate/patients to send their visitors visiting forms

which detail the arrangements for such contacts at Abbotsford.

The decision to allow or refuse access by particular visitors

is made ~y a social worker or the chief psychologist. In

addition, arrangements may be ~ade by a social worker for a

volunteer to visit an inmate/patient who is not being visited

by family or friends. Ex-inmates, particularly sex offenders, .. are encouraged to return to the institution as visitors after

discharge. All visits are contact visits and take place in

the visiting lounge. In addition, each inmate/patient is allowed

two 'phone calls per month as a means of maintaining outside

contact.

Community access is provided freely to the Unit.

There is an active Citizens' Committee that comes to the Unit

frequently. Requests by media representatives to see the

facility are traditionally approved and the media are periodically

invited to come to the Unit.

F. Other issues, •

1. Dr. Roy, the Unit Director, indicated that he believed

that 25% of all inmates within the prison system require some

psychiatric treatment, 100~ in a hospital situation such as

Abbotsford provides.

2. Concern was expressed for the inmate who responds

to the treatment available at Abbotsford. By breaking down the

prison culture of the inmate, he becomes very vulnerable within

the system. His "coping mechanisms" are removed and he becomes

very susceptible to pressure from his peer group. In negative

terms, it was suggested that the inmate/patient is faced with

two rather unsavoury alternatives:

- reversion to former attitudes/actions.

- not surviving in the general prison.

Dr. Roy felt that an an individual under treatment should not be

left so defenceless after his experience in the Unit. Instead,

treatment outcome should take the form of self-knowledge rather

than deeper personality change. However, he admitted that this

is a considerable problem in any intervention strategy •

.. REJi'ER TO THE ATTACHED !'1ATERIAL ENTITLED ''R.P.C.; HEGIONAL PSYCHIATIUC CENTRE, ABBOTSFORD, BRITISH COLU!1BIA" INCLUDED liS APPENDIX 12 --

v. SI~'E VISITS, SECTION THREE:

-- Dr. Henri van der Hoeven Kliniek (and Pieter Baan Centrum).

H.M. P~ison, Grendon. Barlinnie Special Unit.

•

Site Visits, Sect ion 'l'hree: Therapeutic communities.

Institutions Visited~

l.

2.

3.

Dr. Henri van der Hoeven Kliniek (and the Pieter Baan Centrum) Utrecht, THE NE1'RERLANDS.

H.M. PrisonTI Grendon, Ayles 1mry, uckinghamshire

1 ENGLAND.

Special Unit, H.l"!. Prison Barlinnie, Glasgow, SCOTLAND.

These three institutions were the "peak experiences"

of our trip. We were natura1ly interested in the physical

resources, as well as the staffing requirements, that each

of these therapeutic communities utilised. It would be

difficult for us to draw any firm conclusions about the

sort of physical plant that is needed to set up such a

programme on the basis of these three sites because of the

enormous number of difference,s between them. The van der

Hoeven Kliniek is a new, purpose-built facility in which

every imaginable institutional need has been planned for .. and provided. Grendon, on the other hand, is basically

a prison with a large amount of "public space" (group rooms,

meeting rooms, etc.) which is used for the therapeutic

programme. To compare the Dutch and English units would

be like comparing a first-class hotel of international

standing with a guest house. lf, to continue in this vein

of comparisons, we were then to place Barlinnie's physical

plant on this rating scale, we would have to say that it

rates as a shabby youth hostel in comparison with other units

Ho11ever, it is begging the obvious to say that four walls do

not relate to the success or failure of a programme, no matter

how opulent or spartan they are. In each case, the wealth of these I •

three programmes was embodied in the resident staff.

Because we had committed ourselves to the idea that

the Special Care Unit would be organised along the lines of a

therapeutic community, run, in large part, by custodial staff,

we were anxious to view several examples of this species in situ.

Naturally, we were particularly interested in the role given to

custodial staff and the training programme that was provided for

them prior to the start of their service in the institution.

In two of these sites (Grendon and Barlinnie), we found some

of the answers we were looking for in the area of custodial

involvement. In the Dutch institution, on the other hand,

there was no custodial involvement, but much to be learned

about the meshing together of the skills and talents of many

different kinds of professionals.

From the start of our planning for the Special

Care Unit, we had envisaged a multi-disciplinary approach

to staffing. However, our initial efforts in that direction

had been stymied by the Health Commission of New South Wales

which entertained the parochial viewpoint that any treatment '

facility must, by definition, be run by the Health Commission.

We felt that such a "narrow focus" would only serve to close

off treatment options for the Unit we had planned. In particular,

the adoption of the Health Commission's model would have precluded

prison officers (and other professionals, such as clergy and

parole officers for example) from getting involved in therapy.

We were delighted to find custodial staff doing the sort of work

we had believed, as a matter of personal• philosophy, was possible

at Grendon and Barlinnie. (Because the Dutch institution is

privately run, there are no custodial officers employed).

Moreover, officers in those units reported that they were

experiencing more job satisfaction than had previously been

the case when they were working in more traditional settings

and performing the more conventional duties of prison officers • •

Another important issue that we were able to explore

was the extent to which programmes should be structured in

a therapeutic community. Each of the three settings offered

an alternative answer. The most structured programme was to

be found at the van der Hoeven Kliniek where every day's

activity is carefully detailed on a daily program card.

Grendon's routine is geared around the daily schedule of

group therapy meetings, but a lot of the day is still left

open for the inmate to spend according to his own plans.

At Barlinnie, on the other hand, we found what

appeared to be a complete absence of structure. After

a considerable amount of conversation with prisoners,

however, we became aware of the fact that what appeared

to be a lack of programme, was, in reality a function of

our different (and much faster) perception of time. Every

day seems to represent another opportunity for each man

to self-actualise and get more in touch with himself.

As such>the goals for each inmate are idiosyncratic and

personal. The residents of ~he Special Unit are serving

sentences of longer duration than the individuals in either

of ~he other two institutions and can enjoy the luxury of .. being in an environment where "becoming" is more important

that "doing" (i.e., involvement in group work at Grendon;

working in a shop at the van der Hoeven Kliniek). While

we found no answers to the question of structure in programm

ing, we were grateful to be given the opportunity to observe

the alternatives.

Lastly, the observation of these institutions made

us realize there is a philosophical dilemma inherent in any

therapeutic programme that is designed to enable an inmate

to alter his perceptions of himself and take an active part

in dealing with those problems that brought him to gaol.

To release him back into the "jungle environment" after

having stripped him of his time-honoured defences (those

behavioural patterns that served him so well in his peer

group and the prison setting) seems immoral. There are

two alternatives: release to parole or, at the least, to

an open setting that will allow him an opportunity to

(

f

exercise some of the personal autonomy and social responsi

bility that he has begun to achieve in the therapeutic

setting. Grendon and the van der Hoeven Kliniek have

both attempted to come to terms with this issue. It is

unfortunate that only Barlinnie, the institution in which

there would be the greatest justification for release to

parole, is not able to follow through with the logical last

step in its programme.

•

PIETER BAAN CENTRUM, UTRECHT, THE N1'THERLANDS.

DR. HENRI VAN DER HOEVEN KLINIEK, UTRECHT, THE NETHERLANDS.

Our original itinerary allowed us to see only the

Dr. Henri van der Hoeven Kliniek. However, in order to better

understand the process of assessment which logically ends with

discharge from the Kliniek, we decided to alter the itinerary

to include the Pieter Baan Centrum where individuals are assessed

prior to trial. On the basis of this assessment procedure, a

determination is made as to where the individual might be sentenced

for treatment. One of the treatment alternatives is the

van der Hoeven Kliniek. The system is explained in the

attached paper.

--- A COPY OF THE DOCUMENT ENTITLED "DETENTION AT THE GOVEHNMENT 'S PLEASURE: TREATJ.'1ENT OJ!' CRIMINAL PSYCHOPA'l'J.IS IN THE N1'THEHMNDS" IS INCLUDED AS API'ENDIX 13 ---

Pieter Baan Centrum, Utrecht, The Netherlands.

L. Objectives of the Unit.

The Centrum is constituted as an assessment centre to

provide an objective determination of an offender's level of

responsibility only in the most severe cases of criminal

behaviour. This process occurs prior to trial. The

Unit deals with a mixed population of individuals who are

charged with serious offences, such as murder, manslaughter,

rape, violent assault, etc. Though most of the remands

are male, 3 to 4 women are processed every year.


t

I ' i I f ~

' I ! §i

I The Unit emphasises a team approach to investigation and j

decision-making. In our perception it seemed to incorporate I ' f

). Relationship to the prison system.

The Centrum has no physical or formal attachment to the

Dutch Prison System. It exists purely to provide an unbiased

external evaluation to the courts. All information, which may

be of value to both the inmate and/or his legal counsel, as well

as the prosecution, is provided in the final report at the end of

the assessment process. This report may also include information

concerning unreported or undetected crimes which has been obtained

during the assessment.


The Unit has a capacity of 36 beds, but at the time of our

visit, only 24 of these beds were in use (because one wing is ·"

temporarily closed due to lack of funds and staff). There are

20 staff members on the treatment/assessment team assigned to

each group of eight (8) inmates (14 group leaders, 2 social .. workers, 1~ psychiatry positions, 1~ psychological positions,

1 legal representative).

5. Entry and discharge of remands.

Each potential client of the Centrum,is interviewed in

prison by members of staff and a group decision is made to

admit/reject the individual.

Each inmate may decline to attend the Centrum or, after

arrival, may drop out of the assessment programme at any time.

Ho•1ever, he/ she is given the opportunity to take legal advice

prior to arriving at a decision either to not go into the

programme or drop out after having entered.

As alluded to in a previous section, an indivdual's

undetected or unreported crimes may become part of this

assessment to the court. At the point in the process when such

information becomes known to the assessment team, the offender

is given two procedural options:

' I

J I f f I

' ' t

i

! I

(

- allow the information to be included in the report and continue in the programme of assessment elect not to allow this information to be included in the report, resulting in the automatic termination of the assessment process, at which point the Centrum submits a report to the court stating that assessment was voluntarily terminated.

Because of the fact that a "TBR" sentence is highly desirable

(and such a sentence can only be gained upon favourable

recommendation of the Centrum staff team to the court), there

is considerable payoff for staying in the assessment programme,

even at the expense of admitting the previously undetected

offences. The staff indicated that "treatment sentences"

could only be effective if the offender was totally candid

during both the assessment and treatment phases of the process.

Otherv1ise, the entire exercize is empty and useless. In

addition, staff indicated that the judges often queried them

as to why the assessment was prematurely terminated, inasmuch

as the official report of this event does not include this .. information, and this information is given to the judge

"off the record." Lest the reader be left with the

impression that this process sounds very punitive and

authoritarian, it should be added that the offender knows all

about this option to terminate prior to entry into the Centrum.

6. Re~ime of the Unit.

During the first week pf admission, each staff member

meets with the inmate. At the completion of this orientation

process, during which staff get to know the individual and

hejshe gets to meet the staff and learn the objectives of the

asse$sment process, the staff meet as a group to plan the

programme which will be carried out during the following

six (6) weeks.

Such programmes include the following:

- full medical examination - neurological investigation - psychological report - social history which is analogous to our

pre-sentence report in which interviews are conducted with family, friends, previous employers and the inmate.

- psychiatric report.

Each member of the five member assessment team (medical

doctor, psychologist, psychiatrist, parole/social work

officer, a probation/parole officer from offender's

home area and a legal adviser who operates as an advisor)

provides an individual report for the final assessment

meeting setting the following:

- degree of responsibility for the criminal acts for which he/she is standing trial

- determination of the inmate's dangerousness to self and/or society

-advice to~he court regarding sentence

These reports are considered at the final meeting at the end

of the seventh week of assessment and a covering report is then

drafted. This report may contain a consensus decision or a

majority and minority viewpoint (in cases where consensus

could not be reached).


The final report is explained to the inmate. In some

cases, the inmate is allowed to read the actual report.

However, there are situations in which this policy of complete

openness is not followed such as: •

- reports containing confidential information from spouse or other close family members who might be subjected to retaliation from the inmate for disclosing such material

- when the inmate was psychotic or otherwise unfit to deal with the material in a reasonably objective fashion.

While the staff of the Pieter Baan Centrum do not appear as

witnesses for either defence or prosecution, they may give

evidence to the court as expert witnesses.

At the completion of the assessment process, inmates

are returned to the remand gaol to await the completion of the

judicial procedure.

8. Security Considerations.

All external and internal entrances are monitored

by closed circuit television cameras and these images are

projected onto monitors in the central control unit of the

Centrum. There are no bars on windows, but all apertures

are covered with bullet-proof glass or thick, unbreakable

plastic. In appearance, the building looks like a large

office block from the street. Only when one is at the

entrance does one ~et a sense of security systems controlling

access. Internal security is identical with that employed

at the van der Hoeven Kliniek reported on in the next section •

•

DR. HENRI VAN DER HOEVEN KUNIEK - UTRECHT, THE NETHERLANDS.

As stated in the introduction to the Dutch sites visited,

this is a treatment fncility to which an individual may

be sent by the courts after assessment has been made at

the Pieter Baan Centrum. The Kliniek itself is a private

institution that receives funding from the Dutch Government

on a contract basis for individuals of both sexes being

treated under provisions of the "TBR" sentence.

HEJ?ER ~'0 ATTACHED DOCUI1ENTS ENTITLED "THE DR. HENRI VAN DER l!OEVEN KLINIEK BACKGROUND AND TREATMENT CREDO" AND "THE DH.. VAN DER HOEVEN CLINIC, UTRECHT, 'rHE NE~'HERLANDS: THE NE\v BUILDING AND THE IDEAS WHICH UNDERLIE IT" ATTACHED AS APPENDICES 14 & 15 --



a. Stated objectives,

The Kliniek's objective is to treat mental

illness and prevent further criminality. Amplification

of this statement is included in the applicable attachments.

The central principle involved is the re-socia1isation of

the offender.

b. 'l'arget population.

Inmates at. the Kliniek are ·defined as

individuals of average intelligence who are assessed as

emotionally disturbed and convicted of aggressive offences,

including murder, manslaughter and sex offences. The age

range for treatment is 17-45 years, though the most •

representative group under treatment is generally between

20-25 years old.

c. Perception of success by personnel/custodial starr.

The success of this clinical approach is, as

yet, unknown. The Director, Mr. J.R. Niemantsverdriet,

stated that a research project designed to assess effect

iveness of the facility's first twenty-five years of

existence was undertaken in 1975 and is nearing completion.

A small pilot research study was carried out in 1971,

however, and is attached to this report.

liEFER TO RESEARCH STUDY ENTITLED "TREATMENT m;sUI,TS AT THE DR. HENRI VAN DER HOEV:EN CLINIC, U'l'HECHT, '.!'HE NETHERLANDS", ATTACHED AS AI'PENDIX 16 --


The Director, a criminologist and lawyer by

training, stated that the central principle by which the "

Kliniek was run was, "A community sharing the risks together."

From our perception, it is certainly a very democratic manage

ment style in which the decision-making is shared. The Director

is viewed as a facilitator who can aid the organisation in

achieving concensus. This institution was noteworthy inasmuch

as it was the only site that we visited where the directorial

responsibility was not placed in the hands of a custodial

superintendent or a medical director (typically a psychiatrist).

We felt that note should be made of this fact inasmuch as it

was the original desire of those connected with the initial

planning of the Special Care Unit that directorial responsibility

should logically be handled in this fashion. Unfortunately, •

the Health Commission of New South \vales chose to press their

far more parochial point of view that a treatment facility must

necessarily be headed by a medically trained individual.


As the reader may note from the various attachments,

the van der Hoeven Kliniek is not part of the Dutch Prison

System. Instead, it represents an alternative to a custodial

sentence. As such, it is neither physically nor formally

attached to a prison.


There are no custodial staff employed at the Kliniek.


a. Patients.

Currently there are 70 patients residing there.

b. Staff.

There are 150 members of staff (110 full-time ..

and 40 part-time personnel). No breakdown of staff was available

for us. However, it should be noted that the facility operates

on the principle that various roles are blurred (eg., a trained

psy9hologist may be involved in the full-time running of an

industrial training unit and a medical officer could be in charge

of a residential unit). Thus, the sort ~f staff breakdown

for other institutions would not be meaningful,in the same sense3

in providing staffing information for the van der Hoeven Kliniek.




This institution may be best described as a

"therapeutic community" along the lines set out by Maxwell Jones.

A wide variety of staff are employed. Though their formal

qualifications are taken into account, the professionals

(such as social workers, psychologists, criminologists, etc.)

are treated no differentl than trades e

in running trades training shops. In fact, some of these

professionally credentialed staff members are involved in

work that is far removed from their traditionally defined

areas of expertise. This blurring of roles is an intrinsic

aspect of the team approach adopted by the Kliniek. Each

member of the team is considered to' be potentially inter

changeable with another team associate, whether he/she be a

psychologist, sociologist, criminologist, or social worker.

The virtue of such a model is the extraordinary amount of

"cross-fertilisation" of knowledge and expertise that is

possible. Because re-socialisation is the central aim,

every attempt is made to model the Kliniek on the outside

world.

b. Service period reguired in the unit for staff.

There does not seem to be a probationary period

or upper limit of service requirement involved for individuals

working in this institution.

2. Selection of Staff.

a. Custodial Component.

Not applicable to this institution.

b. Other staff.

No, information was specifically gathered in this

' area, but it was our impression that each applicant who interested '

in working at the Kliniek is evaluated in terms of role flexibility' J

and the maximal payoff gained from his/her services to the facility!


All new staff are given a one (1) week induction to

the Unit. During this time)new staff familiarise themselves

with the facility, attend all meetings, and, in general,observe

the life of the Kliniek. After the start of their work in the

institution, new members of the team attend training seminars for

I I !

I I 1-!

I one hour per week, each of which may deal with a particular topic. 1

time to time, in-service courses are provided in such areas as

report preparation and interviewing techniques. As stated

previously, the object of the training is to break away from

traditionally defined roles.

C. Security Considerations.

Closed circuit television cameras monitor the perimeter

and all internal "public spaces." The images are projected on

a bank of monitors in a central control room. All doors are

controlled from this monitoring area. People wishing to pass

through various sections of the building must press a buzzer,

causing a signal light to flash in the control centre. The

individuals on duty (who,incidentally,are the only custodial

personnel on site>occupying a role analogous to that of any

building security staff) activates the television monitor in

that location to identify the individual and evaluate the

request for entry! If approved, the door is released. All

"public spaces" (visiting rooms, workshops, stores, etc.) have

windows that allow observation from the corridors. Each inmate

is provided with a key to his/her own room, but staff of each

living unit retain a master key to the rooms of their section.

Inmates wear their own clothes and are p~id a social service

allowance in cash. Each group must provide for their own

daily needs (i.e. buy their own food, furniture, cleaning

materials, newspapers, etc.) Each living unit cooks its own

meals. Twice a day, the institution shop opens for purchases;

the prices reflect those found in the outside community. Also;

laundry facilities are provided in each living unit.

•

There are no "head counts" made during the day; the

only check is carried out at 10.00 pm. While most of the

of an individual is served vlithin the Kliniek, the latter part

involve day release to work, clubs, school, or family, in the

outside community. In the event that an inmate does not return

at night, his absence is noted and the police are notified that

he is "out", but no escape charges are brought against him.

In fact, there is a provision to "legalise" the escape if the

inmate does not commit another crime, is able to find employment

and successfully survives "on the outside". This feature does

not seem so extraordinary when one considers the focus of

treatment as re-socialisation for a successful life in the

community. Because each individual is placed in the Kliniek

on an indeterminate sentence which is considered to end only

when the staff believe an inmate would be able to survive in

society, the staff may make this decision after the fact of the

inmate's failure to return and demonstration of survival in

a legitimate life-style.

• Security is generally very tight, but unobtrusive.

There is no "dangerousness message" inside the institution.

Indeed, the environment gives one a very comfortable feeling.

Externally, the van der Hoeven Kliniek looks like a low-rise

city office block.


1. Entry and Discharge of Patient~.

Each year, approximately one hundred (100) individuals

are received directly from the courts. The Minister of Justice

is required to decide whether a person is sent to a traditional

prison or a treatment centre such as this one. In addition,

twenty to thirty (20-30) individuals are referred from prisons

by a psychologist or psychiatrist. In these cases, there is

a formal case presentation and the decision to accept o~ reject

is made by a selection panel.

The length of stay in the unit is indeterminate.

This aspect of sentencing is currently under government review

and may ultimately be fixed at 5 to 6 years in the future.

(

\_

Currently, the range of residence is one to eight years,

although the majority of inmates are released after three (3)

years at the Kliniek. Provision is made for formal review

of each case by the courts every two (2) years. The Minister

of Justice retains the right to release an inmate at any time

in the sentence, but we were assured that he usually acts on

the advice of the staff of the institution.


Because the gaol of treatment is re-socialisation,

a wide range of work and activities is provided, covering areas

of basic education, trade courses, social/survival skills and

works release experience. Course provision includes the followit

- cooking - metalwork - carpentry - sewing - gardening - shopkeeJ?ing

school (internal and external courses) - works :f:'elease - day release to family, shopping trips,

community clubs, etc.

Inmates are housed in a living group of 6 - 8 members

and 4 staff members. The emphasis is on the inmate's self

development. As such, any number of techniques are used to

advance the aims of the programme, such,as

- psychotherapeutic sessions - creative games - art classes and art therapy - photography - psychodrama - theatre - video/sound interviews (for self

observation of one's social presentation).

Each living group meets weekly. After six (6) weeks, an inmate

is assisted by the group to determine his/her choices jor future

programming. This session is viewed as a formal "contract"

may be referred back to in the future. After this formal

commitment, an inmate may be seen daily, if necessary, to

evaluate progress and set new goals.

The Director stressed the fact that any issue discussed

in the living units becomes "public" (group) property. No

communication is privileged, with the exception of private

discussions held by an inmate with the chaplain (a part-time

member of staff) who serves in a pastoral role.


Availability of psychiatrists is very limited. In

fact, there is no formal allocation in staffing for psychiatrists

or psychiatric nurses. General nurses are part of the clinical

team, but the use of drug intervention is very limited.


Communication between staff members and inmates appeared

to be very open. Most matters' are ventilated at group or community

meetings. As an example, the Director outlined the steps of a

grievance procedure for inmates which are as follows:

1. discussion with living group 2. discussion with clinic council 3. convene a special committee of the clinic council 4. write to the appropriate governmental authority.

In the case of the first and second options, inmates are in the

majority, while there are elected inmate ~embers in the third

option who are eligible to sit on special committees. In all

three instances, all voting parties (inmate and staff) are

considered to be equal.



There is a "buddy system" in operation at the .present .

time wherein orientation responsibility is carried by an inmate

and a member of staff. In addition, each new inmate is supplied

with an orientation handbook. The Director graciously supplied

with a copy of this booklet; it is currently in the process of

bein~ translated for us by a Dutch-s eaki g nris of cer.

2. Routine of Unit.

The routine of the Kliniek is very structured. Inmates

are required to be in certain locations at a particular time,

according to the demands of their programme. This schedule is

formalised to the extent that the inmate is given a card each day

with the daily activities noted. This card is used for punching

a time-clock every time the inmate leaves a place of work to

attend other activities, such as hobby crafts, psychodrama, etc.

Staff meet together on a daily basis from 9.00 to 10.00 ru

at which time feedback is provided on organisational matters.

Pertinent information is carried back by staff to inmates at

subsequent group meetings. Once a month, a meeting of the full

community is held.

" A number of leisure-time facilities are provided for

at the Kliniek, including a fully equipped gymnasium and an

indoor swimming pool.

As noted~previously, a chaplain is available on a

part-time basis.


No friend or relative of an inmate is admitted to

the Kliniek unless known to staff. When,an inmate is admitted

to the institution, he/she provides a list of visitors to the

staff. Each individual on the list is visited by a social

worker from the Kliniek before being allowed to become an

official visitor.

Family members and other relatives/close friends are

sometimes invited to the institution to participate in the

programmes. For this purpose, five (5) self-contained rtpartments

are available to provide accommodation for these visitors to live

in along with the inmate who moves out of the living unit during

this period of time. Additionally, provision is made for the

inmate to travel away from the institution with family members

to go on outings. As the reader wi

made to normalise the living circumstances of the inmate in

order to make future adjustment upon release as painless as

possible. It goes without saying that sexual relations

during visits, including those with homosexual lovers, are

not against the rules.

There is some hesitation over former inmates of

the van der Hoeven Kliniek being allowed to return to visit

staff because of the fear that they might use the clinical

staff as a prop, rather than testing their self-sufficiency.

The media, local citizens, staff and patients meet

as required to ventilate particular issues as the need arises.

Incidentally, media coverage in Holland seems to be far more

responsible than that enjoyed in New South Wales.

F. Other issues.

1. The reader may gather that this institution as well

as the Pieter Baan..Centrum, are co-educational. When the staff

of both locations were questioned about problems with this

arrangement, they said that very little difficulty has been

encountered. In addition, there is a high proportion of

female-to-male staff at both facilities. Again, the presence

of women in an institution that caters predominately for male

offenders, some of whom are under treatment for violent sex

offences, is accepted as a commonplace situation. In fact,

surprise was expressed that women are not employed in male

penal institutions (and vice versa) of New South Wales.

2. The.openness of access to the van der Hoeven Kliniek

has given rise to a serious contraband problem which staff

indicate is impossible to completely control without resorting

to the adoption of a very repressive regime. However, steps are

taken to control this problem by the use of peer pressure in

the living group with the implicit message that drug traffic

imperils the treatment programme of both the individual who is

H.M.PRISON GRENDON, AYLESBURY, BUCKINGHAMSHIRE, ENGLAND.




It was stated by Dr. Jillett, the Medical

Superintendent/Governor, and Dr. B.J. Barrett, Clinical Director,

that the objectives of the institution were:

- To investigate and to treat offenders suffering from disorders which call for a psychiatric approach.

- To investigate the mental condition of offenders, the nature of whose offences suggest mental disorder.

- To explore the problem of the psychopath and to provide treatment or management to which he might respond.

Clearly, the treatment is directed toward building self-.

motivation of the inmate in a therapeutic community setting.

REFER TO ATTACHMENT CITING "BUTLER REPORT REFERENCES TO GRENDON" FOR ADDITIONAL

MATEJUAL AND INCLUDED AS APPENDIX 17 ---


The population of Grandon is totally composed of

individuals convicted of violent crime. Dr. Jillett added that

the following criteria apply:

- no psychotics are included in the programme - no referrals from the court are taken since judges

are often uninformed as to the suitability of the facility for certain individuals

- inmate must be of average 0r better than average) intelligence and possess the ability to deal with emotions and past offences in a verbal manner.

REFER TO THE THREE DOCUMENTS ATTACHED THAT DEAL WITH CRITERIA FOH TREATMENT AT GRENDON

AND INCLUDED AS APPENDICES 18, 19 & 20,---

c. Perception of success by personnel/custodial staff

We were able to discuss this issue with three

different catea:ories of individual a! nri son offi ,._.,,...,. ; nmA tPR.

{

and one of the psychiatrists who is Clinical Director, Dr. Barrett.

Custodial staff who were interviewed indicated a belief in the

success of the work carried on at Grendon, but could not specify

the "success" in any sort of objective terms. Perhaps the more

crucial measure of staff effectiveness was their "gut-level"

feeling that their work at Grendon was very satisfying. The

inmates that we spoke to were far less guarded in their estimate

of the programme: they felt that 700~ of people who had the

opportunity to come to Grendon did not return to gaol. Dr.

Barrett stated that 30 - ~~ of prisoners would not return.

2. Rules/Principles by which the Unit is run.

Grendon has a formal hierarchical structure such

as is found in other penal institutions. It was, however,

stated that Grendon was run on a very democratic style of

management. From observations that we made during our

attendance at various meetings (small group, wing and staff

meetings), it woul& seem that such a claim is warranted. Within

each wing community, three (3) inmates are elected to serve as

representatives on staff-inmate wing committees and their votes

are considered to have equal weight with custodial representatives. I In tho ovont of a oaao oonfornnoo, tho iomato in quootion ia I always informed of the matters discussed a~d may ~ present at ,

the actual discussion. Wing committees may make recommendations r I

to the Governor who is the only individual empowered to make any

final decisions regarding the functioning of the gaol. We were

assured ~ ~ parties that a wing committee's recommendation is

rarely over-ruled in this manner. It should be emphasized that

in all interpersonal contacts at Grendon inmates and officers

address one another using Christian names. At no time Qid we

feel that this intimacy was artificial.

--- A TYPICAL WING CONSTITUTION IS ATTACHED AS APPENDIX 21

Relationship to the prison system.

The institution is located near H.M. Springhill, an

open prison and the two prisons share an officers' mess.

i i

I f J

I

Grendon is an autonomous institution within the British Prison

Service and is controlled by the British Home Office.


The custodial staff are generally very involved.

They serve as team leaders in group counselling sessions

and formal wing/community meetings. When queried about

working conditions, these staff members, to a man, said

"It was a pleasure to come to work." It seems, however, that

the regime does not suit all custodial staff at the institution.

There are a group of more traditionally-oriented officers

(referred to by some Grendon personnel as "excused convicts")

who have chosen to opt out of the therapeutic work of the

prison and work in areas where contact with prisoners and

other staff is at a minimum (e.'g., prison hospital, the

assessment centre, gate posts, etc.) •

.. 5. Numbers of individuals in the Unit.

a. Prisoners

There are currently 165 inmates at Grendon

b. Staff

(l) Custodial

(2) Medical

(3) Psychological

( 4) Ancillary

140 positions (current strength; 100),

9 (6 doctors with psychiatric training, 3

6 (5 psychologists plus a testing officer)

6 welfare officers from probation service

In addition to the above, the institution is served by: •

- visiting medical consultants - social work students - office/support staff

In discussing the issue of staffing, Dr. Jillett stated that

the inmate-staff ratio was approximately 1:1, he believed that

the ratio should ideally be closer to 2:1 for effective treatment




The model which Grendon was to most closely

approximate was that of a "multi-disciplinary therapeutic

community", according to Dr. Barrett, the Clinical Director.

It was emphasized that it was not to be seen as a "medical"

facility; the inmates are not regarded as "sick" or "mentally

ill." Grendon differed in some respects from the other

two therapeutic communities (van der Hoeven Kliniek and

Barlinnie Special Unit), due, no doubt to the size of inmate

population and the lack of modern amenities (such as seen at

the Dutch location). There seemed to be more ''private

communication" between sta.t'f members at Grendon than at

either the Scottish or Dutch facilities. However, this may

be due to the need to more carefully co-ordinate and structure

treatment for so many inmates.

b. Service period required in the Unit for staff

There is no formal provision for a probationary

period of service at Grendon. However, officers are closely

watched by senior custodial staff and can be removed from the

institution following a written report. There is no specified

maximum length of service withinthe institution.



The background of custodial staff at Grendon is

similar to that of staff in other British Prison Service.

institutions. Additional in-service training of two (2) •

weeks in group work is required before placement at Grendon.

Placement to Grendon may take place in two ways:

(1) by draft from the Officers' Training School (2) by application and selection by a board

consisting of the governor, a senior custodial officer and a member of the Head Office personnel section.

Selected officers are said to possess the following qualities:

- intelligence - empathy - be sympathetic to problems of others - highly developed verbal skills - show leadership ability

Our observation would suggest that the Officers' Training School

selection is equal to that of the Selection Board

b. Other staff.

No information was gathered in this area.

3. Training of Staff.

As noted above, a special course in group work is

required for placement at Grendon in addition to basic prison

officers' training. In addition, ongoing "in-house" training

is provided through group discussions that are held following

each group therapy session, during which time the clinically

trained team lead~r highlights various dynamics of the previous

session and may make suggestions as to how certain situations

could best be handled. Also, weekly sensitivity meetings are

held in order to clear the air and ventilate any problems that

might have arisen during the week. Aside from serving a healthy i

"safety valve" function, these sessions a:re also used to illustrat4 I

dynamics for the custodial group involved. I ' '

c. Security Considerations. '

I The perimeter of the prison is surveyed by c+osed circuit I television and monitored at the main gate. There are no tower ~

posts at Grendon. Internal security consists of manually operated( '

grill gates within corridors and solid doors giving entry to •

wings. Internal security is as based, to a large extent, on

the "know your inmate" principle, as well as the considerable

~-

' ' ~-i i ' ' 1! I I

amount of community responsibility and trust. The institution I has had two (2) escapes in its history. Grendon has a comfortablJ

i "feel" giving no environmental message of "dangerousness" such as f

J ,

\


1. Entry and discharge of prisoners

Inmates are recommended for Grendon by a prison medical

officer (typically a psychiatrist). A preliminary cull of these

recommendations is made by the Governor at Grendon; the balance

are referred to an Institutional Assessment Committee. Prisoners

are generally kept at Grendon for the last 12-16 months of their

sentence and then released to parole. Life sentence inmates

spend approximately three (3) years at the institution and are

then transferred to an open prison facility. An inmate may request

to be removed from Grendon at any time. By the same token, the

community in which an inmate is resident may ask that the prisoner

be removed. However, both of these types of requests must pass

through "correct channels" to the staff whose responsibility it is

to reject or recommend such a transfer to the governor. The

governor always retains the right to transfer • .. 2. Programmes in the Unit.

Daily group meetings and community meetings are held

six (6) days of the week. These sessions may take the form of

discussion, psycho-drama, transactional analysis or "family groups"

(wherein the prisoner's family may be invited into the group to

aid in the inmate's therapy). Each inmate is required to discuss

his background, his offences, his attitudes and feelings within

group and community meetings. The community, in return, assists

the inmate in identifying problems and setting goals. Once these

issues have been dealt with in a cursory sense, a form of

is arrived at by the inmate with the community. This agreement, • which may be a very informal sort of verbal statement or a written

and highly specific set of goals, is reviewed by the community

periodically •

.,_ REFER TO ATTACHMENTS DEALING WITH "AIMS AND METHODS OF TREATMENT ON 'A 1 WING" AND. "NOTE ON TEEA.TMENT IN 'B' WING" AS APPENDICES 22 & 23 -- ·

3. Medical regime of the Unit.

Psychiatrists are available on the staff at Grendon.

However, there is no psychiatric nursing assistance. General

nursing is supplied by nurse officers. It is the official

policy of the institution that drugs will not be used as part

of the treatment because such intervention hinders the inmate's

functioning and "blocks his perception of his own feelings,"

according to one of the group leaders.

4. Communication between inmates and professionals.

Communication was stated to be very honest and

open by staff. Our observations confirmed this claim. Inmates

are generally present at case conferences and decisions are

discussed with inmates. Reports are used at Grendon for "'

purposes of parole and for tr~nsfer to other institutions.

As stated previously, inmates and staff refer to one another

using Christian names. "

It is interesting to note that verbal

aggression is permitted between staff and inmates, but B2

physical violence 1§ allowed ~ Grendon between any individuals.


l. Induction procedure.

A formal induction and assessment unit operates at

Grendon. During the first week of his arrival, the new inmate

is tested and a determination is made regarding his acceptance

and appropriate placement. Drs. Jillett and Barrett indicated

that the Assessment Unit is not functioning at its full level

because of cut-backs in funding. However, it was our perception

that few of the tests carried out in even the presently limited •

assessment seem to be used in the actual programme at Grendon.

This impression was confirmed by the psychologists. Once the

inmate is placed in a wing the basic community or living

unit at Grendon containing approximately 25 inmates -- an

orientation takes place that is determined by the community

(

2. Routine of Unit.

The scheduling of the Unit is very structured in

terms of daily meetings, briefings, de-briefings, etc.

Group and wing meetings take place daily and inmates are

provided with progress reports from staff and peers. Each

inmate is fox~ally assessed by the Assessment Committee of

the community every one to three months.

time,

No attempt is made to structure an inmate's free

A wide variety of crafts, hobbies, games and sport

are available and facilities include a gymnasium.

There is no formal interaction of staff and inmates

at meals, although this was observed to take place on an

infomal"basis. Aside from custodial staff, probation officers

and clergy are also present at' Grendon. Probation officers

perform a welfare role within the institution and one of these

individuals is all~cated to each wing community. Members of

the clergy are employed within the gaol. Depending on the

personality of the minister and his acceptance in the wing,

he may be called on to perform a role in the community (e.g.,

B Wing's Assessment Committee includes a clergyman who performs

a very detailed role).

3. Public access to the Unit.

Visitors to inmates are given access on the same basis

as at any other institution within the British Prison Service.

A list of visitors is submitted for Home Office approval. Visits

are of the open or contact type. Family members are also

encouraged to attend group meetings within the institution.

Another unique feature of Grendon's social life is the "wing

party", a reception with food (paid for by the prisoners on the

wing) at which officers and their spou~es/friends, as well as

families are invited to attend. These parties were said to be

a very positive social experience for all in attendance.

F. Other issues.

1. Those wings at Grendon that have dormitory

accomrwdation, have devised a unique means of utilising

that space for therapeutic purposes. Particularly note-

worthy is the programme developed in "B" Wing where the

community mayvote to have an inmate moved to the dormitory

in the event that the man is seen by the group to be withdrawing

from social interaction, getting''uptight", etc. At the

same time, various other individuals also are elected to

move out of their rooms to the dormitory to act as "social

therapists." When the individual is judged to have passed

through this difficult period, the group can vote to allow him

to return to his own room. We considered this a rather

unique means by which the community is able to become involved

in psychological crisis management without having to resort to '

use of drugs. At the same time, there seemed to be psychological

growth benefits for the "social therapists" that might be .. described in terms of empathy, social responsibility, compassion,

etc.

2. It should be noted that women moved freely about the

wings of Grendon and their presence was seen to be beneficial

by the staff. The fact that these women are performing non-

custodial roles is more a reflection of the British Prison

System's hiring practices than an indication of the danger

involved in allowing women to work with males in a male prison •

•

BAHLINNIE SPECIAL UNIT - GLASGOW, SCOTLAND.

A. Organisation of Unit.



The aim of the Unit is to develop model citizens,

not model prisoners, by providing an environment in which the

inmate is able to deal with issues of responsibility (to himself

as well as the community) and freedom. In a sense, the Unit

allows the inmate to begin rehearsing the role of a responsible

citizen prior to his release.


The Unit was set up for the "treatment"of •

prisoners with propensities to, or a history of, violence

towards staff. It was also viewed as a facility for selected ... long-term inmates.


The personnel who are currently working in the

Special Unit (as well as one member of staff no longer stationed

in the Unit) believe that the Special Unit is very successful

IlEFER TO THE ATTACHED MATERIAL ENTITLED "BARLINNIE INFORMATION BOOKLET" AND "SPECIAL UNIT:

BARLINNIE" INCLUDED AS APPENDICES 24 & 25 --

2. Rules/principles by which Unit is run. •

The Special Unit is managed by the community.

Demisions are made by staff and inmates in a democratic manner

at community meetings. The Unit Governor (Mr. Alee Thomson)

retains the power of veto, but we were assured by staff and

inmates that this veto is rarely exercised.

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The Unit is physically located inside H.I"'. Prison

Barlinnie, a reception and classification prison for the city

of Glasgow. The population of that facility varies, but

generally holds 1,000 inmates. The Special Unit has its

o1~n Governor and is considered to be a separate administrative

unit, answerable directly to the Controller of Administration

for the Scottish Prison Service, Home and Health Department,

whose office is located in Edinburgh (Mr. Richard C. Allan).

Because of the unusual geographic location of the Unit within

the main institution, some conflict has arisen at the main

gate which gives access to both gaols. Visitors to the Unit

have voiced irritation over what they perceive to be less

than professional treatment at the hands of the staff from the

main prison who operate that post. This issue has yet to be

resolved. We attended a special community meeting at which

the Governor of t4e main gaol, l"!r. Andrew Gallagher, and his

chief officer were in attendance during which the problem

was very frankly aired. Assurances were given that the issue

would be investigated and settled by I"'r. Gallagher.


The custodial staff are totally Jnvolved in the

running of the Unit. Our perception of their effectiveness

varies, depending on the individual involved. Because of the

small numbers of people located in the Unit, we were able to

spend time with every inmate and officer resident there, as well

as Mr. Alec Thomson, the Unit Governor. It would appear that

the Unit is presently uncertain of "where it is going." It

was unfort.unate that we had to leave Glasgow for Sydney' the

day before the community meeting was held to discuss the topic:

"The Special Unit as an experiment is dead." He have no doubt

that the quality of the discussion would have given us some

insight into the truth value of that statement. (This issue

will be referred to in greater detail in section F.)

(


a. Inmates.

At the time of our visit, there were seven (7)

inmates in the Unit. However, another prisoner had been

accepted for admission just prior to our arrival and was

scheduled to move in the week after our departure. The

maximum capacity of the Unit is eight (8) inmates.

b. Staff.

(1) Custodial 18

(2) Medical 2 (one consultant doctor from the main gaol and a consult-ant psychiatrist who visits the Unit regularly.

(3) (one Consultant visits ' Psychological 1 who regularly)

(4-) Ancillary 2 (one Consultant occupational therapist and a full-time art therapist •

.. As the reader may note, the art therapist Ms. Joyce Laing is a

major presence in the Unit. Aside from being an artist, she

has had analytic training and has proven to be an extraordinarily

valuable individual in the therapeutic work of the Unit. Her

success may be measured, in part, by the fact that six of the

seven Unit residents are involved in some sort of artistic

endeavour. Prior to coming to Barlinnie, none of these men would

have essayed the act of artistic creation. Additionally, the

week after our departure the Second Arts Festival, organised by

Joyce Laing and the members of the community was being held in

the Unit to be followed by a travelling exhibition of art from

the Unit that would be seen around Scotland. •

B. Personnel: Staffing, selection and training.

l. Staffing of the Unit.


The Unit is a "therapeutic community" emphasizing

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I

Because of the difficult inmates housed in the Unit, staffing

ratios are high (2.25:1). In fact, when the Unit was originally

set up, these staff-inmate ratios were higher, but the custodial

staff petitioned to have staffing figures lowered because there

were too many officers competing for the chance to work with

too few inmates in a very small building.

b. Service period required in Unit for staff.

There is no' formal probationary period in the

Unit and no specified maximum length of service. Continuity

of staff is seen to be very important to the smooth functioning

of the Unit. In spite of this, the Unit staff has had

52 different members from the time of the opening of the

facility in February 1973 until February 1980. 1'he Unit

also has had six (6) governors. During this same period,

sixteen (16) inmates have been admitted to the Unit, seven (7) .,.

of whom are still there.



Staffing is on the basis of normal custodial

background, but at least two (2) of the sta~f must have nursing

training. All staff members are volunteers. In an effort to

give officers a sense of "what the Unit is about," all

prospective applicants are invited to spend one (1) week in

the Unit before applying for permanent placementon the staff.

Volunteers are interviewed for selection by a panel consisting of:

- The Governor - Chief Officer

Consultant Psychiatrist - Consultant Psychologist

b. Qther staff.

•

The only point worth noting is that the position

of Governor is an appointed position. Clearly the mortality rate

for this post has something to do with the wisdom exercised in

the past when selecting the individual to fill this post.


Initially, the training of the staff consisted

of visits to various institutions that are defined as "treatment"

facilities, including H.M. Prison Grendon and two of the special

hospitals, Carstairs and Broadmoor. These visits were of two

weeks duration. In addition, instruction was given in group

work and understanding of "deviant" personalities. At the

present time, induction for new officers is not nearly as

thorough: trips to Grendon and Broadmoor seem to have been

eliminated. However, according to a former officer in the

Unit, Mr. Ken Murray, much of that original preparation was

carried out with the implicit notion that the Special Unit

would be more akin a psychiatrically orientated treatment

centre than a therapeutic community, such as described by

Maxwell Jones. ..

C. Security Considerations.

The Special Unit is in the centre of a major maximum

security prison. Additional security is provided by closed

circuit television cameras which are mounted to monitor the

perimeter of the Unit and relay images to the control room

at the main gate of the prison which is oversighted by officers

from the main prison. Internally, the Unit has only basic

security. A grill separating the cell areas from the main

section of the Unit is closed at night. Inmates cook their

own meals, have access to metal cutlery and tools for carrying

out hobbycrafts, wear their o~m clothes and handle money ..

No area in the Unit, including the officers' staff/muster room,

is "off limits" to any inmate. Christian names are used for

all staff-inmate exchanges (including those with the Governor)

In short, internal security is based purely on the personal

relationships between staff and inmates and may be summed up

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1. Entry and discharge of prisoners.

Entry is recommended by the governor of the prison

in which the prisoner under consideration is currently being

housed. The nomination is discussed by the community and the

inmate is accepted or rejected. If the vote. is for acceptance,

an interviewing committee consisting of the Unit Governor,

the Consultant Psychiatrist, and two (2) members of the Unit

staff go to the inmate candidate's prison to speak with the

staff there)as well as the inmate1 in order to ascertain the

man's suitability. If this group agrees to the inmate's

acceptance, he is escorted to the Unit by.Special Unit staff.

Discharges occur in the reverse manner with Unit staff preceding

the inma~e to the receiving prison to explain any special problems

to staff there. It should be•noted that this escort procedure

is "under fire" from staff in the main prison system who believe

that escorts from the Unit should occur in the normal impersonal

fashion with staff from the receiving gaol coming to pick up new

receptions.


There are no formal programmes in the Special Unit,

other than art therapy, community meetings, reception of visitors

and escorted paroles 3 a form of day leave in which the prisoner

leaves the Unit in the company of an officer (seen as a means of

aiding a prisoner to adjust to the outside world's pressures

in the company of a trusted acquaintance). Each inmate is free

to structure his own day. Some informal "contracts" may be

negotiated between the community and individual inmates,.depending

on each member's particular needs. A basic rule is that no

physical violence will occur to anybody and drug use will be

minimised.

I

3. Medical regime of the Unit.

A consultant psychiatrist attends the Unit as required.

There are no psychiatric nurses on duty, although at least two

(2) of the officers on the staff are trained as general nurses.

The use of drugs in treatment is minimal. Even when drugs are

prescribed by the psychiatrist, officers typically encourage

inmates to reduce dosage or give up the drugs, if at all possible.

4. Communication between inmates and professionals.

Communication was seen to be very open at a personal

level. On a number of occasions during community meetings,

officers and inmates challenged one another about the issue

of honest communication in day-to-day functioning of the Unit.

At a more formal level, communication of inmates did not appear

to be &s open as at Grendon (i~e., inmates did not seem as

ready to discuss personal issues of background, family, offence,

etc. at the Special Unit as at Grendon). Also, though departmental "

reports on individuals as well as the Unit are discussed with

inmates and the community, there appears to be no formal access

to these documents. Again, we were left with the feeling that

in this area, Grendon enjoyed a slightly better situation.



The community has devised a system of induction for

both new inmates and staff. It is called the "4 Group System",

consisting of the new community member and experienced staff and

inmates. Meetings are structured to inform an individual about

the Unit philosophy. They also may be used for indiVid~als who

have difficulty in coping with the larger group.

-- REFER TO THE ATTACHED PAPER ENTITLED "BARLINNIE SPECIAL UNIT _ ... 4 GROUP'SYSTEM" INCLUDED AS APPENDIX 26 --

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2. Routine of Unit.

The routine of the Unit is generally unstructured.

Although there are provisions for formal community meetings,

any member of the community may call a meeting at any time to

discuss a particular problem or issue. (Additional information

regarding routine and programme option is set out in the

"Barlinnie Information Booklet" included as Appendix 24.)

3. Public access to the Unit.

Any person may gain admittance to the Unit by making

written application to the Governor of the Unit. It was very

apparent during our stay at the Unit that outside involvement

is greatly encouraged. We discovered from participating in

the community meetings that two (2) issues were the source of

some contention:

(1) the need to obtain approval from Head Office

to admit members or the media (a rule that is applicable to

all prisons in Scotland).

(2) the need to obtain approval from Head Office

for escorted paroles (applicable only to the Special Unit)

Certainly, the Unit receives a vast amount of media coverage

ranging from sensational and irresponsible reportage in the . .

"yellow" press to more reasoned statements in the quality

newspapers. In the case of attacks by the former, the Unit

cannot make statements, but.must sit back and wait for a

typically bland defence to appear from the Home and Health

Department.

. restricted,

Visits to inmates by friends and relatives are '-ill·

They can take place all day every day of the week •

After an inmate has settled into the community, these visits

may take place in the inmate's cell. This liberal arrangement

has occasionally given rise to some problems of contraband;

these have been handled in a very mature and responsible manner

bv t e co itv .. Howeve ... the ViRitinD' AT'T' YIO",:lm Y'l Q houo cla

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been played up in the sensational media with the accusation

that the Special Unit is a place where killers have access

to booze, drugs and sex. Little can be done to combat such

bad press.

F. Other issues.

There seems to be a problem of where to send an inmate

when he is ready to leave the Special Unit. A couple of men

have gone directly to parole, but the Prisons Department seems

to prefer to discharge inmates to parole from more "typical"

institutions. Thus, a man who has learned to act responsibly

and stop playing "prison games" is forced back into the very

environment he has sought to overcome. Clearly there are

some enormous philosophical problems to be dealt with here.

2. There was considerab~e concern voiced among the

residents of the Special Unit, as well as some of the Officers,

that other special units have not been set up throughout Great ... Britain, in spite of the fact that the success of the Special

Unit is so evident to all who come in contact with it. In

part, the problem seems to relate to the Home and Health

Department's lack of interest in publicising the achievements

of the Unit for fear that some incident will occur there that

will cast doubt on their bureaucratic credibility. (In fact,

two incidents have taken place there -- one death by drug

overdose and one knife attack on an inmate by another inmate

but the community has dealt with both incidents in a reasonable

fashion.) Unfortunately, the achievements of the Special Unit

are unknown to the general public (e.g., the positive advances

made by the men who have been there and are now out in the •

community, the intellectual/artistic advances of the men in

the Unit, etc.), Even more startling is the fact that the

Home and Health Department has not attempted to scientifically

evaluate the effectiveness of the Unit. In the past, the

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community (staff and inmates) have called upon the "powers

that be" to commission such an evaluative study, but Head

Office has not "come to the party." As early as 1974,

the Department of Sociology at the University of Salford was

approached by the community to explore this issue, but they

were ultimately refused access to the Special Unit for this

study. However, certain problems were explored in a working

paper prepared by D. Webster for discussion with the community.

-- ATTACHED IB A COPY OF 1'HAT DOCill'JENT ENTITLED "THE SPECIAL UNI1': SOME CEN'I'RAL ISSUES" INCLUDED AS APPENDIX 27 --

3. It was earlier stated that a debate was scheduled

to take place the day after our departure from Glasgow which

was to focus on the statement: '".!'he Special Unit as an experiment

is dead." "' The pessimism of that topic relates to the current

crisis at the Unit preceipitated by the removal of Ken Murray

from the Unit to another gaol and the iminent departure of

Jimmy Boyle from tM' Unit, thus depriving the community of its

two "wise elders," their connections with the history of the

Unit and its early struggles. Deprived of informal leadership

from both custodial and inmate ranks, the community is now engaged

in the painful process of fending direction for itself and, it is

hoped, renewing its commitment. This process is difficult for •

an organisation to deal with at the best of times, but for the

Special Unit it is complicated by decisions taken bY the Scottish

Prison Service in the wake of the prisoner's suicide in late 1977

which resulted in a tightening up and codification of rules/ ,, ~

practices in early 1978 and, still more recently, in the appointmentf

of a Governor who believes in taking a firmer directorial control

of the Unit. •

-- ATTACHED Allli A COPY OF' THESE RULI~S CONTAINED IN A DOCUMENT ENTITLED "SECllli'l'ARY OF STATE 1 S INSTHUCTIONS ON THE OPERATION 0]' THE SPECIAL UNIT AT BARLINNIE PRISON (21st February, 1978)" INCLUDED AS APP~IX 28 --

While it may be comforting to bureaucrats to call for a more

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security and less "experimentation", all of these measures

seem to be antithetical to the therapeutic method that

has been so successful to date in the Special Unit.

Perhaps New South Wales can profit from these problems

should the venture be replicated on the shores of Botany

Bay. A fact sheet about the Scottish Prison Service is

included in the Appendix to give the reader a sense of

the context in which the Barlinnie Special Unit operates.

PLEASE REFER 'l'O ATTACHED MATERIAL ENTITLED "PAC'l' SHEET 18: THE SCOTTISH PENAL SYSTEM" INCLUDED AS APPENDIX 29" --

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·spNiili3:;:lli rlVNOiiJiJliJiiiJiSNI-NON .itO .h.llVW[.Jfl8 • lA

'

Summary of Non-Institutional l"Ieetings.

At several points during the trip, we took the

opportunity to meet with other individuals working in the

field of corrections in order to discuss the concept of the

Special Care Unit with particular reference to the following

issues:

l. Therapeutic communities 2. 'l'raining programmes for custodial staff, particularly

in the area of counselling skills, etc. 3. Security arrangements for treatment facilities 4. Visiting arrangements 5. Staffing needs for "special programmes"

(therapeutic communities, drug rehab., etc.)

In addition, we spent a great deal of time talking about the

New South \vales Department of Corrective Services (as well as

handing out documents preparea for distribution concerning the

Department and the new training scheme for prison officers).

What follows is a~very brief summary of matters discussed

during these meetings.

l. Professor Duncan Chappell and Dr. William E. Lucas Department of Criminology, Simon Fraser University, Burnaby, British Columbia, Canada. 20 May 1980

At this meeting, aside from describing the concept

of the Special Care Unit, the issue of Health Commission

participation was discussed. Dr. Lucas expressed scepticism

that such a Unit could be run adequately with custodial staff,

feeling that a psychiatrist should be in charge and the staffing

be handled by the Health Commission. Professor Chappell was

• more optimistic about the success of the concept, but stressed

that staff could not be placed in such a community unless

they were interested in doing that sort of work. Dr. Lucas

remarked on our enthusiasm and agreed to take a "wait and see"

attitude.

2. Mr. Ross Duff, Regional Manager of Security Regional Headquarters (Ontario) Correctional Service of Canada Ministry of the Solicitor General of Canada Kinr;ston, Ontario, Canada 22 ~lay 1980

We discussed the security needs of a secured psychiatric

facility and Mr. Duff agreed to give us a set of the briefing

documents for the proposed Regional Psychiatric Centre (Ontario)

and, in addition, most generously consented to mail them to us •.

(These volumes are now at Long Bay and are available for anyone

who is interested in seeing them.). In addition to security

matters, we discussed the need for training custodial staff

in roles that involved greater participation with inmates.

In response to this discussion, Mr. Duff arranp;ed for us to

meet with the Director of the Correctional Staff College

(Ontario) and his Regional Tr~ining and Development Officer.

3. Mr. M.E. Millar, Director Mr. C~~. Burton, Regional Training and Development

Officer. Correctional Staff College (Ontario) Correctional Service of Canada Ministry of the Solicitor General of Canada Kingston, Ontario,· Canada 22 l'1a 1980

The main topic of discussion was training of custodial •

staff. Mr. Millar was most interested to receive a copy of

Mr. A.V. Bailey's paper about the new programme of training

for prison officers in New South vlales. We took an extensive

tour around the facilities of the Staff College and were quite

impressed with the facilities (a very well-equipped audiovisual

laboratory with video taping and editing facilities, a full-scale I firing range, large library, living facilities, cafeteria, etc.)

Both men spoke of their success in running simulation exercises

for custodial staff (hostage taking, gaol riots, escapes,

communication problems within an institution due to poor staffing!

and lack of preparedness, etc.). Some consideration should

be given to sending our Staff Development officers to see this

(

setting up simulation exercises. Messrs. Millar and

Burton also agreed to send us material (which is also

on deposit at Long Bay).

4. Federal Bureau of Prisons United States Department of Justice Washington, D.C., U.S.A. 23 l'!ay 1980

a. Mr. GeorRe Diffenbaucher, Executive Assistant to Mr. J.D. Williams Correctional Prosrams Division.

Mr. Diffenbaucher has had considerable

experience in running therapeutic communities for treatment

of drug addicts. He suggested that such communities have

often fallen apart because they were perceived as democratically

run when, in fact, the true m~del for such organisations is one

of Earticipatory management. We discussed staff training and

he advocated the use of sensitivity training for staff. He .. stressed the crucial matter of inmate induction into the

community and suggested that the best solution was the use

of welcoming committees composed of pre-selected inmates.

If a therapeutic community is successful, according to him,

one will be able to train prisoners as "linkers" (lay therapists)

and they, in turn, would train other inmates to run groups.

The issue of definable objectives was also mentioned;

Mr. Diffenbaucher advocates the use of contracts which he sees

as a measure of the inmate's involvement.

b. Dr. Hobert Po1vi tzky, Chief Psychologist and members of his staff

Dr. Powitzky spoke of the mixed success of

•

therapeutic communities in the Federal Prison System and

felt that there was a need to properly evaluate what is

being done. He stressed the need to obtain interested

staff, but seemed to feel that communities for prisoners

with s cholo ical roblems would be djf'f'i"nlt- +~ _,_

c. Mr. Garland Jeffers and Mr. Thomas \lalker Training Pror;ram Development

Both men are ex-prison officers who have been

working in training for some time. They were most excited

by our plans for the Special Care Unit, feeling that since both of

us were involved in selection, our chances for the success were

very high. They offered us assistance in the project by

sending us material developed by the Federal Bureau of Prisons

for training prison officers in counselling skills. 'l'hese

men did not share Dr. Powitzky's scepticism about the success

of the venture, Mr. Jeffers then arranged a meeting for us

with Ms. Nancy Sabanosh.

d. Ms. Nancy E. Sabanosh, Publications Writer-Editor National Institute of Corrections.

The principal accomplishment of this meeting

was the establishment of a liaison for our Department with

the extensive document retrieval system of the Federal Bureau

of Prisons. The National Institute of Corrections is involved

in the commissioning and publishing of problem-based studies

in the area of corrections. 'de discussed a variety of

programmes for which we were interested in receiving document::-.tion

including: •

- Therapeutic communities - Prison industries - Training.programmes for custodial staff - Visiting arrangements for prisoners -Young offenders' programmes - Alternatives to imprisonment

(community service orders, etc.) - Pre-release programmes.

•

(1-/e have already received a great deal of material which is

also at Long Bay.)

5. Dr. Donald J. Hest, Professor of Clinical Criminology Im;titute of Criminology University of Cambridge Cambridge, England )0 Nay 1980 (also: 31 Nay and 7 June 1980)

Dr. West spent a considerable time in discussion of

the need for a detailed and independent evaluation of the

Special Care Unit. For him, the situation of developing

"innovative" pror;rammes in penal institutions has had little

impact in the field of criminology because procedures were

not sufficiently documented to allow for replication. In

addition, these programmes were rarely evaluated to ascertain

if the claims made for them were demonstrably valid. He

felt that :my programme that humanised prisons was a positive

step, but it must be evaluated to be credible as a contribution

to penology. On Saturday, Dr. Schwartz spoke briefly to

Professor Nigel 1:/alker who expressed interest in the Special

Care Unit as well~s the information that was gained from

this trip.

6. Scottish Prison Service Home and Health Department of Scotland 9 June 1980

a, Nr. ll.ichard c. Allan Controller of Administration.

Focus of interest for us was a discussion

of the administrative problems connected with the running of

the Barlinnie Special Unit and the great deal of time demands

made upon Nr. Allan by the Unit. He stated that there was no

intention to close the Unit, but there is also no intention of •

replicating it at this time. Nr. Allan was interested to hear

of our situation with violent offenders in New South Wales

and informed us of the Scottish system. From information

provided, the size of their system and the number of individuals

in the gaols seems to be very comparable to that of New South

Wales.

b. Mr. Allistair 'rhomson Controller of Personnel and Services.

Mr. Thomson joined us in Mr. Allan's office

and John Horton discussed the issue of a prison officer

exchange programme between Scotland and New South ~/ales, as

per instructions given to Mr. Horton prior to his departure

from Australin. It was envisaged that officers (2) would

be seconded to New South \~ales to work in the Special Care

Unit (or some other special programme) for a period of

three to six months, during which time a couple of officers

from our Department would go to Scotland and gain first-hand

knowledge of the Barlinnie Special Unit. Both Mr. Thomson

and Mr. Allan thought that such a plan was feasible, but

said that the Scottish authorities might not be able to send

individuals to Australia because of lack of funding. They

felt that, in principle, there was no problem with having

two Australian prison officers seconded to Scotland. At .. the conclusion of the meeting, Messrs. Allan and Thomson

agreed to consider the information about transfers left for

them by Mr. Horton and see to it that their department sent

the Corrective Services Commission of New South \<!ales a reply.

?. Mr. Philip Barry, Chairman, Parole Board of Scotland 9 June 1980

Mr. Allan arranged for us to have a brief discussion

with Mr. Barry. He was most interested to hear about the

situation of parole in New South Wales. At present, there

is considerable difficulty in granting parole in Scotland

because of the very stringent criteria. Mr. Barry regretted •

this and hoped for a change soon. He expressed an interest

in our new Parole Act and asked if he might receive a copy of

it when it is proclaimed. He invited us to attend the next

sitting of the Parole Board of Scotland, but unfortunately, that

{

was not due to take place until after our departure for

Australia.

8, l'lr. Ken Murray, Principal Nurse Officer H.l'l. Prinon Low Mosn 11 June 1980

\1e spoke at git'eat length of the problems of

maintaining the momentum of special programmes, such as the

Barlinnie Special Unit. He made a large number of suggestions

about ways to avoid the problems that beset the B11rlinnie Unit.

In addition, he spoke positively of his experiences during his

visit in New South Hales as a guest of the Law Heform Society

and was most interested to hear about the continuing interest

being shown in setting up a Barlinnie-type of programme, but

he cautioned against an exact.replication, feeling that

conditions here might call for variations to the Scheme now

in practice in ScQtland.

The meetings with representatives from liadical

Alternatives to Prisons (R.A.P.) and Dr. Oliver Briscoe

did not take place. In the case of the latter, telephone

calls were never returned. In the case of the former, the

organisation seems to be beset with the problems of most .

volunteer-staffed organisations·(nobody to answer telephones,

lack of reliable staff, etc.). Upon arriving at our hotel

we found a letter from R.A.P. stating possible times for

meetings. However, 1ve were never able to find anyone at

their office who could arrange a meeting for one of these

nominated times. John Horton returned from Cambridge to

London expressly for the purpose of setting up this apppintment,

but contact was not established. In addition, time commitments

did not allow us to contact Mrs. Sarah McCabe at the Centre for

Penological Research at the University of Oxford as originally

stated in the proposal for travel.

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RECOl'lMENDATIONS.

l. Ji'emales should be employed in the Unit inasmuch as foreign authorities have positive influence on the environment and way of risk in male prisons.

Special Care

indicated their little in the

2. Psychotics and manipulative psychopaths have no place in the Gpecial Care Unit (or in other therapeutic communities) because they tend to create destructive

dynamics among staff and inmateo.

3. A multi-disciplinary approach must be taken to staffing of Special Care Unit or any special unit to allow for a variety of experimental programme options and role sharinp; among staff of the Unit.

4. Staff-inmate ratios in the Special Care Unit

(and other special units run along the lines of therapeutic communities) should be at least one-to-one on a

24 hour basis, but all staffing need not be drawn from custodial ranks to achieve such beneficial ratios (i.e., probation and parole officers, psychologists, .. clergy, etc.)

5. Continuity of staffing in the Special Care Unit

is imperative for ongoing programmes and routine of the community; it is further sup;gested that some sort of contract be entered into with custodial staff in the Unit to preclude industrial action.

6. The backing of the Corrective Services Commission must be given for the Special Care Unit to implement "experimental" programmes without the restrictions imposed by current rules and regulations (e.g., visits, telephone contacts, mail, clothing, etc.).

7. Access of family and friends of the inmate is a necessary element of therapy that should be encouraged and facilitated in the programming of the Special Care Unit.

• 8. Consideration should be given to encouraging the

return of ex-offenders to the Special Care Unit inasmuch as a number of therapeutic communities abroad have found

these individuals to be useful as therapeutic agents.

' \

9. All efforts must be made to make the Special Care Unit open and accessible to the gen0ral public (any interested parties and the media), subject to the discretion of the Superintendent of the Unit. Non-departmental requests for access must be evaluated on grounds of safety of staff

working there, security of the institution and the privacy of inmates.

10. Escorted parole of inmates from the Special Care

Unit must be a part of the programme options, at the approval of the Superintendent of the Unit.

11. Drug therapy must be considered only as a last

resort in the Special Care Unit.

12. No physical in the Special Care

will ~e allowed.

violence of any sort can be tolerated

Unit, but verbal statements of any sort

13. Continued placement ·of an inmate in the Special Care

Unit must be voluntary, in order that treatment not be seen to be coercive; procedures to allow inmates to leave of

their own accord' or to be compelled to leave by the community must be a part of the Unit's regime.

14. Discharge from the Special Care Unit should be either to liberty, parole or to open environments.

15. Follow-up of ex~inmates from the Special Care Unit

(and any sort of special unit) is an essential adjunct to the progranooes of that institution.

16. An evaluative study examining the functioning of

the Unit, the role relationships among staff and inmates, and the ability of the Special Care Unit to meet its

objectives should be commissioned from some independent body such as the Bureau of Crime Statistics and Research

(currently evalw1ting "Day in Gaol" programme, bail law

changes, offences in public places law, etc.) to insure accountability to the Commission (as a valid innovation in prof~ramming), the Government and taxpayers. •.

17. A secure prison need not look like a traditional gaol and may, in fact, look no different than a high rise office block in the city. !

I ! ' ' I

(

18. Electronic technology should be utilised to a greater extent as an adjunct to security practices in

the Unit and all other N.S.W. institutions in order that custodial manpov1er may be concentrated where it is most

needed: one-to-one conctact with inmates.

19. Replication of the Barlinnie Special Unit in Nel'l South 'dales must be given every priority.

20. A Special Hospital System should be set up in New South \-!ales to provide a facility for mentally ill offenders.

21. An assessment unit for court-referred psychiatric evaluations should be included in a special hospital system •

..

•.

~

' l ' f t ! I

t i

I ' ~ ' E I

! I I ~-I I

I

•

;~

.• }

..

·rnA

l. Itinerary of trip

2. List of individuals cont:1cted durlnl~ the plnnuin['; and execution of the trip.

3. Herstcdvester 19?8/79 - Danish text and English tntnclat:i.on

Ln'G Nielsen.

l>. 'l'he En((! il>h Special ilospital System Dr. F.G. McGrath

5. Custody and release of dangerous offcncters.

6. Broadmoor Ins. and Outs: 1960 - 19?7 ............ Dr. D- rl1idmarshot

7. A five-year f'ollov1-up study of male patientiJ diDChfcre;ed from Broadmoor Hospital --- D.A. Black

8. Moss Side Hospital: GuidelineB for management of 1iolent patients.

J.O. Hq~ional Psychi:-1tric Centre (Pacific): Nova '.lard induction bookJ.t: t --- The AdmisSion fJ~eam, Nova ;:lard ..

11. fief~ional Psychiatric Centre (PAC): Directi.ons and ree;ulations ---Dr. C. Hoy.

12. H.P.C.: Ile[';ional Psyehiatric Centre --- Solicitor General of Canada.

13. Detention at the f",overnment' s pleasure: Tren.tment of cr•:iminal p:sychopathB in The Netherlands

Centro.l llecruitment n.nd:Traininr; Institute of the Prir;on ;3erviee and the Care of Criminal Psychopc,th [)crvice.

1'+. 'l'he Dr. Henri van der Hooven Klinieb Backc:round und trentment cJ·edo

P.A,l'l. Hendricks

15. ~'he Dr. Henri van der Hooven Clinic, Utrecht;, 'l'he Nctherlcmds: Tho new buildinr; and the ideas which underlie it --- A.~l • .toosEmburg, Director.

16. Tre;,tment results at the Dr. Henri van der Hooven Clinic, Utrecht, 'l'ho Netherlands --- ,J .I.. Jensen & A .l'l. Hoo8enburg

1?. l3utlu· report references to Grendon --- B~J~ Barrett

18. CriteriR for treatment at Grendon --- JL :; . Bn ,,,..~ti:

/\ FFJ\r/D l X" ~-~~--··------

20. 'l'lw p:roup of pr:oplr' \vr: treut at Grendon nrc tho:3e v!i th ncrc;orwli ty di:;orderr;

B ... J .. E:-lrrett.

2lo ''B'} wine COD!ititution.

22. AimG and ;nethods of treatment on 'A' 1-:in(~

23.. Notes on trcatmc.rt in 'B' wing

21f. Tlo.r} innie information bookl<et

25. bpeci:Jl Un~i t: l:,~:c-linnie --- Scottish Info~nation Office.

26. Darlinnie i.Jpecial Unit - '14 group' :.;ystom

2'7. The L>pecbl Unit: Some central issues D. \:ebster.

28. Sec3-'etary of L~t.:;.te 1 :-:; i!'lstruct'i.on.s on the

operation of the Specio.l Unit at · Barlinnie Prison (2l!Jt ~i'vJt\ru:~r;;r, 1978)

• 29. Pnct Slwet 18: ~L'hc :;cottish ponnl syc>tcm

bcottish lnfor-r:;nt:Lon Office •

..

3

1,

) ,,,

51

t/

)/

i/

'/!

:'~on~

'L\lc.s ..

:.'ed.

'l'hurs

rpn,t ' .

~>un ..

Mon.

Vied.

lC)/')

;:O/') am.

pm

21/5 am ..

pm.

22/5 am.

pm.

23/5 am.

pm.

21</5 am.

pm.

25/5 26/5 ?7/5 am.

pm.

2B/5 am.

pm.

'I'hur" • " 0 / 5 "m - L.) ~ '

Itinerary.

Depart Syc}ney - f ... rr:ive Vaneouccr, 13 .. C ..

1. . .L J' ' , . " ' (.. . ,. . ) J.e f'~~~~?!~~~::t_e11 J:_g t T'l c '" C'~~ ~~:r·c~ .t~ac 1-~-:2..£ Abbot:3for:cl, B:C. ·

••• lnte nft. departur-:: for:

l)rof.. Duncan C:hTnr'E~ 1·1 n.nd Dr. \i.E. Luea:J at· Dept. o!' Cri.rninoloe·y, Uiroon Yrascr Un1.versity.

• • • mid night d.· parture for 'l'oronto, Ontario.

••• drive to K:lnp;ston, Ontario ami rn·esent credentials Qt Her;i(,nal lleadqu:·,rtcrD.

Refional Psvch~ntric Cen1·re (Ontario) I •n;::;:;>cr1 On·•·.,.,:.1· o. ..,!.. l _, ... !_, , VC A. • &

tleetine:s: l. Hoss Duff (Hecional !·lanngcr of Security) 2. M.E. Mill~r and C.~. DurtonJ

Correctional S'taff College (.Ontario)

••• drive to Toronto and early eve. departure for h'a~>hinr;tcn ,D.C.

Meetinr~s: llederal' Ilureau of Prisons, U.G. Dep,;rtment of Ju,;tice.

l.

2.

•••

Geor1;e Dii'fenhauchcr (Exec.Asst. to J .D.':Iilliams)

Rob~rt Povitzky (Chief Psycholoe;ist) and staff rncm1~ers.

Ge1rlanc'. Jeffers and Thomas Halker {Il1r'ain:Lng Pror~rarr.s Division)

Nancy

early

E. Dabanosh (Publications \olritcr-'Editor) National Institute of Corrections).

evening flight to Europe.

• •• late aft. arrival in Copenhae;en, Denmark. .. Host Day

Prepare material from Canadian sites and U.S. meetings

An,:talten ved Herstedve>:tcr, Hcrstcdvester, Denmark •

••• early evening flight to Amsterdam, Netherlands

Dr. H. van der Hooven Kliniek, Utrecht, The Netherlands

Pil"ter Bnan Centrum, Utrecht, The Netherl:md.s. .---pm. • .. late aft. departure for I,ondon, Ene;l::md.

I<ri. 30/5 am .. pm.

•·· pick J:'ieetine;:

up car and drive to Cambridge

Dr. D.J. \.'est, Inc:titute of Criminoloe;y, University of Cambridge.

returns to London to arran(~e meeting \·lith u ·I' 4 '~h D o n · h'l D 1• c .L\.ol'.. ... anc .. HJ.t. r. .. Jr:tscoe_. w J. e .. -1 .... ) ..

stD.ys in Cnmbridp;e ..

B. Australian contacts:

Jli s Honour Judr··e D. G. Stewart, ChLim.bers, {~ueen' s Square, Sydney.

l"ir. Gordon Hawkins, Asr3ociate Professor of Criminolor:Y and As£:i£>tant Director, Institute of Cr:i.minoloe;y,

Sydney University h1w School, Sydney

~1r. Tom Kc lly, En.rrister-at-J,aw, Sydney

Mr. Col Bevan, Assistant Director (Traininc), Australi<m Institute of Criminoloc;y, Canberra, A.C.1'.

Dr. Jeff Sutton, Director, Bureau of Crime Statistics and Research, Sydney

Mr. A.H. Green, Bureau of Crime Statistics and Research, Sydney

Dr. Charles Cullen, Penal Hefo;rm Council, Marrickville Community Health Centre, Sydney.

Dr. Norman 1. Thoml"son, Senior Leeturer, Dchool of Behaviouro.l Scienees, ~laequo.rie University, Nth. Hyde, Sydney

jgh

(nogle facto os· tal) •

1, llrwtalton ved !Iorstcdveoter fUD£,'Bror som psyldatrisk institution for krim1nalfo:r.norgen. Opgairen er at modtnco, obocrvcro og b&bandlo indsatto' dor hnr behov for rsykiat:dsk bistand.

2. ilnFJtaltens kapacite·t er lo6 + 23 rii BpMialilfdolinger (sygo- oc; isolatiorwafdcling). Dosudon or der en ponsJ.on 1igo udcnfor hovedanstalton (llolrJbjcrffi'Oj 15) mod plads til 17 beboore.

Anstalten lodes af en psykiatriok ovork>t,'O. Endvidere bostiir 1edolsen af en fron(\De1sinopolctor ( ju:d. st), en forsorgsleder ( socialriidgi vor), en undorvionin;:rslod~r (1ro:rGr) 1 on froneooloforvalter og on overve,gtmestcr~~

4. fu1staltcno personale bcstar iovrigt af: 3 psykiatriske overlrogor, 2 yngro 1mgor, 3 pBylco1oger1 1 oversygeplojereke, 3 sygep1ejersl:er1 6 forsorgsmoda:rbejdcro 1 4 lm~:ere, 1 doltidsansr,t gronlandal<: toJ.k 1 ca.~ 24 VJJrkrnester samt ca. 125 ve.[:,rti!lestre og §cJngsolsbetjen·te, hvor:1f 3 har tjen8ste pa pensionon. Adminiotrationsporoonalet (heruncler sokrotmrerne for 1mGQr, psykologor og forsorgsmedarbc,jclere) udgoros af ialt 28 hel- og deltidsansatte.

5. I 1978 blov 135 personer indsat i anstalten; horaf var do 44 varetmgtsar.rcstanter1 lworaf 15 i l,obet af 1978 fik dom. Af de ialt 1o6 domfmldte inclnat i 1978 var 1 dc,mt til fmngoc1 pit li votid, 2 forvaredc, 2 cliroktoriilbagoforte pii vilkiir eftcr provoudokrivning fra forvarinc;, 5 domt after den c;ron1andolce kriminallov og 1 idomt § 68-fornnotaltn~ng. De rostorenclo 95 var idomt tidsbcstemt frongse1. Straflmncdcn scs nedenfor: ·

6 mlineclor og derunder: 1o over 6 11 til 1 dr: 24

II 1 a:C II 2 II 26 • II 2 II II 3 II I 12 II 3 II II 4 II 10 11 4 11 "5 11 1 5 II 511 II 6111 ) "611 "9ft 0 II 9 II II lo II f .2 II lo II II 11 II I 0

II ll 11 11 12 II I 1 II 12 .II II 13 II 1 II 1) II II 14 II 1 II 14 II II 16 II I 0

6, Indomttolseskriminaliteten for de 1o6 domfroldte siiledes:

l1anddrab og forsog herpit Voldsforbrydelser Roveri Srodo ligJwdslcriminali tct :Brandstifto1so Ejendomckril1ina1i -l;et Ejondoookriminalitct + lov om oufo:r.i.oerondo ctoffor Straffe1ovono § 191 Direlcto tilbqgofort 1ihrc1J;elolov ale ,

fordeler sig

11 8

15 9 3

44 •

9 4 2 1

(

Der er beny-ttet folgende inddeling:

Vold omfatter legomsboskadit<cloo, ulovlig tv:mg og frihedsbemvelse.

Roveri oofatter bo-cigclsesforbrydeloer, d<:r bar v:crct fo:rbundct mod vold eller tru<Jler or.l vold 19. ''•

Sedolighcd£JkritL\r.ali te·c or:JJ'attor overtn::delr.1e af straffelovens kapi t1er on forb:rydcJ.sor i famiUefo:rllolel og noel kBnssmelelis1-welon.

Ejondomskril~inalitet omfatter overt::-melelse u.f stra.fi'elovens bes<;cmmclsor om dokumcntf:1lalc D.'.\1i\t bori.gclsonfo:chry(].elser (eksk.l .. rovori) 1

b:r:ugstyvor.i, tingsbookad:Lg~;lce ors andre formuok:r:nrJcelso:r.

Poraoncr, cler er el<'lL~t .foL.-krJ.min:!litot a.f forskellig art pl tvmrs a.f den her va1gto indelolint;, vil l::'Jn blive meelt~_go-G et steel. Veel en silclan b1rmdingskrininali tet skcr plrwcringen t'Deler clen krininalitetsart, som konkrot bedomt tall formoden i storst \1.dfJtJ~Dkning at huve vwret bostoL1l:Iondo fo::: otraffenn otorrelse.

7. Ialt e1: der i 1978 uclg:1et 141 a.f anotaltcns mandtal, eftor

at have ud.stilet clon .fulcle stra.f proveloslaelelse vod 1/2 tid

t1 ll 2/3 II

at have vmret clirokto tiJ.bagofort den gronlandske ITiminallov bent'ldning oo1 vr:10rel proveuclslcrivning fra forvaring over.forsel til undet famgso1 under

21 8

43 2 2 1 1 2

a.fsoningon 37 varet~gts.fmngsling (over.fort til anden inoti tu'tion ellc;r looladt ). 24

8. Pr. 15 november 1979 or inclsat ia1t llo porsoncr:

hera.f

Livotielsindsatte forva:rode va.rotmgtaarrestantcr cl01:1to eftor Gronlanels krioinallov idomt § 68-.foransta1 tn.ing overtrmelolse a.f provelosladelsoovillcar fmngsolsa.fsonero

idont 6 mfuleder og deruneler . over 6 II til 1 ll.r:

II lfu II 2 II

II 2 II II 3 II

" 3 II II 4 II

II 4 II II 5 .II I II 5 II II 6 II

II 6 If If 9 " " 9 If u lo n .

" II lo 11 !I 11 II

II 11 II " 12 " ·" 12 If II 13 II

II 13 " It 14 II

~ 14 II II 15 It I II 15 II !I 16 II

7 12 11

9 1 1

69

0

4 19

8 11

4 5 0

4 0

4 2 4 0

4

•

,,_

9. Ai' do ial t llo indnatto or dor 5 udlmndingo, fordolt sS-ledeo:

lira Polen II

ll Isme1 Svcri/30

3 1 1

lo. Dvr cr pr. 15. november 1979 14 gronlanclsko indoatte. 2 or cbrrG cfte1· dansk otraffolov - 9 or cloart eftor gronlanske straffulov - 3 or varetmgtoarrostanter.

11. Der or pr. 19. november 1979 17 (•• 18,7 %) af de indsatte, der or p oykoti nko.

12. Udgan(IGtni obrug i do 3 forsto kvartalor af 19791 l''oroinlwlso uden ny kriminali tot 24

,,, ,, foroinlcelse mod ny kr.irlinaHtot o udebli volse udon rry krj_mil1't1Hot 15 udobhvolc;o rned ny lcdminahtet o rry krirninalitet uden udebliveloe/forsinkelse 3

Dor har i nrunmo ticlsrum vmrot ialt 537 uclgangstillaclelser.

Unclvigolsor og borte;an13e i de 3 forste kvartalcr af

Undvieelser forsog pii undvigelnor bortgwge forse(l' pll borte;anae

14. Vedr, beskmftigoloon;

De indsatto har arbejdspligt,

1979:

1 5 0 0

ilnstalton hux ialt en k:apacitet pll 125 arbejclsp1adsor, fordelt rned ca. 65 pladser pil VdJrkoted(?r (trykkol·i, snoiUcori, monta(ie, cellearbejde), ca. 35" pladser vod oygnin((Svmsen, rongoring samt ca. 25 pladner vod skole, torapi og bibliotek. Mod dot nuvmrende bolmG' p11 ca. 1o6 inclsatte or ca. 1/3 arbejdsmrosoigt boslcroftib'Ct pa vmrlcoteder, ca. 1/::S ved okonooiornriidet 013 ca. 1/3 ildco i arbojdo. Varesalget fra rmstaltens produktion andrn(,rcr ca; 2} mill. kr. pr. iir. DGr frernstilles tryksa.(,>Br til statninsti tutioner, mohler til kontorer SOJ'lt montagBarbejdo til det private erhvorv. ilnstaltrms areal_ andragBr ca. 35 tdr. land, clor dyrkes mecl !corn.

AHSTALTEH VEil flli:US'rliDVESTER, den 2,3. novoober 1979.

i • < •

I i_',. ,- '

Lars Nielsen,

(

I!LW:>'J'EDVE~l'J'l;'~ 1 9'7R/?9.

1. 1'he iw;titution at Herstc,dvester acts as the psychiatric

institution for the Department of Corrective Services.

Its purpose is to receive, 0bserve and treat inmatns in

need of psychiatric care.

2. ~-'he capacity of the institution is 106 + 23 in special

care

3. The institution is headed by a p[;ychiatric medical

superintendent, assisted by a prison inspector

(lawyer), a social advisor, an educntional supervisor

(teacher), a prison superintendent and a chief prison

officer.

4. The staff of the institution consists of 3 psychiatric .. doctors, 2 junior doctors, 1 charge nurse, 3 nursing

sisters, 6 social advisors, 4 teachers, 1 part-time

Greonland interpreter, 24 overseers and 125 prison

officers. The administrative staff (including

secretaries for doctors) totals 28, part-time and

fullmtime positions.

· 5. In 1978, 135 people were admitted to the institution.

Of these, 44 11ere remands, 15 of which v1ere convicted

during 1978. Of the total of 106 convicted admissions

during 19?8, one was sentenced to life imprisonment,

2 to indeterminate sentences, 2 to balance of parole, •

5 under the Greenland Criminal Code, 1 under Paragraph

68, the balance of 195 were given sentences as follows:

Under 6 months 10

Over 6 mths to 1 year 24

Over ') yenrs to 3 years 12 '-

II 3 yea.rs to 4 years 10

II 4 years to 5 years 5 II ,. years to 6 years 3 .,

/

II 6 years to 9 J'ea:rs 0

II 9 years to 10 years 2


II 11 years tJ 12 years 1


II 13 years to 1'+ years 1

II 1'+ years to 16 years 0

6. 'l'he 106 were convicted of the following offences:

Manslaughter or attempted Manslaughter 11

Violent Crime 8

Robbery 15

Sexual Offences 9 .. Arson

Misappropriation and Stealing

3

ll.4

Drug Offences

Criminal Code Paragraph 191

Revocation of Parole

Traffic Offences

. The follov1ing Index has been used:

(a) Violent crime includes, bodily harm, abduction

and holding hostages.

(b) Robbery includes, stealing with violence or the use of force.

(c)

(d)

Sexual offences includes, incest, rape, etc.

Misappropriation and Stealing includes larceny

and stealing without violence.

9

4

2

1

•

People who have been convicted of more than one offence in the

above statistics, appear in only one category.

1'he major offence detPrminero each offenders placement.

7. Tho total discharr;ero .from the institution durinr; 19713

8.

were 141. They were dirocharr;ed as .follows:

Full time roerved

Paroled at half sentence

Paroled at two-thirds sentence

Balanee o.t: parole served

Greenland Criminal Code

Indeterminate sentence (Lieense)

Suicide

Special Parole

Transfer to other priaons

"Remands (transferred to other institutions or not convicted to custodial sentence).

21

8

43

2

2

1

1

2

37

21J.

On the 15th Noltember, 1979 the institution held llO

Life 7

Indeterminate sentence. 12

Remands 11

Convicted in Greenland 9

Convicted under Section 68 1

Balance of parole 1

Others 69

Sentences of the 69 others were:

6 mths or less 0

Over 6 months to 1 year 4

II 1 year to 2 years 19 II 2 years to 3 years 8



II 5 years to 6 years 5 II 6 years to 9 years 0

inmates:

• i ~

·}

t

~ {

I

Over 10 years to ll years 0

" ll years to 12 years 4


" 13 years to } I' - t yec)rs 4

II li~ years to 15 years 0

II 15 years to 16 years ~~

9. Of the 110 inmates, 5- were not Danish.

l!'rom Po land 3

l!'rom Israel 1

From S1ved".n l

10. On the 15th November, 1979 the institution contained 14

inmates from Greenland, two convicted under Danish law,

9 convicted under Greenland law and 3 remands.

ll. On the 19th November, 1979, 17 (18.7%) of the inmatHs .. were psychotic.

12. Breaches of day leave provision during the first 9 months

of 1979 includ.ed:

Late without committing new offences 24 _

Late and committed new offences 0 ' Failur·e to return without committing new offences. - 15

Failure to return and committed new offences 0

New offences committed· without failure to return 3 or late return.

During this period 537 applications for leave were aJlproved

13. Escapes during the first 9 months of 1979. •

Escapes 7

Attempted Escapes -5

lli. Emnlovmf'nt. ~--~-

I 'l'he institution haro employment for 125 inmates,

65 in the 1-10rkshops (printing, cabinet making, fitting,

work in cellro), 35 in building maintenance and domestic

cleaninr~, 25 in school, therapy and library. At present

with 106 inmate<;, Y1 are employed in the workrohops,

~ maintenance and cleaning and ~ are unemployed.

The sale of items produced in the inrotitution raised

about 2}(> million D.Kr (A1~850,000) in the last year. Items

sold included printed fornw and stationery for Government

Departments, office furniture and assembly work for private

industry.

30 acres.

The institutions farm area is approximately

~'he main crops are rye and barley.

.. Anstalten ved Herstedvester, on 23rd November, 1979.

Lars Nielsen. *******

Original Danish Document Translated By:

Prison Officer Kai Duetoft,

~1alabar Training Centre.

***************

•

_)

I APPENDIX LJ: -------•

'

'IHE ENGLISH SPEClt\L HOSPITAL S"\311\1!

Dr. P. G, MnCrnth, M.n., Ch.n., Dip. Psyoh, Ed,

Phynician Superintendent Drondmoor Hospital

---~~--------------------

This contribution does not noconsnrily rei'leot the official views or poUcy of the Depnrtnu:>nt

ofl!enlth and Social $eourity

NB: V{rltton bef'oro introduction of the Criminal Procedure (Insanity) Aot 1964.

:£liE SPl\GIAL HOSPI'PAL SYS15~M

The Special Hospi tala are thoaa at Broudmoor in Berkshire, Rrunptori in 1

NottinshuJnahire; and Moon Side near r,i verpool. • 1'/hon the Minis tor of

Henlth, by the provinion"l of Part VII of tho 1959 ll.ontalllealth Act,·

:wail uuthorillod to eatublinh speoinl hospitals for tho treatment, in

conditions of special 6ocurity, of patients of "dangerous, violent,

. or c:dminal propensities" he designated these throe already existing

· paychiatrio units no Special Hospitals. The Hospitals have different

histories, and serve rather different olinical ends, but must be

· oonai<hlred together ns they hnve a common ntatutory nuthori ty for

their existence, a common purpose of treating their patients in secure conditions, and a conimon adminiatrati ve background, all being

managed directly by tho Doportmont of •llenlth and Social Security

without the intervention of Regional Boards or local Management

Committees, .. !!:'hero is n further il1!pOrtant point of uniformity between thom.-

1\.uthoritative legal opinion has boon given that tho Spocia.l Hospitals

oan not admit inforr.ml or 'voluntary' patients, as Section 97·of the

Mental Health 1\.ot of 1959 opooifically statos that tho speoinl hoopitals

shall bo established for the treatment of compulsorily dotainod patients>

It .is trua that, :i'cr a variety of reasons, runging from insight to

payahotio apathy, a. proportion of tho pntionts actually want to remain

in those soouro hospii;als, and at least ~ne patient waa 1 volunt~y'' to tho axtont that he oo.;operuted actively in tho proceaa of.liis own

:·compulsory ndiiri.risicin fe troatment under Section 26 of the. Act, This

does not altar tho fnot, however, that no pntiont mny be discharged

oxcopt on tho authority of those parsons or agencies spacifiod in ti1o

Act • tho responsible roadiocl officer, managers, Homo Secretary,

Mental Health Review 'l'rib1.1nal, ·or noxt of kin, depending on tho

section or soot1ons of tho Mental Health Act ur\dor which he iu .. dotllinod, Tho' Special Hospitals differ in this respect from tho other

fncili ties described olsowhoro in this book; from tho Henderson

1. liri. t't.en prior io e;;t;bll;h;l~;;t of Fark Lane Hospital I ' I ' ' f ' I

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Hospital, the 'pcrmis :Ji vo' c<;ffiJlonont of the Baldorton Unit clescriborl

by Craft, and oven f:ror.1 Grendon Psychiatric Prison or tho otl.<lr

psychiatric services off.ored, by tho Prison D<Jpnrtmont, as no prison

inmate muy bo exposed .to formal psychiatric treatment against his will,

Broadmoor, tho oldest of' tho throe hospitals, 1'/as opened in 186.3, being

than directly unrler the control of tho Homo Office, both as to mrurage

mont, and selection and diaposcll of patients, all of whom cume from the

Courts or prisons •. Tho patient.~ i't·om tho Courta had been found .instmo

on arraignment and thus unfit to plead, or olso "McNaehton mad", tmd

could only be dischar15cd when the Sovoroicn' s pleasure was oxpre ssed

through tho Home Secretary; , tho so f'roh1 tho prisons had beoomo

oortifiably innano during tho currency of a sentence, and wore sent to

B:roudmoor for treatment, In 194.9 as a ronult of one of the provisions .. of the Criminal Judice Act of 19~.8, the management of Broadmoor was

transferred from tho Homo Office to the nonrcl. of Control, but 1vithout

altering at 11.11. the role of tho Homo Office in tho admission tmd

discharge of patients, Finally, on tho abolition of tho Board of

Control in 1960, Broadmoor caJ:IO dirco tly undor tho administration of

... the Department of l!GJ\l th nnd Social Soc uri ty, rmd broadened its baoia

of admission, now ·taking in the old "Her tlajesty's pleasure" cases,

under Section 71 of the !.\ental !loalth Act.; trunsfers f'rom prisons

(Section 72); patients tho subject of Hospital Orders (Section 60)

and diroot adr.Qssions, or transfers, of patients subject to

compulsory detention under Part IV of tho Act, without tho intervention

of nny penal or judicial procedure.

Rampton similarly was :rounded by the Homo Offi<>o in 19111• to fulfil

oxaotly the same functions as Broadmoor, but in 1920 it was handed

over to tho Board of Control, nnd under the title of' Ramp ton State

lnati tution, bocat~e u oentral hospital for the care o.nd treatment

o:(' Mental Dof'cctivoa, as subnormal patients wero then called, of

dll!lgerous and violent proponsi ties, Its population wll.ll drawn i'rom

•

other h,ospi tala. for montul do foeti vcs, and all woro dota:i.nod undor tho

provisions of th<) MontoJ. Doficion~y Acts •. As with llroa&noor, in 1960.

Ramp ton boc(llno v-ootcnl. ;Ln tho M:Lni,Jtor .of Heo.Hh, and drew its. patient:; . . .. - .? . . ···- ..

from tho. Sll,mo .. aourccs and undur. th.o same .. :.we tiona of .tho Aot •...

. ,. Moss Sido, on tho othor hand, )lful novor como under tho e.oe:is of the Home

Offj,ca 1 but was opened, under tho MruJugeme,nt. of tho Iloa.rd of Control,

in 191lt for the treatruont ot' Mentnl,.Dofootivos of' dMgorous or. violent

propensities. For n period between tho wru·s, 1920 - 1933, it wa<:

cloned; but from 193.3 onwa.rds it fulfilled its stated fl1nction ac;:rln

until its closic;nat:i.on as a Spoc;inl Hospital in 1960.

'Iho oOJill!!On n&ninistrativo baclcground to, tho throe honpitt~ls orrphn.t1i.MC\S

their indontif:i.catiqn with tho medical rathor than tho penal ;~ya tom of '·

the oountr;y, Th<3Y are run by thp, Depnrbont of Honlth nnd Social; 3ocurity,

thoil' pl'Of%sional,,staff , .. medical, nursinc, 1mcl medical ancLL;tar,y, nro

conditioned. to Nationn.'L Health. Service terms of sorvicr;; ;anil.,thoir

patJonta ar? dotainocl, and protected, undor tho provisions ,of Hental

lloo].th rnthor the.n Pena1 leg:LsJ.at;\.on •. They dif'fer adrniniatrativoly

from conventional pqych:iatrio hosp5, tnls in thn t their executive and olcricnl. otaff's nro d.::'a.vm f'rom :tho Civil Servico, nnd tho nursing a tuff

have n.:P.ntaincd their tradition, ,.established in Broadtaoor, of belonging

to the Prison Of'f'icors .. Association as a professional barga:~n:l.ng and .. ,

protective ~ody.

Tho hospitals d:i.ffor oliidcally in .that Broadtaoor - appro'4mately 820

bods, 680 men nnd 140 \YClJ~on 7 danls; by and lnrgo, w:i. th v.syc:notio

or psychopathic pn1;i0nta vti thin tho normal range of' :~J,~tc,~liGcr.co.

Rampton - 960 beds,. i:wico as many mon (640) as woman (J::iO}, t•.nd l·!o~s . ' . ' -' •. ' - ·. ' . . . - . -. J; ·- .·.- - .

Side.-:-, 350 bods, 260 men q.ml 90 women, havG ml.\inly sul;morp~,l pnt:lontn, ··'· _.,_._, . >· 1 -•. _.-_,_ 0- • - - •

though in each hospita;t.. th8re. u~·o a .number of patiento who,f_qll l'iitl<in:

the normal rnngo. of psychomott•io. a coring. . .. ·: ., ;,.. •

.,_. ·, .·

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I

Tho rolo of thci S]JOciltl Honpitnl in the troatmont of psychopat)1.io

disorder; though :i.mpor·tant, onn readily bo over-evaluated. It is

probably tnw that tho most extreme of the aggrossivo and soxuo.lly

devim1t paychopnths arc to be found in tho npocial hospitu.lu; but

they do not uppu(l).", in roturns, as nn import1mt component of' tho

population of tho hospitals, nor as n high proportion of' tho designated

psychopathia disordors ;mnunlly nttruoting nttont:Lon in monta.l health

statistics. In 1962, of 2,213 psyohopnths (sufferm·s hom psychcipathio

disorclor within tho dofini tion of Section 4- of' tho 1959 Mental Health

Act) admitted to all psychiatric units, only 4.9 (2.2%) wore a<1mitted

to Spociallloypitals. At tho end of thut yen.r, on .31 December 1962,

277 of n total Special Hospital populat~on of 211/,.8 were designated

as nuffcring hom psychopathic disorder. The oompn.rable figures

for 31 December 1963 wore 306 out of 21 11,3. These t.;ross figures would

probably be modii'iod by Cl,!U'Ci'ul and ori tical ro-llOl1.1tiny of all

diagnoses in tho hospitals; a certain runo~t of nosological inertia

undoubtedly exists, whereby patients who havo been lnballod us

psyohotio or montally defootivo, without qualificntiop, for mu.oy years,

continue so to bo diagnosed, though moro properly they might be. assessed

as suffering from "mental illness", or "subnormality" ~psychopathic

disorder". ~'his is troe of Broadmoor, whm'e a small, but diagnostically

and predictively worrying group ·or sexunlly abnormal homicides were

fowld, at tcial or by medical enquiry ttftorivarda, to bo 1insu.oe 1 ,

though not i'i tting into any neat Kraepolinio.n slot, and tppoaring as

"hyatorionl insanity" (sic), or as vn.riu.ots of epilepsy, sor.wtimes

with li ttlo onough firm clinical ovitlenco of upilopay as defined by

Russol Bra;tn, Similarly, before tho oatablishmnnt of psychopathic

disorder aa a psychiatric state rendering the sufferer lie.blo to

oompulsory measures· for treatment, a number of psychopathic patients

woro transferred from pdson to Broodmoor as having boon certifiably 1insano', Those wore mon who, in a transient psychotic episode

in a por.~istant psychopathia stato (e.ncl Honclorllon recognised tho

exiatonco of such psychotic episodes) could creditably be reported

us payohotio; or who, in a t'lu.ro-up of psyohopnthio reaction,

•

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{

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inflicted upon thcm3elvon injuries wlrlch could bo conntr>JOd as suioJdul,

and thel:'efore ware thought of' as being psychotically depressed.

Treatment of. psychopaths as of othct•s in the Special Hospitals ia

very much, conili tioncd by soouri ty needs. Each of tho hospi tills has

'peri motor' seourity in tho way of waUs, or wall and di toh, surrounding - . I •

tho whole hospitul; ar.d oach group of wards offers its own Bcourlty,

of vuryi.ng dogreos of s tringenoy depending on the clinical Md seouri ty ,

statG of t.lw patients in it. Sectu'i ty domo.ncb that lifo inside the

bspi tuln .shull in. many ways, indl viduu1ly tx·i vial but cumuli> ti vely

importMt, differ from that <Wen in conventional hospittW.s and, of

course, even more from lif'e in the community. Matches, monoy, 'pen

knives, eto., .aro not carried; heads oro counted regularly; locltcd

doors .check .free moverr.ent within the hospi ta1 perimeter; bod timo

is fix,od and fairly early. Much mere importantly, howeveJ~, than the •

physical components of the soour.ity system, is the fnot thD.t high

ace uri ty demands rules 1 nnd those rules :i.n their t\U'n <lennnd people

to enforoo them, und sm..,tions to uphold th.om. 1'hus an authori tariM

orientation ia impono<l upon the nursing staff, who nro in constant

cont110t with tho patientu; tho drill o:f locking of doors of

dormitories and roomu at a set time at night docs not pcrmi t of

discussion at the timo, either i;roup or v:i.s-ll·~vis botwcen patient and

nurse. ;·rarm an1 productive rolat5.onships eM and do grow up betwGen-,.

in<lJviduDl p11tionts and groups of patients on the ono hand, an<l nursing

staff on the other, but this reflects only th0 hit;h <legreo of skill

of the sta.ff in overcomi.ng initial diffic'ulties, and the early

negative at.t'ctude of patients \'lho. ~eo tho nurso. at :t'lrst simply as

tho mM who looks. him up at nitht. Thie attitude of tho patient is

much more, marked in thG aggrossjvG·pGychopath with ti prison record

who sco.s._the nurse IW noth;tng hut a "scrcwn, and the whole staff of' tho

hospital as a grour, of 1 them' who not only locked him up, bl)t looked

him up with "nut caaos". Such a psychopath resonts bitterly his

disposal to a psychiatric unit, both because of tho affront to his

ido:w oi' his own montul health, Md booauso of' tho uncortilinty of

his future, as he is no longer confident of return to troodom at

tho expiry of a fixed Gontenoe, 'fhoso physicnl and psychological

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suo uri ty factors exert a considorablo influence on treatment

techniques. 'J'ho usunl physical mut.hods of troatmont, by elootro

pl.oxy and psycliotropio drugs, aro usotl. in tho puychoses or rluri.ng

psychotic opinoclcls, much os they 1).!'0 used in conv.ontionnl hospitals;

· ·but thoro has, of rocont years, boon no rccow.•so' tO co~~bral aurgor/

in ;my. of tho spooinl hospHnls, A n.uiubcr of patients sh.~rlng vary

aovol'O · b·ohv.viour d.ioturbanoos woro louootomizod by stande.rd

procoduroa in Hampton s orne yours ago. Tho results as roportod by·

1!acKay woro oquivoco.l. lfo louootomtcn, oi thor atamlard or modified,

have been carried out n.t, or from Broudmoor or Moss Side.

Individual uncovering psyohothernpcutio tochniquos have boon omployod·

in Broadmoor by Jonathan Gould, but it is doubtfUl if his.casos could

be describod as 'psyohopnt:uo! within tho terms of the Act. Few

wri tors ·hovo 0:'.ro 'r.wd succ0ss with suuh toc.hniquos in acvoro aggressive

psychopathic diaodol's 1ll11f it is obvio11s th{lt the basis of such

therapy, the ostabl.ishmont of productive rapport, will b0 made vc:ry

difficult by tho "affectionleasnoss" which appears eo oonsi·r·~ent.ly

in clinical dosc:rrlptJ.ons of psychopathic disonlor •. s.troot has

recorded that suoh forms of troatrr.ont aro not practised at Hampton;

nor are they, with tho m:oeption of the cases tre8.tod by Gould, ·at

Broadffioor. Fcmal· group therapy, with groups of soleot&d patients

·whica:inolude psychopath.~, is, ho·:evor, in uso both at Hampton and·

Broadmoor.

Tho limitations imposed by security on a.nalytical.ly-oriontatod group

nnd indiv:i.dua.l psychothc:~a.py, even l'ihen these arc clinically indicated,

1).!'0 serious, 1110:;o troatmonts ·ossontinlly ·tum at tho discovery and

rooogni tion by tho patic,nts, of fm•ocs in his mental Ufo which aro

U!llioceptablo in consciousness, and find outlot in anti-social

activity• 1Jlis <lisoovory and recogniticm is often accompanied by

"acting out" behaviour, with ovort or symbolic· aggression directed

to tho therapist, tho environment as a whole, or the pationt1'

himsolf; and h:i.s "actinc out" beha·d.our is regarded ns intolerable

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in 4 disciplined, ntruoturc<l cor:ununity, 11rounos repro:Jnivo monauros

Md ntt:i.tudos, r.nd no in itn turn, a further phar.o of anti

nuthoritn.rian b(:lmviour can bo evoked. '!1w uso, of <loop psychotherapy

domnnds a l'Oma.rkablo dogroo of clinical <lotaohmont on t.ho purt of

tho tlwrapint 1 who must emphan:Lzo to his patient that he in of'foring

nothing but cvontu:1l relief from intr<Y·p,9yohic tonnion, a.n<l nothing

aob all in tho way of' immodiate rown.rds such as increased privilogos

otc. Similarly, the pationt must bo oapnblo of co-operating in

troatmont Ylhich will bo at best omot:l.onnlly uncomfortable in :its

early B tngea, and possibly acutely iliatrossing.

Group therapy,. of' a loss structured so:rt, doos, howovor, ox.i.st in all

throo hospitals, perhaps ton groator extent :'.n llroadmoor, with its

more intelligent population, than in Mons Sido or Rampton. Patients

tond to 0rystalli1.o out ln croups 11i th a cotnmon interest - football,

criokot, clrrunatics, 'pop' musio, etc., and to oaoh of these groups

.\lJ:'O attaohGd ono Ol' moro stat'f members, largely nclf selected by. thoir

own interost :Ln tho oontcnt of tho e:roup's D.Ctivitios, Comrn:l.ttocs,

olootod by tho patients, aro formed, and in those Committoos (m8lllbor

nldp of' which. attracts certain privileges) patients tend to .show a

real concern not only for tho rights, but for the clinical interests

Of their follows. A mooting of tho 1oMting committee' of tho ·,

dr<tmatio club will discuss whothor giving Joan or Poter such I.U1d such

a part will do good or harm to their recognized. pro carious stability

(McGrath 1958),

The tn!li.n theme of non~physical methods of treatment in all three

hoapita.ln is based on oaroful, rntiont, training towards· aocial

conformity, with a complex system of rewll.rds, both social and

monetary, and an equivalent rango of disincentives to unacceptable

behaviour, by loss of' privilege and amcntitios and a return to·a •

more strictly structured and closely observed stratum of tho hospital·

society (Craft and McDougall - StrGot 1963. McGrath 19.58), This

I I

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syr;tom, which of nocosai ty appJJ.oa to irro~vonsiblo psychotics as much

as t.o ."rational" p2yohopathu, is frankly rcgnr(\Od by pll.tionta as one

of rewartlo .hnd puninhmonts, The no torms ttro hm•:;h to the ourn of

; vlinioians ;, hut it is u•Jroali::;tio to expoo't tlwrn not to be used by·

thos~ sub'joot to the l'ogi:no, aml· to· thoec wlm:inintorints it. It is easy, fortunatoly, to rationalize the:diolncontive round the nood of

olosor observation of someone l'lhoso oJinioal condi tlon · shov:s signs of

dotoriorat1on1 .ot• tho nood for moro atrlngont !leourity for n patient

whoso behaviour ·:mggoats lmpending or· actual risk to otho!' patients,

staff, or public,

Tho trninin;;, unilor medical control, cover:: all cwpcots of the patient's

JJ.i'o 1 occupatiorwl (!Jl(l roc:contior,;,tl. , !Ioro t>go.:i.n aocQri·ty oonsidorut:lons

ure p:.trrunount; . tht' newly udm:i ttod putiont can only bo gi'von oompara

tivoly oimplo work, involv-ing no usa ol' tools wlci.ch· m:ight aid escupo

or bo uneJ lis wo~pons, -till ho haa boon M.sessod 1 both clin.i.cally and

as to his J.uvel of security risk, Also in mrodmum security aroas in

:the hospi tc,ls, ere n t care is excroi nod in tho typo of' skills ono our aged

nnd tools used. . Ono very r0ul· c1ifi'icul ty thus enoountoreq iii how to

moot tho needs of the mucoular young ndult psyohoputh of average or

less than average intolligenco, who has neither intorost in nor·

motivation towartls acquiring dolicato skills hut who hr.s always been,

and wants always to bo, a labour·or. His neElds, l'or rul ultimate

ooonom:tc.:~lly suooeauful return to tho community, are at present seen

tQbo :for his hands and muscles beinc kept hnrd, and for training in

tho satisfying and nooeptnblo uso ot' lois\lre, It is, however, not

possible, without arousing anti-thornpoutio s t11fl' tensions, to equip

a:xplosivoly Lllld impulsively ar;gressivo young psyohopntha with picks,

crowbars·, :Colling rucoa., ·etc.,· nor would it be wise to do so,

Recreation, too, is modified lly aoourity requirements, thou;ih not

so d.rnmationlly. A hardy mmunl joko at Bl•oadmoor ia a request for

tho polo vault,, at a spot corivcniont to the wall, to bo included in

tho Annual Sportn, Day • . ..

(

Aguinst this ~;onerul baoke;round of' c ondition:ing of' behaviour,

individual oourJsnlJing and disctlBsion of' past, procont :md futuro

dif'f'ioultios, goes on botwoon pntionb and nursing and medical

staff', lln;rpton runs formal courson for patients whose oarly

dir.oharge ·or transfer to an 1 open' tmit has been o.pprovod in

pd.noip1e, ·

It'is extremely diff:iou1t to quantify tho results of treatment of'

severe pnyohopa thio dino1'rlcr in the Spacial Hospitals, Subjects

or .such disorder tend naturally to bo long stay patients, nnrl tho

condition has not boon sepn.rately categorized long enough for

illuminating follow··up studios to be carded out. A very careful

study by Cru.i'~t and J~oDou,~nll of Moss Side patients was unablo to

apli t of'f' psychopathic from intclleotuqlly subnormal factors

oporatinr; on recovery ro.tes; but th(; general conclusion was that

1 0 por cent of Moss Sido patients showed runeliorn tion to tho ox tent

of being discharged or tl'(U1nforrod to open units. Stroot, in 1960,

found that only 10 per oont of' Rarnpton' IJ population hwi been thoro

tor more than ton ycsrs o.nd those ware largely physj.cally diso.blod

patients, Tony and MacKay (1959) in o. rofinod stntist.ioal :Jtudy:

of' 12 years oohOl't of dischnrg&s, carefully not identifying their

materilll with psychopathic disorder ("high grade nental defectives" -

"behaviour of' a sort prescribed by tho criminal law" - "not

inf'roq:umtly called psychopathic"), o:une to tho conclusion thiJ.t the

Sto.to Hospital systeut W<W thox·apoutioally 'offoctivo in that serious

relapses were relatively utlrlommon. So far, not a nufficiont number

of' undoubted p.~yclwpaths in ptu'e oul turo have boon discharged from

Broadmoor for vulid conclusions to be drawni but it is relevant

th~Lt of patients who hlld b<wn charged with hor.doido and subsequently

dis char god from Broadr.wor 1 none has o.gain boon char god with n;urdor;

Md of this group, which now o·;er a century numbers some hundreds,

a minority have be on person.~ who would now be diagnosod as

psychopaths. So!!JC 3 per oont of Brondmoor disohergos and

trnnsi'ox•s. rot\Jl'n to tho honpi tal, seldom bccau~v they are

"danBorous or violent" but more etten .~t thoir own r·oquoat1 aa they

had not boon sufficiently prepared f'or return to the community, or

are distreBGed and unhappy in stran(l"J hospital surroundings. Again

•

not nll of tf:.c:ic x·otu:::·n:> v;o:'o p:i_r.:;hcpt.:'.tLn~ but hn\·o boon o"g •.

recurrent .<lcpl·or.ni vcv, ro curnine in rolnpno to tho f'nmilior hospital,

Tho Dopm'hr.ont of gnr.U;1 c.:1cl :;:,1Giul S.ccw'itY roports tlw.t in 1963

diaohn.rgco and_ t;:'t.nzfor;1 fro;n t~a sre~:d.al Ho:Jri t:: .. ls llumborod 25 7 I i.e, some 12 por cont oi' tho tot~tl Sp~1c:l.o.l Hospital population.

Roturn:!.ng ac,nin to noou·,'i'"Y• i.q, tho probction of the publlo, tho.

most drrunaHc 1·::-oc.cll wan :Ln ·19;:;2 l'::lcll Stl•aff'cn, having nbsoondod

:from.Brondr1oor, ldllcc~ n J.::.%lo L,;:~rl during his nhort absonco. At

the tim8 of y:ritin~ there is no Spooio.l lfo~pital patient nbsent

without lonvc; :Ln·~rn C:lJ.:.'ally, in all t':lroe hospitals thoro lli'B

:froquen·c, ruc•ours of e:ccp0 rJ.ot.,, usually involving psychopaths,

Fortuna toly 1 by tho very r:~. ~L·.:-o of t::teir d.l "·Orrhl', pnyohopntha

3Bom unnblo to 1Jar:Q toco:thc:c lo:1g ~u1ough to plan and execute an

esoapo; incvi ta:;ly tendons arise rti thi.n thG 170up, resolved by,

one mombor i"<li'Ori:d.nc O'n tho ot11ors, or bonstf'ulnc::u lends to

indiscroot disclo~m·u:~ to p<:Lt:'.cnts G:~:ce nn::cious to conform to tho

hospital' n st!•.ndu.rt!.:; of con:-1-~) t. J' .. :) t.1n.l occupcs from the Woe

hospi tnls vary .f'ro:1 yo:1r to year 1 i.':com nil to ~9n in totul •

. ,-···

Tl'\J;'oe Special llcsphals o;;ist fen:- th3 j;l•cat;m(mt, under condi tiona ot'

special security, of rr.cntally disordered persons, subject to detention,

of dangerocw, violent, Ol' ol'J.dnnl propensities, Theao hospitals are

vostod in tho Minister of' Jtoalt~, and arc part or tho nation wldo

Mental Hoa1!;h Scrv:ico, J'l,oy cater for persons subject to psycho-

pathic dioo+de:r, c_'nong other diae;nostic groups, ,,-- Tho psychopaths

acll!li ttod to tho SpildaJ. Hospitals in 1962 formed 2.2 per eont of' all

psychopathia adm~ssions, :md at the end of that year formed 12.8 per

ocnt of' the 3pooial Ilospital)))pulation. T:roatr.•ont ia mod:l.t'iod by •

aoourity considc:·ationo, &dis essentially based on oomU.tioning,.

educative procosso::; rathor tha.'1 .analytical onoo. Considering that

(

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tho olinictll nature of' tho conditions troatcd, and pulllic safety,

:i.mpouo oxtromo caution i.n tliopasal policy, a natinf'aotory

runolioration rate of between 10 per cent - 12 per cont han bGon

mod.ntai.no<l for $Omo yours, with a vory low rnto oi' rc-adminsiontJ

to tho Spooial llonpital Sorvico. Tho soom·ity provinionu have

provided an adoqunto protection to tho public.

Cr!li't & McDougall

Gould Jonathan

Poraonal - Communication '

British Jour nul of' C:U.nioal l'raotico 1957

, H01vard Journal 1958 MoGra th P ~(;

MaoKay G W

Stroot DK

Journal of' Mental Soionco 1957

Lancet 1960

Tong & MacKay .. Brit,. J. Delinquency 1959 IX 4.

lllbpad.ment of HeD.lth and Socia.l Security, Annua.l Report 1963 (n.M.s.o.)

• . ~

I

A PP:ENDIX r):

I

"Duneorous" ofi'endora obviously vury in tho degree of dlffigur thoy prasont

to society; and it would be very easy to b'Jcoma boroeshed in a disouBsion of

. dograoa. o1' imm1)di,acy and r;pocificity·or tho dD.nger preaented. Ho.·;evat·, the

dMgilr content of tho offence of. homicide cnn not be g'unsuid; Md tho o.Ot

itself 1 tho a,~bient circumstances, . the puraontlli ties and tho hhtorletl of both

·offender and victim aro likely to be oxhauatl.voly dooumontod (McGrath 1958) •

Moreover nearly all homioida.s in this country como to institutional care • · Homicide

is thorofo~ a useful modal to oloj;he with a disousllion of custody and relacae,

and will be the prin:nlJ' frame of rof'erenoa of this contribution.

Custody. hD.S gonoro.l chara.oi;oristicn an,d affects, no mutter whnt the danger

gua.rdod against may be·. "The work of oustorly oraatos a. rolation of' opposition

between those vmo exeroiae it and those upon whom it ia oxercisod 11 (Smith 1965), .. In seouro ouatody,the offender-patient is subjected to r. wide rungo of rostdctions,

many of them trivial in themselves, but with a. cumulutivo effect of diminution. of

dignity and perso~ality, Movements are controlled, heads counted, viaits observed,

programrqes strictly adhered to; loose chRngo und penknives can not be comfortably

jangled in the pocket. All this provides a soil on which resentment of tho nurse-

custodian readily grows.

Tho domanda of aeourity~custody ho.ve their affect on stuff us wall. It ia now

part of Moepted psychiatdo doctrine l.n thia country that open-door in-putient

units are therapeutically more effective than locked ones; nurses and others in

aeoure units tend to feel defensive ubout being out-of-date and reactionary. . .

Soourity domandn rulea, aanotio~a to uphold them, and poople to enforce thoro, If . ' i .. ,!

those people are nursea, they. will inavitubly lean towards .a hierarchical etruoture '· .,.

not only administratively but clinically. Jlreaohos of security will create anti-

therapeutic tensioM v.mong stuff, and between a taft Md patients• Thill tension will ~ 1 : ·• ' • ' ' . -

bo exacerbated if the surrounding oomrounity in security-sensitive, and censorious.

Wo at Jlroadmoor have bitter knowlGdge of this following tho esoapo, fifteen yoara ... ~

(

. ngo, of a child-mm<terol' who Ullc:l a thJ.rd child victim within 11 few hours

of ab::oon,\ing. · Some r;~curo hor.pitnl ctn.ffa solve thin proulem by divorcl.nr,

thom .. qolvos· from· tho' uooudty sHu·,,tion c0!3plotcl:,< and O~>~r~ting clinically ~ \

literally within a'fci1co ·of bnrbo<2 vd.l'e'and nr"lnod i1mt; othota ova r-id an tify

with tho OU!Jtodial role, ' ~;lio burdo~ pinood 0~' tho n~r~e:C.U3tOdiOJl, Who ~1.1 . ,. ..

o~w<m by the of'fondor-putioii:'{·o:a the ~HJl who' ao tualJ:y wield a tha koy;, is ;\ .,. '

• ' ' . . _, •· ;" ; . I • • .

. '.: , .. , 'VOl"J'heavy ono;"· and. ho noi~ds aldllcd ond continuous support and help in

olear peroopt:i.on of hill 'rolo and solf-oonf'idonco in hia IJXilroi.sa of H.

S<:>c1tritY: needs for tho .,·normal"· offend or ·aro not unif'orm, a faot eat out

··very. clearly by the rooont if.ountb:>.ttotl 'Roport on Security in Prisons

(Mounthattun 1956), This is also truo of the dangerous offender-patient,

whoso fluctuating payohibotl'io state, ~,; volatility of response til stimuli,

oomplioa.to tho p1'oblem ovon fu1'U1or, Fortunately, in aooure hospitals wo do

not have to contemplate the foarsC!l!il nnd appallingly expensive moaauroa

onvinaged by Mountbo.tton to gunrd ae;ainut woll-moc:nted liberation operations

. from outsido, \'lo b~liovo thnt the proi'c83.iona.l criminals onpa.ble of sottin~

.. , up auoh an attempt woul.d no'.; b3 likely to do so in the case of a man whoso

mental state and raliability wns moro th~ auspaot. Within the hospital,

however, very varyi!lg soou.t':ity needs have to be r::ot. lJMy factors aro _,,,_

)

· .. involved, 'and I find it hurd to set. out tho needs ,;.s a. continuum. For inatanoo,

·• , 11. young, agile, intolligent paychopath~ho hAS already wo.ntonly killed while ; ' .. . :,

absconding from a Boratnl, in pro:..oocupled with ideas ot' escaping, has serioullly

WHlaul ted nursing stat'!'~ ~n'd 'is. cheerfully open in preparednoas til kill again

in tho oourvo o( asoapa~· A.t· perhaps 'th~ ~pposite p;le is a gentle, d~e-.Jl\Y'

llohizophranio who, despite troa'tme~t, ·~mains con~i~ood ~hat he has a divine .. ,., '. ,·

millsion to' snve tha world by libax;o.ting the soul of a girl which will then .·.··

" must be denied uncbse~vod' ·~co~~a· to girls - but within tha perimeter socurity

I .I

{

9f a woll-3taffe<l. ho!lpi tnl doe!! not pranent n risk. At another point on the '>

porlmoter of tho. ouourity problem is tho man who has a fh:od, non~spreading

dol,wion about hiu landlord;_ iu d~torminod to kill him; and makao ropea.ted, >

rl!-ther inept att9mpt3 to oaoapa to achieve hin objeot; he hq.u already gravely

injm•ed a ato.f'f mqmber in an onoapo bid. Yot !\gain t.'lere ia a compulsive . . ·... .. . ,.

o.looholiQ >who, brain darea~cd, (h•unk and po.ranold, ahot dead a son-iti-lnw;

in oontompol'o.ryEnclia:,pnychiatdo practice his care oru1 t::oot humanely be

oar:ried out :!.n a seouro hoapi tal. 1'ho ouutodit<l naods of this tla.mple ve.ry from

a. high dceroo of ph,)'eioal soouri ty merwuroa tlild clos<l ob~orvation to a level

of porlphcml aocurity r:hich would not havo been foreign to 1J.r1y mental hospital

in Englund before World War II.

Still uning hoclcida .. IIS a frame of rofcrano<:, dbposal of tho danc;aroun

ofi'ender-patient is not purely a meilioal ronponsibility. !lc::doidoa who have

tho utatua of pationta ure pr;;ctioally invariubly subject to ootu.al or notional

"reatdotion" ordora, i.o. thoy can not be diaollllr<;od to the oorJl!'llnity, t;tvon

leave of abnenoo, or t••£msforrod from one hoe pi te.l to another vii thout the

consent of' tho Home SJcrot:l.l:'y. I should omphusho that I have never known this

oonaent to ba unroaac~e.bj.y wi l:hhald; and. I'porllont.Uly have found it a useful

intollootunl diuoiplino t~ pros0nt what ia usually a technical psychiatric oaao

in torms which f:-111 bo intelligible ,and. oogont to a layman charged with the

roaponnibility of protecting the publio •

. In aa3ostLi.ng prl. tabili ty for discharge, or transfer to opon condi tiona, ·

ona must f':lrnt mnka a careful asaaanmant of the paychiatl'io otn.ta of tho patient;

. then its relatio~ship to tho offence;. and finally the likelihood of a Situation ·

t

I arising which f:ould. reduplicate the original, fatal concatenation of' oircumatanaea. 1 Thia is sometimes .fairly oe.ny, as in the "extondod melancholia &uicide"

denot~bed by Prof'oaaor Schipkouenaky, But even with thia diagnonia, any

psychie.trlst J:nowa that payohotio d.ej>reBnion has a.n unhappy tendonoy to recur •

(

,/ ., no aftax•cm'O mu:lt be v.rl'IU\[;Od with thin in vdnd. Tho schizophrenia homicide

presents a much more <l.if'J'icult problem. 'l'ho rolationnhip between illnoaa

· .. and of'i'onco w1y well be· obsoux•e and conjectural, as in tho cano of the

divinity student nho out off i1ia motlwr' s head and put in in tho oven to bake

... it like a pie. ·At the tJ.me of' the trnt;cdy he wnn unable to givo oven psychotic

· ~·onnonil ·for his behaviour, und now he can nai ther recall nor w1dorntand hin

motivation. I do not think that a Jaoininn interpretation of this matricids

would improsn a Homo Soc!'Otary; and in any event, mothers (even dead ones)

·can h~<Vo ourro~;ates. I nm a.wo.ro of no work which establishes that fatal

aggreosion to a mother figure is completely dischax•r,ad by the victim' a <loath.

In thb patient careful clinical study failed to reveal ar1y psychotic residua,

and a Wllrn and integrated !Jersonali ty emorged, upparontly s.i.uctlur to the

prepsychotic one. 1'hilt happy state or affair3 waa mrrintuined for aomo years

to a point after which ralapae wa3 a tatintically improbable, and the man has

now been free in the oom'llunity for 7 years. A lllOl'C difficult problem was tha

schizophrenic who wandered from another hospital and pushed a perfect a tranger

in front of an oncoming train because "God told him to do it". Though active

in lkoadmoOl', the marks of his illness are still thick upon him, he ia inaccessible

tc discussion of the offonoe, and his discharge or transfer has not yet been

recommended. \'le recognize that not all eohizophronios rospond completely, or

at aiJ, to treatment; we oo.n attempt an assessment of' a level of' conative

blunting being roached sueh that the likelihood of florid and fatal manifostatiow

.of illness is reduced to a minimum, after which suoh patients can be safely . ' transferred to open hoapitals for long-stay care, or for induntrial Bnd social

',. rehabilitation with eventual return to sheltered conditions in the communi t'J.

Mowat (1966) has studied 63 male murderers who had been admitted to

Jlroadmoor over a period of 20 years, and 11hosa presontint.t symptom was patholo[lical

· 'Jet;lousy of their heterosexual partnera. Eleven of the men ware dl.schargod

'

within the datum period, wlthout (up till now, the prosant) fatal

oonsoquoncoa; 'fhe ·nubjocta ovmo frow 1!. mixed group of dopresnivos,

aohizophronion; n:ono·deludc~laJ poychotios Md alooholioa, But wo are

· otHl very cautious in tho dispozal of morbidly jealous ll!UrdoL'ors of'

: · · · riw.rl'iagoable ago.

l!omicidoa flowing from tUaturbod sexuality prosont probably the moBt

difficult problon, particularly in tho absence of a dmr.ormtrablo treatable

pnychoais, · Ono · ourmot carry· au·~ ono 1 a professionP~ job of' naeessmont in

·a aooial vacuum, und ono must \veigh, an a factor, the offoctcr. of' public

reaction to a repetition of a violent eoxual offence by a diaohargod patient •

• Thoeil offoots could be prejudiCial to t!Hl disohLU'fiO prospeote of a whole

generation of patioJ'lta. Clinical o.nd poychomotric oortliinty of a changed

sexool orientation must bJ \lractic!llly absolute for confident recommendation

of diaoharge; und this is prJ.otically imponsiblo to nchieYo, though it OM

be dono. A young mn of impoconblo fnmily bMkground, upbringing, omploymont

rooord and sexual adjustu:ent, sustained a houd injury. Hl.u prof'auuionul

atudioa fell of'f dmma tior.lly l'.nd ho hud one amnesic opis?do, One evening

ha drank rather more than his us•lal quotu of beer; he· murdored• mutilated

and attempted to cremate two prosti tutea, and wuu found, umnosio 1 in a town

' 70 miloa awa:y. · Contemporary clinical, neurological and psychol.ogiclil

examination: indicated frontal lobe dumago, which a·tudicls repeated on admission

to Broadmoor oonfirmod. Af'tor a few yaara of close clinical observation,

which· revealed nothing rore thun itr.mutul'i ty manif'onting aa u. peacock

·presentation of' himaalf to women, tho studios 11oro ucain curried out, even . ·;: •

mora· exhaustively, and including an olectroencephalocram after the ingestion

·of f'ivo pints of boer (tho quantity takon on tho f'utal nigl>t). Tho results

were entirely wi tHn no~··1 1~ ~ +.·. fl9 is now dinohu.rged.

'All techrucal aids must bo oallod in evidcnoa - oleotroenoephalographio

utudies, aa ubovo, can ba helpful, eapeoiu.lly if' A lesion auacej\tible to

{

(

treatment oan bo ilelllonetra·l;od or, ovor a ({lvon poricd 1 !t sic;nif'lc!~lt chango

in tho dh·cction of maturity and stability of cerobral rhythrnJ. Similarly,

poyc)1ometrio gtudioa ww nhow quantifiable movement in the dirootion of

rooilionoe and control. Such studios, avon in inolaeion, oan provido uaof'ul

'prcdiotivo indicators. Blackburn (1968), at Brondmoor, haa rooently a.ttornptod

to reduoa to. m!lasurnblo terms tho "ovor-oontrol" associated. with oxoeptiona.l

aggrQoaion nnd tho "uncler-oontrol" found with histor'ios of modorc.to a.er;roosi.on~

Some new tools aro boinr; put in Olll' hand.s, whose siGnif'ica.noo requires

further 1ongi tudinnl studiea. Prioo and his co-workers ( 1966) have esta.bllehod

a. connection botwaen certe.in chromoaorna.~ disordors and some forms of anti.aooial

activity. This wo1·k is exciting, but I would not .vet let the presence of an

extra "Y" chromosomo weigh too heavily against the dinaluwgo of an aggressive, ..

In the last analysis, however, with homicide a wo aro denied the basic

res_eo.rch tools of follow-up on di.5charga of recognized hic;h-risk patients, and

Of unaelootod samples. One is left with the uneasy fooling, expressed by

Dr1. Stump, .that we are too cautious in out> dischr..rge policies.

So far we have discussed only the aatnali ties of homioida, A further

problem is. the care ?JJd dinpoaal of' tho pationt who ontar-tains violent phantaaios

without evidence of' violanoe in aotlon. I am a.waro ot' no body of knov11Gdgo on

tho inoidenco ot' phanto.aias of ldlling or rape in the e;eneral public, On two

oooaaions recently I have been asked to aeo patients entertaining such phantasies,

and have a.rra.oeed to admit them, ll.3 unrestricted patients, for study ll.lld . ._ . '

obuorvation, Having admitted thorn to a secure hospital, ono hno. adwi ttod also

the potential of danger. It took a consider-able oft'ort of. will to discharge

one of them after atudios so detailed a.nd long--<ira\vn-out that I had to adrrilt

I was procrastinating. So far, all gooa well,

Finally, disposal doos not ceane when tho patient leaves tho hospital,

In rastrio:ted casas, diaoharGi.l is always conditional, !llld the Homo Secretary

'

retains tho right to rt1oull as long as tho restd.ction order lasts •· usurJ.ly

w:l thout limit or timo, This, ns Dr. Sturup points out, enables us to muke

appropria to ru't•anb'Om~n tn fol' aoo onlDl()du t:J.on, omploymon t or afte roaro. Social

workora go to ondloss pains, a!'tor oonoultation wi j;h tho dco tor, to necuro

ideal oondi tiona including, if ncco~>Slll'Y, uupport by a montal wolf.ll.ro off'ioer,

pnyoh:!.atrio ol:!.nio or voluntury agonoy.

It i:J enormously imJ>Ortant for the hospitv.l to keep in touch w:!. th tho after··

onro agencies, who ot'ton f'eol out or their depths in oaring for homicides in

the community, and have to b6 Bupportod to copo vii th their rapugnll.lloo at their

own feeling that~ they may be tha instruments of reailmisnion of a patient who

ha:.J not yet offended D.go..in. This potential of guilt ia not the aole prerogative

or tho lay case-worlcer, but in shnrod by the doctors, who d.o not delight in .. inoa.roeratinc: tho loga.lly dofonooloss,

The more aura our discharge criteria. a.ro, the less wHl be dootora' guilt,

staff' tensions and public anxloty, It is through meetings of colleagues auoh

aa this that our oritorio. will be refined. a.nd made moro acouro.teJ and for thia

I am profoundly grateful to tho Ciba Foundation.

REFERENCES

BJACK1JUR!f, R. ( 1968), Br, J, Pnyohiat. In pro as, MaGRATH P. G. ( 1 958). Howard. J,, 1 0, .38../;J, MOUNTB.ATTL11, L, ( 1966), Report of }:nquil."J into Prison Eaoapos and. Soc uri ty 1

Cmnd .3175, London: lil!,SQ, MOWAT, R.n. (1 966). Morbid Jealousy and Murder. London: Tavis took Publicationo, PRICE, W.H,, COURT llROi\'li, W.M., SELBY TULLOCH, W.,.tr,1VSAM, J.E,, and MACLEAN, ·r,;

(1966). Lunoot, 2, 69-71• SMI'tll, D.E. (1965), Psyohio.tcy, 28, 311-323.

APPENDTX 6:

' _l1iW/,JJ!,;(JOll JN:; MiD OU'I':i] 96.9 - l97I

lJy Dr. D. 'l'idmn.rsh, !·!.lJ,. .D.P .. t•L. Con:.nlltant P:;vchintri:._;t, Broudmom~ lfo.EJ?~

J, paper r011tl at the meeting of the Forcnuic :iection of the Roytcl College of Puychiatristc; on 23 rd M<w, 19'18, at the Staff Education Centre, Droudmooc Hospital.

Mr. Chairman, lc=.tdien and gentlemen,

Dr. l<lcGr;"th thought that it 1;oulu be appt'opriate foe me to decct·ibo to you how the numUerB of our· admif.JBions and dir>charges have chant~od over the yearn since tlw 1959 lkontal Health ilct >~llG implemented'· nd to dir;cur;s Borne of the reusonf.> for thQse changes,., As is always the case the presentation of evo11 tl1e simplest statistics raisec all sorts of questions which need answe1·ine and which I hope, in \he not too distant future, to pl'OVide ans;wrG to, J.\eam;hilc rny intel·prctation of the figureo inevitably reflects my o1m prejudices and preoccupationu and I am sure that nobody here will think that I ~tm upcakine; in anythine other than a personal capacity.

Let me bct,>-in therefore in a rather pedeutrian fashion. According to some figures bequeathed to us by Gavin Tcnnet 1-1hi ch he had extracted from some annual returns, one hundred ye;;lrs ago ,an average of forty men and fifteen women were bei.ng admitted to Broadmoor each year. 'rhese figm·es did not change greatly from 187b to 1957 being f'i fty-two male and fifteen female. adminsiom; each year on.avcrugc. There >:as a rim; durine and just after the first war and a rising t1;end aner the secord•

l•IY first diaeram shows v1ho:t has happened to our admissions since the 1959 Mental Health Act """ implemented. '!'he figures for 1960 and 1961 are virtually the same as those for the prececdine ten years, '!'hereafter you will nee that the nwnber of female admissions did not change very much, tho aver«ee for 1960 to 1977 being eighteen instead of the fifteen of the previous one hundred years. The males hovwver did incre~sc roaching one hundred and forty-four in 1970, more thccn doubline the figures for earlier years, You will also see that from 1973 there has been a steady descent from the plateau of the 1960s. '!'he figures for 1977 are sixty-nine males and ten females 1 and very similar to those found before the Act came into operation•

The reason for this fall in o .. l' adrnissions are no d0ubt various, but one thing this fall wus not due to was any decrease in demand. 1'\Y uecond diagram, the figures for Hhich were supplied by the DHSS, shows that demand, ao expressed by applications from all sources to the DHSS for beds in Special Hospitals has been increasing steadily since 1961. Until 1969 only about a quc.rter of these applications were rejected and admissions kept pace Hith applications, Prom then until 1973 the number of putients accepted remained static at about three hundred and seventy annually, leading to an increase in rejections from a quarter to a third, In 1974 there wan a sudden fall, which has since continued, in the number of pati<mta accepted in all the Special Hospitals, so that i.n 1977 only one • hundred and seventy..: four putients >:ere admitted and half the applicr<ti ons were rejected,

(

I do not knoH ;ilwther this abrupt ch<cn(;C ic in the words of "1066 and All 1fhut 11 h Good rrhing or h Bad 'I'hin~> Cle.:...rly if previously c...pplications wore bc!ing ll!f-tdc for trivi<-•l ro.;,..;;on:; .::..nd p~ttients were beine adl!litted to !:>pccio.l IIor:;pituls unnccos!;hrily, then the reduction of .such admis: .. >ions in to be HOlcomcd. If, on the other hLdHl 1 dangerous mentally abnormal offcnder.s are nm·l heing divei'tcd to lcu:-:1 ::.;ui table estubliuhments then one ce;n only be diuturbcrl c.t this tcencl. I tlo not know Hhothor this incre<csc in applicc.:~tions rolr:te:;; to pt:.ticnLG ~lre2.dy in ho:;pi tal or to people on rcrn<:.tnd or to tho::;c servine pr·iliun nentcnce~;, but rny hunch is that mu.ny ht.l.vc uullucqucntly found thcmselve!""i in prison. If one takes the years ~ 1968 to 1 ')7 3 to lie no1·mal for modern times ~;i th an aver<tge of three lmndrcd r.~nd f~eventy admis~ionr:; htmu&.lly to ~::.11 the :.ipeciD.l Hospitals, then uince 197 3 «bollt nix lmnd!'Cu and hwnty P''tients have not been fom1d beds Hho previou.::>ly Hould h.:~ve been [ldmitted. Dr. Grr 1 the Director of the Prir;on l~iedic<-•1 :3ervicc 1 l18.f3 Sti.lted that there i:ll'C !301110 HiX hundred (or is it nine hundred.?) men in prison ~·1ho t>hould be in p;:;ychintric hospital:::; ~ this uhortfall in ::>pccial Hospi t<:cl c.dmifJ>Jiom; goefJ at least some Hay to cxplainin(I his problem. I believe thcct t!:e ;:;pecial JloGpi tal ilefJearch lJni t have forrnlllCltcd and GUbmitted to the !JH:c;S n rcsez.rch project dcsir;neci to explore what~ happenu to the De rc jcctcd c.:·.0eu. It wi 11 be i nterecti nt~ to sec hoH dancorous they turn out to be,. hoH much trouble they cr:.wJc other oGtiibli:;lunonts Lnci how much Uwy Gnci their rolativec; hc.vo suffered from their inappropri.::.tc placement.

Before going r~ny furthm~it is worth looking at some trends in the medicolugu.l t;ti;.tw:; of our admissiowJ.. t•i.y next d'i<:tgr'wn shows hoH wlminsi ons under Section 60 of the 195') r.lentr,l llenlth Act, Hith a restriction on discharge, not; almost inv&l'iubly ;,i thout limit of time 1 hits become the norm - last year sixty-seven percent of our admiHuionu cume in under these provisions. NoH ho,;ever much MIND objects to an indefinite restriction order, there is no doubt thr"t many p<"tients have been rele&sed from llro&dmoor earlier than they 1·10ultl huve been Hi thout n restriction order because of the pol'ler of supervision and recall it provides. J::qually there is no doubt that lives have been saved by a tin)cly recall of patients Hhosc illnesses have relapsed or Hhoue propensities h.::1.ve ro-emQrgcd.

J,droission under !:Jection 71 of the ll.cntul :Health Act 1 noH superceded by the Cr-iminal P!'ocedurcs (Insanity) J,ct form a ci~;indling minority though of course once in a :Jpccial Hocpital detention, discharge and uubscquent uupcrvi~..>ion are the same r..s for p(_.tients Hi th a Section 65 restriction order ;,ithout limit of time. No;; because !:Jection 60 on its own givcc only it short liverl opportunity of supervising patients in the community after discharee, we do not like it c..nd ito usc iu also dHindling .. Transfer from conventional Nl!:3 hospitals under :3cction 26 of the J;ct has never been import<,nt numerically «nci also appe<,rn to be \vaning thoaeh I mwpcct that this reduction is somewhat artificial. flhat I think is hapi'ening is that turbulent p<Ctients urc being charged for the arson they commit, for the as::-;wul ts they m~ke on fellov: pc:~tients and of couroe for their assaults on nw·oing staff <mel then they come to uo convicted unrlcr !Jccticn 60/65.· ~Nen before this redttcticn, the total of ~ection 26 admissions did not reflect the number of putientu in cont11ct 11i th the psychiatric services at the time of their offences. As 11i th :micide :;o 11ith homicide and other forms of serious violence - the maJority of our pctients hz.ve had contact Hi th the psychiatric services at vr:tryint; timeo before the final tragedy which opens the gntes of Droiidmoor for them.

j

'Ph ere have been moce important chungcu in the nwnberG of patients admitted under ~cction 72 i'l'Om prisonD Hi th a. reduction from ahou.t tHonty-·Gix a year ll)J to 1971 to only four in 1')76 ;.nd t•even in 197'/. 1'hcre h&u, at 13rou.dmoor ut le~.:Jt 1 been u H<.dting li:...;t, intermittently clo~;ed, and one hus lw<.t~:d that doctor~; in tlJc Prit3on J.ledic<:J.l Jervicc Hl'C no lont;er even tryi nu; to /',Ct the i c pat i cntu on to it. !lccaw3c of the 11ait i ng list 11e have h~~d to mlmit po..tients vcr.v neL~.r the end of their scnteuces, a procedure 11hich quite richtly ucenw to them to be '' form of double jeopardy ami Hhich lead:J to a quite poisonous rclation;:;hip Let;veen stilff and patient which may last for yeers. lt has been said thht mentally ill patients in prisoq arc not br<dly plhced - they ure ufter all uccurc and mcdic2.tion i0 av<.~iluble,.

'!'his hm;evcr i:; not ''11 that is today expected for the mentally ill and I can only deplore the reduction of these r.dmiDuionu.

I have been unable to obtain a complete run of the Mental Categories our pttticnt:~ bave been r).dmi tted w1dcr and c:.tn only s<.-.y that as far as I can tell about sevonty-five percent of our patients have come in under the rubric :.ientc.l Illne>m and the remaininG h1cnty-five percent under Psychop<cthic Disorder 1 though in 1973, some sort of annus mirabilis, the psychopc. tl1s re,,clletl no 1 e~s than thirty-six percent.

I do not have a breakdo11n of CLtr patients' psychiatric diagnoses though you can take it thut Mcntcil Illne:Js ulmo::;t nhvays mei.-lns a schizophrenic illneur;, Nhich I tr~ke to include pHrhnoi<J.. .. h'e still have the occhsional pati.ent Hith an affect,.ive illnesu, thouc;h unless such patients have a strong schizophrenic or paranoid dement. they are not usually considered dangerous enough for Broadmoor, hnd \vo h<.<.vc 4 few pc.:.ticnts with organic illnecses~ PsychopBthic Disortlcr covers a Hhole range of personc1li ty diuordurs 11ith or without sexual deviation and includes a significant proportion, 11hich I ,;ould de;,rly like to enumerate properly 1 of patients whose nchi zophrenia has what one cu.n only CLlll u pseudo-pt>ychopathic onset o.nd is not diagnosublc until the pGychosis erupts often some years after admission ..

It is not my purpose to talk of' treatment here, Hhich is quite conventional, or of the hospitiel environment "hich has improved out of all recognition in Dr. McGrath's time, but it is pertit\cnt to point out that folloHing the opening of Park Lane llospi tal, ,.;e have D.t lust been able to do something to relieve the overcrmvding commented on by the Parli£,mentary Estimates Committee in 1)>66 and by the Butler Committee in 1975. '!'he seventy beds vacated when theBe patients Here transferred were to.ken down v..nd remain down. '!'he fourth diagrc;m shoNs that in the early 1960s there was a considerable reduction in the number of female patients in the hospital. '!'he standing population on 31st Dcccmoe1' 1 S:59 consinted of seven hundred and t;;elve males· reduced to six humlred and t>~enty-one on 31 December 1977. '!'he females fell over the same period from one hundred and seventy-three to one hundred &l.Jd t1;enty-four ccnd the total hospital population from eight hundred and eighty-five to seven hundred and forty-five.

We no11 come to patients le&ving Bro«dmoor or separations «s I suppose I should c«ll them. Bettveen 1876 and 1957 the pattern wc.s forty percent deaths, thirty-eight percent trund'el'S and ttventy-three percent discharges, the liAttcr including the minon ty tvho returned to prison. i•IY fifth diagram shoHs tt,c picture c.fter the 1959 ;,ct. Overall it is one of a riqlid increv.ue cd'ter 1760, some fairly 11ild fluctuations and then a plateC J'Cr ''nnum in the late 1960u and early 1970s leading to a more recent plunGe• This hctually occurred in 1974 but on this graph it i3 mac;ked by the thil'ty-fi ve patients 11ho 11ere transferred to Park

Lane Ho;spi tal in 1974 and .:tn oquu .. l cruup i·Jho left in the Game direction in the Collowint• JC'C:.r.. rrhe 1 tf/0 fi('rurc Hi";.S nJ.nety-three sephrations and . ' ~ " )

the 1977 one humtre<t und three - lov;cr than any year· o;incc 1~61.

rrhc overitll figuce of tJCpnrations hide~; .:~ variety of vm.ys of leaving ho;.;pi tiJ.l. You will remember ~IJL•t until the 1959 /let some forty percent of our D(;tients \-Jere allen-Jed to end the-11' duys in the ho:::;pital - discharged to cemetery is the way the old hospitv.l reci.uterr.; put it. '->ince 1960 the picture hns changed considerrd;ly.. Noh' only eight percent of our separations are caused by d cat hr. .... perhaps t~·lO or three ~juicideB a year r~nd the rest by natulY1l c<....uucs. 'Jlfw geriatrien \-'!ere the first to le&ve Brou.drnoor in the 1 )60s and now we hc.ve very fe\-I p<-~tients over sixty - quite unlike conventional pD.)'Chiatric houpitD.ls overt.:~l:on as they have been by the conntr,y 1 s dcmoe:eo.phic changes ..

Another six percent of ouP patients ,,re rep;;tri&ted. This is frequently a time consumin{!. bu0ine::>s but juutified. if a p~-..tient is soci&lly iDolatcd here and ht~s rcl<.tives .i.n his Oi>lll country Nhich muut havo an t.dequate psychiL tri-c r.;ervi co or r~.q)a trii..~·Li on is not conuidered.

Only three percent of our p<•tientu r'eturn to prison. There is oome point in retul~ning a man with a pcrL>onalit,y disorder \·lho has h<;!d D. bout of depression or a brief psychotic epiBode if he is serving a long uentence but the schizophrenics ["dmi ttcd uncler 0cction 72 we usually rdain until they ar-e Gtablo or mc.lfftge;cblc onont;h for,,·, conventional NH~ honpitr,l.

In the last eighteen yours about ten percent of our patients have been tran~ferred to the other ~pecii:il Hca;pi tuls 1 the tr;dfic bei.nt:: from us to them rather thDn vice versa. rllhe p~tientc \vho have gone have, in the main, been burnt out schizophrenics sol acted because they have been considered not to require Dro&dmoor's level of security and to be likely to benefit from being nearer tbeir horne cc=.tchment area hoopi tals and their relatives. IJ.1heue forry1 a group Hhose subsequent progress we know little about though Dr. Neville of Park Lane IlospitEll has discharged a significant proportion of the patients we cent him in 19'/4 and 5.

Deathn 1 rcpatriution>S 1 returns to prison and tpansfeps to other ~pccial l!ospi tuls together mGke up &bout tv;enty-scven percent of our neparations and moot do not pouc problems to us connected Hith their ceturn to the

·community and nubscqucnt violence.

I have found that pec;ple visiting Jlroadmoor are usually under the impression that most of the patients ;;ho leave c.re discharged to the community, This is not so. From 1960 to 1977 dillcharges made up twenty-three percent of our separations. Uf these two-thirdu \'/ere conditional discharges undep the provisions of :>ec.ti.on 65 of the J,ct und one-third had no conditions attached to their discharge. l·iy sixth diagram shows these dischccrges since 1960. 'rhere is no ptcrticular trend &mi the 19T/ fit::ures ure up on 1976- from twenty-four tC< twenty-nine, These figures need to be compared >~ith those before the Act which were as many as seventeen a ycLr in the quinqueri.niwn 1948 to 52 and about twelve a yec.r between the wurs. As 1;e have rather few patients detained under ~octions 26 or Go there is less scope for the Mental He;,l th Revic11 Tribunal to diuchurge po.tients than at the other ~peci<:.l Hospi kls. 1'ribunEtls in focct only discharged forty-two patients between 1 y60 and 1977 or c. bout two a yeE.r.

lfho most irnporthnt component of our ucpLi.rv.ti ons comprises thocc tranGferred to conventional, as oppo8cd to ~pecialt hospituls. These come to almoot exactly fifty percent of our sop<.il'a.tions. My seventh diC<grwn shoHB hoi'! this modo of ::;,.)p<::.rc.~tion Jn,s f;;.r~od and you will sec tho by no;; familiar rise in the 1960", a some;,hat bumpy plateau, follm-1ed by u recent fall. 'l'he maximum number wa:.; ninct,y-one in 1964 but this fell awny to forty-four in 1976 r.nd forty-six in 1977. This reduction i.n the number· of pr~tients trG.nufcrrcd to convotJtional poychiatric ho:.>pi tals accounts for ullllost al.l of the decline in tlw numbers of patients leaving tho hospitr.I &8 you can soc in my eighth Glide.

You "re no doubt much better mwre than I am of the pressures on conventional houpittds and their conuultv..ntB v:hich lflilit<-lte ag[.inst the r~cceptancc of our paticntc. It is nm1 fashion&ble to believe that the mentally ill can do no Hron[~ nnd ccluue no harm &.nd that· therefor(! a patcrn~··listic approach to them in ttlljtWtifietl. Not only huve ~ocked dooru gone bttt so it gecms has tho close olJoervr~tion of r,atients Hhich iu the only real Hhy

of predicting &nd forenttclling impulsive beh<.viour. ~iithout the long stop of the closed ward people ~re lcsu and less inclined to ~tand up close to the wicket to receive the more erratic p.:~tientuo Sectorisation has meant that hospi thls c.:~n noH no longer staff intensive care units and District General Hospitals nrc in practise, if not in theory, unr"ble to accept either potentially disruptive or lon;; term cases. fie no~; h"ve the problem of poli tic&,l ucti vist~ Hho <-:.ro prep~rcd to dinrupt or t<::kc ovm::~

the mantcgement of our hospitals- for those of you unfumiliar with the local geogrLphy I 11ould''point out that the Peoples Republic of :Jouth Brookuood is but a feiv miles from here along the !lagshot-Cuildford Hoad. LE:Bt but by no mec~nu lettst vw have the objective dangero posed by our ex-patients.

lvhut are these dangers? Here, taken from a paper by Steadman and Cocozza which ;,as Hri tton in 1775 and seeks to play dmvn tho dangerousness of the mentally ill is a quotation - or I sur;pect in p«rts a misquotation -from Dr. McOruth himself:

"In 1968 P. 0. lt.cGrath reported the results of his study of two hundred and ninety-three murderers .who were released from Broadmoor Hospital in Bngl<:nd. Not one killed again. He got in touch 11i th l·icGr"th four years later, and by that time only one had killed acuin .. Jtloroovcr, sv.id_ Dr. j:;cGr<.dh, in the past fifty yc<:crs about one hunured and forty patients >tel'e released each year from Broadmoor and. only two had been convicted of murder since release''.

Can one say the same today?

The ans1-1er, alas, is no. It is true however that bet<~een 1960 and the end of 1977 only three patients admitted follcming homicide huve been convicted of homicide ufter leuvinc Jlroc:dmoor - surprisingly t<~o of j;hese were women. 0UJ' record for patients admitted follo;,ing other offences is perhaps less good but a sense of proportion needs to be kept. DetHcen 1960 and the end of 1977 one thottshnd eight hundred and forty patients had loft Broadmoor either transfecred to conventional hospit,.ls, disch"-rged to the corrununi ty or returned to prison. ~'hreo of these were the homicides who repeated and fifteen,· admitted after lesser offences, conuni tted homicide after leaving llro"tlmoor. It is interesting, though of doubtful significance, tllat only four of these repouters received ~ psychiatric di~gnosi~ of psychosis, three \>Jere reputedly depreusi ves i-.:.nd the rest· psychopt..tha.

The diff'ict1lti.es he1·e lie in the probccblc chc,ngcs of our diagnos-tic habits Hhich mnkc cornpa.rinonu of such c.:....::;cG difficult over a "t\·Jcnty yeD.r poriodo Of these cic;htecn p;.:.ticnta only Gix were trt:.m.;f'erred from Bro.:~dmoor to o'the:r ho:.;p~ t<tl:J, four vwnt lJnck to pl~ison and eight were discharged in variouu \·:a,yu. rrhin at;ain does not reflect our Ltsual pattern but probr:..bly doe}.; reflect the preponderance of non-p:.;ychotic patientD in thin particular r,roup.

1l1hus nine-ty-nine percent of those Hho let.~vc Broaclmoor do not kill anyone thereafter- ..... or pe1•ho.ps I choulU :;q,y have not done BO yot. fJ.1his CDVCht

is nece;;;ut..x·y for three re::.r;on0 fir~t the population of ou1~ ex-po.ticnts is being Hd.ded. to year by yer:..r- 1 um sure dc.:1ths are not yet in equilibrium with onr ~wpar;:~tionu - second, the pattern of the timing of thcue rcpei:..:.t homicide~ is a curioun one, \Vith about half occur-ring Hithin tHo yectPG after lec..:v:i.ne the hospithl n.nd the romt~indcc strung out up to tHelve ye(..;,rs hfter lccving. In pt.renthenis hero it is of Gomc intcrc~:.>t thut a recent aclJBiooion suffering from doltwion<tl JCillouey H8.i ted thir·ty years before ki lli nr, hio 1·1ifo 'o imc,p nary lover' all of 1·1hich time he Hils an unobtrusive member of the> <;;omrnuni ty of a conventional ps,ychic,tric hoopi tul.

The third reason for my caveat rolc,tes to tho care patient,; receive after they leave us. Unti 1 noH such cure h{:UJ beo n cxcoll cnt.. \'ic have rccci ved magnificent co-·opc:r;;..:.t:i.on from consultants P.nU supc.~rvising officer::;.. \Yhn.t worries me though is that the nd1nini~trativc pressure to ''rot1~bilitute'' pr,ticnts at «ll costs and .JJC'ttle thorn in the community come Vlha·o may could be too much for patients Hhos0 rcv..l need is ·for peo..cef'u.l stressfree asylum aw.u.y from rclo:tivef3 and others who muy reactivate their delusional processes.. I·t is becoming difficult in some areas to find ps.vchiatric services Hhich Hill offer long ot<w beds and this trend is gathering force.

In terms of objective danger, therefore, out of one thousand tHo hundred and three transfers to ordinary hospitals there hilve been six repeat homicides or 0.5 percent over tho lust eighteen years. None of the victims were nurse::.; or doctor:.; ..

Hhat about violent behaviour let;ding to injury? Here I can onl,Y suy that our readmissions: uro riqing though only slowly as my lust diagrv.m shows .. I lookecl briefly at the 1)76 reLdmisoions cf 11hich there Here eir,hteen. Of these throe ~Yore proph:tlactic recc.ll:; of patients Hhose symptoms hcul relapced, three vwre admitted folloHinr, thr'ec.ts, three follo11ed t;r·son -none in a hospital set 'tine, one follo••ed the stabbing of a stranr,er in the street by a patient Hho had been refusing his medication as an outpatient, ono follo11ed an attack on a felloH patient ;~i'th an iron bar and four involved attr,cks on both patients and nur3es in conventional hospi tr,ls.

It is of course possible that some violence occurrine in hospital and rather more occurring in the community is not kno11n to us and that such events ure leading to imprisonment and the diversion of our ex-p~·,tients out of the hospi t<•l system ul tor,ether. ~'his certainly occurs Hi th so1ne patients 11i th personality disorders but I uuspect Hi th fe>~er of the mentally ill. I do not hoHever think th,,t violence not knoHn to us is of great uie;nificance - it has not chovm up in ouch formal folloH up studies as h<.<vc been done, und I can only conclude that by and lrH'ge our ex-pe>tients are a remarkably sd'e collection of people e::;pecially Hhen it i:J remembered thu.t before admission they have to be considered to have dangerous and violent propensiti.es. For the }>OpulC<tion '"' a Hhole the riuk or being

killed b;r <m ex-!Jroadmoor pa-tient in ubout one fifth of that of being killed by lightning.

I do not therefore think th<"t there is any rc&l reason why the nwnbor of pntientr; th,nsl'crrcci to conventional psychiatric hospitals should not return to the level of the early 1 '/lOs •

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+ A F'IVE-YEAH li'OLL0\'1-UJ' STUDY OF 1.\ALE PA~'HWrS

DISCHAHG1'D l"ROM JlHOADMOOH HOSPITAL

by

D. A. Bla<'..k Consul tnnt Cl inica1 Psychologist

IJ:roadmoor llospi:tal Crowthorne, Berko

..

+ This is an editocl transcript of a spoken, paper pres en ted to the l<A1'0 Advanced Study Inntituto on "Computer-Assiutod Decision Making in Parole", Cambridge, July 1976. With amendments for chango of context the same paper was presented to the annual conference of the British Poychological Society, I<:x:eter, April 1977 and several other professional meetings, A full l'eport of' tho· research, with appendices of data relationehipa, is now in druf't und will be available in due couroo.

This research was completed as a result of a Cropwood Follovmhip at tho Institute of Criminology, Univol'Sity of Cambridge 1 September 1975- January 1976, tho fucil.i.tioo for whl.ch uro gratefully' uclmowlodged by tho author. G1•atitude i8 alrJo exprorwod to Roscmm•y Steadman-,Allon for pNparation of tho trannoript and clraft; to S!!HU for obklining umch of the follow-up j.nformation I to clerical staff of tho Depw· tment of Paycholot,'Y, Tiroadmoor, for painstaking searehing and collating of the o6ginal data; to Dr D.P. l'arrinr;ton aml MisH M, Guy and colloaguos ut the Insti tuto of Criminology for theil• holp with planning and data pl'oparation; and to tho DHSS and the management of Droadwoor Hospital for affording both faciliho:J to carry out tho 'renearch and s-ttuly leave to analyse the rosulta. At the same time J.t must be pointed out that opinionu oxpreosod and conclusions drawn must riot be attributed to these bodies or persons hut ar·e the sole responsibility of the author •

..

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Broad moor is onu oJ' f:i.vo Special l:lm;p:i. tal:J in G-reat Hr:i. ·tain which nccep ts mentally disordered offenders. 1l'ho so aro mainly sent from thr. courtn on n ho.<;pital order, h.:tving co! .... :. Llnd ~ d-.n'lr;r;routJ offGnce frotn which it is ttocrnctl tho public needs protoot:i.on, but wlJ(J are also presenting somo paychi,ttric di:Jordor which noods treatment.. Such horJpital orders aro in effect 1 indotorrainato sentencHti' :in that patients remain in hospital until they are thoucht to be f':l t to go, at which timo they arc rocommondod (or di sch,_Lf'(JJ. rrho BronU.moor d:i.scbnrgc process :is thus sic1ilar to a p<Irolc docision-·wn.ldng s:L tuz-\.tion in that a prechction has to be rnctde as to whether thCl individual in fit to r<,ttrm to tho con.munity without no1wtitutin;r, a clangor to thac conunw1ity.. In tho context of 11 computer-asg:i.stod-dccision-m~J..kine; 11 ,

th:i.:J :Lt3 very much a p:r·clirninary oxorciso., What I am prt;senting in tho contoxt of' thin wonk's confm·onco is a kind of' case study which you m:i.[)ht like to consido_r and t1iscuss becau::le tho s tag0 at which it ond.s is the uta{)e at which the otn.tisticiuns among you might bo able to S"-Y "And now you need to do such--and-such to cot soma prcclictivo index".

The study I shall no11 describe grevr naturally out of p:1,ychological work dono in tho clinical situation at ;)roaclmoor. Since 1960, there has .. bGon developed a psychological service for tho hospital comprising the usual roles of nsnessmont, trnatmont and research .. Until 19GI., thoro woro no psycholoc:lf>ts other than n\Ysolf employed in the hospital ancl the clinical service had, therefore, to be enti:coly assessment whilst research capitalised on assessments by rolat:Lng findings to the collection of clomo~_,raphic (lata, id.on tifying the so cia!!., psyohologicr~,l ruid psychia-tric chaructoristics of the various offender groups within the patient populatio;1, By 1970 when there wer'e two of us and a trainee, plus a clerical officer, we had com!Jle ted a number of descriptive and tyvlogicctl studios and hacl i\trther collected a c· 3rt/tin amount of follow-up data on people who had left the hospital in tho period 1960-1965. i"fhilo this f'oJJ.ov1-up data was gradually being collated, ther•o occurred several incidents of dischare;ecl Broadmoor patients co1mn:Ltting further rather sensational offences and it was at the conclusion of the trial of one of' these - Graham Young in 1972 - that tho Government announced the setting up of the Aarvold Committee ( 197 3 )Jo:<ancLne ilischarge and after care procedures and the 'Butler' Conmi:i.ttec (19'1')) to review the lavr governing men tally abnormA.l offenders, These events maclo it seam imperative to hurry up the YIOJ.'k on this discharge study so as to iliscover, if possj.ble, what was tm degree of success or failure of our discharging process and \\nether My features could be identified in the groups which JILi.ght increase the efficiency of tho process in tho future. The problem .of incroased re-offend:ing arose, I think, from tm changes which followed the implcmen tation of tho 1959 Mental Health Act in November 1960. Prom that date anrl for reasons I will not discuss noVI, the a1mual admissions dramatically increased which meant, of course, that, since tho hospital.' s resources were limited, an equivalent number were discharged, FortW1£ltely the Mental Health Act enabled many patients to go by a.. route hi thorto not possible nama: via a local psychiatric hospital. Tho increase in discharges was largely acconunoclated in this way. Figure 1 in the Apprond:i.x shows this rise in admis,Jions ancl dicharges through the periocl oi' the sixties. 'l'hen in the seventies, tho position was reversocl and the controlling factor was the fall in discharges following tho several dramatic cases which had caused public ooncern, Extra precautions wore instituted and thoro was increased reluctance by other hospitals to receive our patients on transfer. 'fhis brour;ht about tho drop in the admission rate shown in Jt':igure 1 becuaso, as those who J.ivo in this country know, Broarlmoor is ovor crowded and

could not mu.intaiu its increased int~Uco once diBcharees had been cut back. It theroforo, boc:a"'o extcomoly important to look at dic;chargc criteria ..

My scw>plo comprised all tho 12(3 male patio nts dis charged during tho pod.ou 1960-65. Jlroaclmoor harl a populhtion t\;c,,, of about t'.';-0 patients, * some <r;o mun and ~tbout 120 l'lornen. \'lo cho'w to study the men fin;t ::.;imply bec~•use there l.L.ro mure of them and th~:.v constitute a l<1.rgor swq;l(-: for de1•iving meaningful stnti~>t:i.cs. Pationta are disch~:t.rced by a number of' nwthodn aril I have boon looking only at tho::w dischargoc_l diroctly to the community which, du:ring tlh1 whole of tho sixties, a~~ you can see frolll Pi[;Uro 2 in the Ap1x:ndix was a fifth of all thoso who left: 21.-7 or 2J~o As Figure 2 :.tl})o ghows, the majority hnvo 1oft by traw;f'er to other hospitals in Enc.lanil and VI ales. A small proportion 11ro returned to their counL·y oi' m·j.gin (we have quito a largo number of imnii.grants) ~ Somo go back to prinon (but only those who were transferroil to us from prison in the first place). 0 Lhors are trn.nafurrcd to other Special Iiospi tG.ls and a f'ew, of' course, d.io in hospital.

Ini t:i.ally I selected thi.s ccrr.muni ty di schargo group for my sample becaur.o these,- are the only ones for whieh post clischarge superviDion wrw arranged di r<Jctly f1·om llrow:l.moor. ,J,l.l. the remainder becowo tho rcsponsibil:lty of' another authority ancl Vldre thought likely to be moPe difficult to follow up. J.ly sample is, i;horcf'ore, a fifth/quarter of' nll those who lef't hospital durinr; the 1960-G~) period and roughly half of' u11 those who WCJ;C condi t:Lonally di~chargocl during the whole of' tho sixties. '!'hey wore followed up for five years, that is to say we recoruud inf'ormati.on about them for the five yem·s after tho yac,r in which they WGre discharged ..

The follow-up infonnation was derivlJd from throe sources:

i our ovm hospital records ii ~>'i.fiHJ, recorcls kept by the Special Hospitals

Hesearch Unit iii Tho Mental Health Register

I would like to express grnti tude to those two latter services for tho inf'orrnation they provided, You nny think thi>1 a somtoiYhat sparse data collection. All we hn.vo really looked at is: did those pooplo 'survive' 7 Did they gtzy in tho commun:lty f'or thoHe next five years or were they re-admitted to the same or 1111othnr psychi~ttric hospital? Did they commit fm·thbr offences? ·The cri tcrion adopted is virtually 11no nerts is good ne\'13 11

• If wo don't hc[t.r of them a. gain, then vto o.ssume they are 'surviving'. This nY\y seem a crude and simplistic ori terion but in tho context of' an almost complete dearth of follow-up information on the llroadmoor type of population, this constitrtc>u quite a sit,>nificant and useful advance in our knowledge and rms about as much as a small department could achieve in a limited time and when providing a clinical servico 1'/Los oul' principal 'raison d'etro', 'J:able 1 summarises this • doscriPtion of 'the sample and providos oomo further defining information about tho group,

·:f 'fho population is now down to some 700 (560 man, 120 women) duo wainly to the opening of the Park Lane Hospital udv'"ncecl unit a!l(l robuildine; wo:rk at Broadmoor.

(

number Di:.:c:htlTfJl!d ( Ma1o~1 on) y) Vur:i.ng Period Followed-up for By moww of

Average Age on Admission on di a chn.rgo

AvcrD.t.!fJ lC;ngth of Stay \'lith Previo•.<:r Con vic iions

liosp Hal AclnrLsnions Brott.dmoo1.~ Adrnisni onn

+ 1 Hr.mp ton

128 1960...65 5 YBt1t'S

Hospital roconls Crinri.nal rc:1cords !.!on tal Ho,d.th l1egis tor 34.07 years h1 • 51e yOC.l'S

7.lt8 years n (Gcr;,) 6 3 (!.970 1 3 ( 11 )6)

Seventy sovon (6CY/o) hr.d previous convictions; 63 (nearly 50%) had previous hospital admissions; ·13 ho.d proviou:>ly boen in Broadmoo:c an cl 1 had Jloo n to Ramp ton~ :l'ho cl:Lngnos tic groupings m'O lis ted ,in Table 2 ctml show about a quurtor to have been schizophrenic, ~L third some sort of' affective diso1•dor, whilst tho largest group (1,250) wore psychopathic. A few woro organic or subnor·mal but usually res a ncc_Ondnry diagnoa i!3. A socond or third diagnosis occurred quite often hence the total of 14 7 diao1oscs for tho "'swnplo of 128.

TABLE 2

Schizophrenic Group Affective Disonlers Psychopathic or similar Organic Subnormal

Total

33 (26%l 41 (32'/o 54 (h?.% 14. (11%)

,_} __ (!.,fti__ 14.7 for 128 men

It should be said here that Table 2 is n·ot representative of the diar;nostic groupings either amongst incoming paticn ts or those l'Csiclent in the hospital at any given date. The discharge process is, of course, so lee tive. For example, the hospital population on the 1 Januaty 1970 was 56% schizophrenic whilst in my dischnrgo sample only 26;;, i.u. less than half as many. By contrcst, there • is a greater proportion of psychopaths - 1,2;-:; as against only 25~~ of the resident hospital population. Again, affective disorders are G~& of the resident population but are m~ny more in this eli scharge awnple at 32)·~. '£ho .sample is not, therefore, representative of the hospital population as it was in 1970 and any results should, therefore, bo tn.ken as referring to this sample only and not as any inclication of how an equivalent number of new ~ccl.missions or residents would fare if unsel.ecti voly dis chi1rgod at soma lntor dato.

(

Table .3 shm•r3 tho offences for which those !11Cn were originaLly admitted, juut unclor hulf of tht.1 ;;.amplo bo:i.ni.~ homieillo:). i;.ll othiJl'" -:'ffunces of violence ttguinst the person, at 35, represent ,just ovcl' rt quarter of' tho :..;:.:unpluG 'l'he mn.jo.ri ty of property uffon<JOr!J were ncquisi ti ve, whereas only 5~~ wore da~ti·:~ .. r;e ~ of theso, u oat were ;u·son unU the others 1 malicious damage 1

• SexurJ..-1 offend ora constitute a very L'.Jnall group <..;..nd clcur1y nrc selected fox· dinchareo with very e;roat caution, although it should be point~nd out that they rcprecent only about 7~-~ of all o..d:nis::d.on[J anyway ..

Olt1J!,EN Cl~S --·-----~-~~

Homicide (l!iur<ler and ll.anslaur,htcr)

Other offences against tho person .. l'l.'operty offences -

Dawagv ( ii1cl, Arson) Acq uisiti VG

Sexual offences

.YLfi_'!'fJ•1S.

Wii'e (partnw etc) Oth8r family or known Casual or stranger

62

33

6 23 4

32)76 44) 20

(1,.8%)

(26%)

( 5%) ( 18%) ( 3%)

Again, tho distribution of offences in my sample is not roprescntntive of either new admissions t>J: tho resident population, Figure 3 in the Appendix, for instance, shows mO>.let\\dmissions between 1963 und 1970 to have averaged 201~ homicides whiht)f:osident population contained 33% in 1970 and again when sampled in 1976.

).

\,

ou·w::m.J: DA'Nt ~ ""---~--- .•. ~ __..,.

11\'··om Cho tbr-eo nouroes oi.~ information - our orm roconla, criminal :~·ccords P.ml tho Dl!S~; montaJ. h:~nlth index - \H) r:erv ah1o to D.!J!}C!Jhlc

thH set oi' thirteen meanur-~· s lis ted in Ttlblo Lt.... 'l'hose defino dilforc,Jt aspects of' tho two ~c.ind:J o£' uha.t I !1ave called 11 fu.il 11

cvcnt~l, viz psych iatric re-ad:rLi. ::;si ons and i\t::·th 1-::e '1 f'l"cncc s and they subdivide as follons: t"'e--~dmissionn to Bro.:::.dmoor and ro-n.dmi~::.d.ons

·~o othcx· psychiatric hospi t.:1.ls; nnd oi'fei·wcu nhich on tail n. court D.ppct-tr~tnco as again:1 t those 11hich renul t in imprisonmc nt. ~.rhus wo havo a rou~~h cl:~ssif'ic,'J.tion or der;r>r:ws oi' severity of 'failure 1

..

Subsequent Psychiatric Rc-adrnissionn Subsequent llroadmoor Re-admissions Subscquont C<lur·t Appearances Subsequent Imprisonments

Time until l'irst Psychiatric Re-admission Time until l"irst Court AppBarancc Time until .l.''irst Imprisonment

Time spent in Psychiatric Hospital Timo spent in Broadrnoor again 'i'imc spent in Prison 1l1ime spent in Community

Subsequent Death (incl. Suicid~) or Survival

Types of Subsequent Offence

V/o aro able to look simply at tho incidence of these fail events, or at other aspects such as tho length of time that elaps8s before a fail event acout?a and illw prutiorl oiJ :t:i.m11 Dor which n failure. ltwts, 'fhaso may provide other aspects of severity or degree of failUll3. Another important aspect of f'ailuro will be the kind of offoncu committed by those who reoff'cnd (remembering that the majority of tha sample wore originally admitted for a 30l'ious or violent personal offence). Finally it was possible often to loam of the death of a discharged. patient, sometimes by suicide, and this seemed a variable wonbh examining. By contrast, a measure of' success \'las 'available (apart from simply rccordins 'nil failures')

•

in tertns of tho proportion of' the 5 year follow up period spont at liberty in the conu~unity (although it is to be notorl that those who incur:red Court approanccs which resulted in fine, probation or discht.•rgo might often record a 1 00:% 1 scoro 1 on peri<Yl spent. in com.11wri ty whilst also recording one or more othnl" sortn of 'fail' event),

CRT'J'ElliON DA'J'A .._..,~-- ~-·----=-----

Variable:.\ that 1'1() ha<l readily available f'x·om hospital l'oGordn w1d tho Psycho1or;y Jiopa rtmunt. 1 s rueorJs a1'H Lin ted in To..b1e 5 o.nd it itl these which wore set ngaj.nst the outcome data first to provide inforrr.ntion as to which pat:icn t grotlp~3 ach:icvod s1..1:~coss o:r f'ailuro and secondly, us a rosult, to provide possible predictors of suc~1 succosB or f'ailuro.

' I

TABI;!.J._l:l

9JIT.11Plli.Q!i~'[/~I~~~g~.~l.Jl~Jg·~i_:l!~ \l'os si ble Pl•edic tors)

Year of Discharge '"Age on Adrniss:ion ... Ago on Discharge Len~;th of stay in llroaclnwor

Diagnosin - Schizorthron±c Group Af'f'flcti vo Dis order Pnychopathic or similar

"'0 r gnn :L c Subnormal

Mcntalllenlth Act (1959) Clns:;ifiNtion - Mental Illness - Psychopathic Disorder

Discharge infonnntion - l'onn (conditional or absolute) - Initiator ('1esponsible Medical

Officer or Menttcl Health Rcviow 'fribunal)

- Placo (Private residence in the community, or hostel)

Original Admission

Previous History

Social Background

- Offence Form ( 'Sentence' ) ic section of Mental Health Act un<lor which committed to Br011dmoor

- Number of Convictions - Number oi' Psychiatric Admissions - Number. of Special Hospital admissions

previously

- Education - Occupation - !.lnritcl Status

• Relationship of Victim

(

f_; ~-~LTr~lifQ_~t- vliJ~L~u~~~~?.. ..<I;:~ y gJ!n.I):Qi~T:-cl~) . \l'o:>si!JJ.u Prodictor~>

I.Q' s Wechsler - Verbal - Porfor11Wnco - l'ulJ. Scale

··1nvon's P:cogJ.'n~.Jsivo MaLricos ~.lLU JU.ll Vocabulary

+ Computed Discrep.:1ncy Measure.:~ associated with impairod functioning:-

Ylvehslor V > P J.1atriccs < Mill lliU

MJ,JPI ("Minncnota Multiph,1,Jic Pcesonality Inventory") •· seloc ted sealon c-1~ meastu~e:.J i'rom this c1in:Lcal/ personality que::.: Lionn,·_U.r-o

Vall.rlity Scales J', K, L, Dn Clinical Scales D, Pil, Mf, Pa, So, Ma Factor Scales Ii'oulUs & Caine

Portctb Maze Test

A, Jl, Ex, Im 'l'otal Has ti1i ty DL·cdion of Hostility

Quanti tat:Lvo Attatnmont ("Test Age") Qu<~.itativo Errors (1Q mot1sures) ("Q Score") - recorded ,:u; a c;ross total (as p<er manual)

and as a moasuro reln.tod to distance traced

Psychological Report Proenosis

Table 5(a) comprises a broad range ot: social factors, information about tho committal and oric;inal of'fonco, previous history and, of courso, in!' ormation about the dischnri:~e procoss. Diagnoses, an also listed in 'l'able 2, subcli vicled most conveniently into f'tva nl:tin groups. 1'ho ron~ctnder of the criterion Ol' possible predictor vr.:.riablos aro listed in ~~,abJ.o 5 (b) .:md comprise various psychological tcwt information. I apologise to those who don't holcl with suoh tosts, but clinic1il paychology was vary dif'forent in the Cftrly 1960's. (In any Cftso, with such a small clcpart!llent there Y>ilBlittlo time available for any more.) So there is a range of IQ information from tho Wechsler Scccle ancl from two Brit:Lsh mea,Jures, the Havens Progressive Mcctrices ancl tlr Mill Hill Vocabulary, from which the computer was prograrn.110d to calculftte the discrepancies be two en certain scores. indicative of impairment and henco usually indicative also of the typo and extent of' disorder which the patient may be presenting. The MMPI was then, as now, quite" populur questionnaire with many people and widely used both in lldtccin ancl the USA. It is particularly convenient because it can be answered by the p1.1tient at his leisure and a great doal of information can bo derivocl from it. 1'ho sciuos seloctod ('l'uble 5) wore those that have ei thor proved to be uneful in the cUnical work nnd previous rosollrch at llroadmoor (Blackburn 1968) or olse seemed relevant to the discharge nuccess or failure problem. I would draw particular attention to those scales that wo have used ru1d which aro not in tllo stanclard display. Tho standard cli.nicn:L

(

(

scn1on l'oally nrc not very satisfactory as they nr·e not factoriully pure and they mix 0ymptoms nnd per~•on2lity vnrihbltJ-5. 'l'his is ~·1hy only a sclect:i.on rnthur than U10 whole clinical proi'ilo was included in the: ;;tully. llv 1970 we hncl n groat d~al or inf'orm:~tion from Bluckbm:·n 1 s work- as to Hhich sc::LLe~J \'/OJ~e redundant and which {Wemed roar;onn.bly indcpon.<.lunt and ro1cvant to our popula .. tion. 'l'o thnse havo boon acldcd various fac-tot~n s<;a.lHs: an a.nx:ioty monsuro (A) Cilolsh 19)6 ) which i:J a good measure of the f:i.rst (emotionality) ... 'actor from Ud.0 tent; a r\·!pl'e3aion mca.sure (H) (\'fel~;h 1956) which is a good t;·;,:,.:u:Jure of the socond (:Lntl_"'ovor·:-:1ion-·<Yx:trover·sion) factor, and Extr<cvorsion (Giudt &Dmming ·J961) c.nd Impulsivity (l3lackburnl971b) scales which are very relevant to our· population, particularly in viovt of' thl: x·o:;enl'Ch dono by ~omu other m.r:mborG of tho dcpar-Luh:nt, for iu5tunce DlacklJurn' s ( l9'(1a ) work on perrionn.li ty typolot~ies. Also from the MJ.IPI wo used two scoro'l fx•om tho Foulds and Cnino (1960) HoBtili.ty f;calos. 11hdn there was tho Porteus Maze ~eosto rrhe ability to solve nHzos is associated. with intdligunco, but specifically with tho ability to plan Mil use for8si;;ht. It also yields qtucli tativo measures of motor control. Finally, I included the opinion on outlook oxvrosnod in tho psychological report m:lde prior to the prttiont leu vine;.

~

I wrmt to look fh·st at nhat actually happened to tho sample after they left, before looking at il1e rcelat:i.onships between outcome ;md the possible prodictors. You will sec t.ho sample clid rath&r better than does most offender populations. Figure 1, in th.) Appendix shows tho nuliJbor of fail events that occurred in the five yoac follow-up period. 'l'wo or' thG sample could not bo trrwod and one returned to the West Indies during tho: five year follow-up period, so tlus n.ncl several ensuing figures nre based on the 125 for whom the information was cor.:plcto. 101 hnd no re-admission to any psychiatric hospital, Broa<lmoor or otherwise, 97 had no imprisonments and 76 bEHl no further court tcppoarances. 1'ho remainder of the ernph shows tl1e numbers of mon who incurred ·1, 2, 3, 4 and 5 or more of those events. For oxwnplo, 5 had five or moro court appearances, whil.st only 1 had five or more psychiatric ro-8.dmissions. ('rhis patient was an alcoholic and in fact hail 11t furth,;r psychiatric admissions in the 5 year periocl,

Lookinr; at hmv long thoy lasted boforo a fail ovent occurred, Figure 5 in the Appendix shows whether tho ficst f'ai1 event occurred in the first year, second, third, fourth or fifth nnd indicates that tho tendency for any kind of' psychiatric ru-[<tlrrd.ssion to occur i11 ,;im:Llar to what hns been observed elsewhere with roconvictions ie is most frequently in tho first year.

Court appearances, of course, tend to happen enrlier than imprisomflcnt which may nof happen if at all, until several court appearances resulting in conditional discharge, probation or· fino, Figure 6 in tho Appendix shown how long the sample spent in all the possible situations, both 'fail' and 'succeed', ie psychiah·ic hospita1H, in Broaclmoor, in prison or in the community.

(

Exactly ha.lf tho pupul<ttion (61,.) did, in fact, spend tho entire five yeurs out in tho cor~ammity. 'l1en of' tho::w had court appearancGs durint~ that tiu1o so wo r.unnot :coga.rd this as a rwrt of glolJal t succossf'ailure' moasure. Nove:ct.hclcss, at Joast they woro neither f30 ill nc·r so danc;erous n.s to require removal from tho c:ommunit.y so, in tonns of hr•oudmoor 1 s 'raison tl'otre',. this rr.ov..sut·c ia probably as good. an ovornll measure of suecous a~J we 0httll find~

1'he outoowo events shown in Fic,uros Jh 5 and 6 are sununarisocl in 1'hble 6.

~'fJ3LE 6 OUTC01!:E S\r.~:1£\...'If.

Subsequent Psychiatric Admissions ) )Both

Subsequent 13roadmoor Ho~·w:lmissions Subsequent Court appearances Subnoquent Imprisonment , Remai.ncd :in the Community for tho entir c 5 years Conun.i ttt:::d l<1urther li.:::osaul t::> (No homicides in tlu 5 yoxr follow-up but 2 ..

YES J:JQ

61,. 13

lator)

1 01 - l.l9 ( Nd the r)

101 76 97

61 1 I 2

From this it may bo soon that 21, patients hatl further psychiatric admissions whilst 24 wGre re-admitted to Broaclmoor. 'l'hese are not the same 2~. patients in both cases of course. 36 in fact, subsequently had both Broadmoor re-adm:i.ssions and psychiatric adritlnsions. elsewhere .• Fifty had subsequent court appearances, ·76 did not. The outcome event of "conunitted further assaults" which is listed in this sullllllary table when it has not been detailed elsewhere allows me to comment further on tho criterion of success or failure in the Broadmoor context touched upon in the prcviow; paracraph in connection with figure 6. 'l'he general opinion at llroadr.mor is that, since we accopt daneerous, violent offenders who have comllti tted erievous assaults, including sexual offences and homicide, then e. rclati voly 1ninor re.:orfence such as tnking-anddriving-mmy (TilDA), stealing or breaking and entering, cannot be put into the same 'failure' category. It llk~Y even be classifiable as a success in so far as the new offence is trivial compared with tho original one. So the important question is how many of thin sample commi ttecl further assaults of' a clangorous kind? Ji'rom 'I' able 6 we see • that the answel' was 13 out of the 125 fully known about.

In addition, howovur, we h.·1ppun to know what ha~; ocem:·r-od af'te.r tho five yca:t""'i~ in <Jany cast;;; (up to t2n y ... ~u .. rfJ fhJ'.',' for mtUJ:,r o.C 't1;·~_,~;·;~") c'lnd U!30 ot thin :Lnr'o:cnr~tlm1 incrc:r.:-:,(~:; th0 tnm;bur of' o,~:;:;aul tcr· l'eoffondors to 17 kno\'.'n t41i the prcf_;,._;nt: ti1;1o ,, f-!OltCJ cnri!~tri.t tt;J. n homieitlo in tho period of the fol1c.w··up, but tr10 ha.vu since. Tlwso wouJ.U not, in fact, havo boon mi[.i:.:cd by tl1:::: five yccd' .folloH~·up or a prodic t:i.on cys tom ba.0Bd on :i.t Uccat:stJ both ol' :_·haw hml tlll·t::;_uly committed. assaults J.n tho S year pc:riod. Ono of' tL0 1c...ter hou::i.c:i.do:: was of a fGllow pl~isont'P whore th!~ cx .. p..-J..ticnt, [.tl:t'L'm.l,y .:J. 1':;-oi'i'endu.t.·, wu!> subsequently dota:irwd Cind it i:; IWr~EtpD not unreaJon:tblo to ~ruggnst that the public would 0t:i.J.l rl;(;<:trd tltcms.:;lvc:-- ::"!.:~ ;::vlef1U<-J.tc1y protected if' any i'urth0r of1'oncc~3 \'101.'\J con~m.i.ttcd \,hilo tho oi'fr:nder wa~ ly,;ing <lutaincd in nnothor soctu·o plccn.

':J.Ihis cowmcnt conVtH!i~Jn tJy bring.:~ 1~:0 to th~.: end of this fir·st section oi' ro~1ul tn do:;;cribing d:i.scharGG cutco:~:o Q In making the comment, howevot·, it enableD me tC~ re:c:~p on the purvo:5e of tho study which W!tS to try to dis cove:..~ rel.::t~~:L 0:1~:_::1j ns bct·~'lnen ou tco~:o and d~tta obt:ainod on tho patients 1'1hil,;t"·;;::GTit{-l;·~·;:l;:ft;1;·- ·'ilh:i.lst :lt is of interest to lr.now what the ou tcomc w.2s· .f'or nuoh a snmrJlc, cr.pccially Hhun no sueh inforrna.tiOn previou~dy c):i;.:tod 1 thu impetus for the study was the incrunsi.ng numb:;L-:-s of roof'fend:i.ng disch_arg8s who were cl.:dming public ru1cl official attont:ion nn<l \l:1o wore hampering tho admission and dbchargc procodurns of' tho hocp:Ltccl. Clearly swnples later than this 1960-65 cohort wonlU ir:.clurlc lnrrs2r number::; of' violunt roof'i'cndors .. Yet no Bubsoque~t groi.3pG !u:·tve benn sy::_-.te!He.tioally a.sses~ccl on discharee as thiD 1950~·65 group hns been~. Generalisations noed to be derived, :i.f' posniblu, from thi~ group so that the crucial prcclictivc sign~; ean then bo iclontifiec1 for usc in later cliDchn.rge decisions. 'l1his, moreover, is the sub,ject of the conference at which this research is beinc rcpC'rterL .tho next sdction describes duta inton-rela tionship::., thvur)1 t~·ta O.e1•i vinG of' a predictive index i'rom such inter-rolat:i.orwh~-P~ i~, ~l.s I sc.id ct th.J outso~~, something I hope you, the conference r::ombc::·:;, will l:o able to say how best cnn be done, if it can bo dono at all on such a sarr:plo and such data.

Let us now thcroforo look at hO\'/ these otrGcomtJ events reluto to pre-discharge data. 1'ha ntat:is·~ical programme used was SF~'3. All the interval rr.Dn:>uros of the cri_torion variablcn were compa~ccd with all the interval mensure:J of i:1.e outcome variables and the usual 't' tos ts and oorrcla tion:.l obtained r;horo appx·opriato. 1l'he category measures wex•o cl.·os.'3 tabal0.tcd, u:-.dng chi'-cquarc to dotcrnUn0 any relationship. All mea0uras were ::.ubsequrm·i.;ly r;rouped into categories nncl i.lnally clichotor.;iced co that 2 :: 2 continc;oncy t;.-,bles wore obtained for the final an"-lyeos, Jl.l1 ·':hose ihta rtill bo presented i.n appendices to the full l'C1j)ort of this study, 1'odo.y, time allows mo only to Llraw attention to the e.;9.in findin~;s of interest. Not unoxpoctedly; the bust pred.ic·~~or of .succe::;!j was round to be tho previous record, so fin:1lly a throe-way cross tc.bulntion was done, controllinG for p·ovioJs hist0ry nhich, in context, consisted of both p;·nvious convictions and prc<•ious psychiatric cwents. Subsequent pr;ychia tric OV9nts WtJro bo st prcdic tod hy previous psychiatric history ancl sukcquent offender ovonts by previous oftending history. H.my of tho predictor and outcome variables turned out to be si~;nificantly Nlated only fo>.> this rola tionship to Llisappear when previous oonvic tionn i'/Grc con trolled for: }1or instance, the

f,{C;J-rLctl Health Act cJn.ssif'iue.tion of mentn1 i11n,.:3.:l or p.~;ychopathic tlinorder \'la!.l n:i.g-nif'ic ;urt ly re1a ted to ou tcomo no doubt btJct:tu;:;o thcrG is an o.rtii'nct of pl·ev:i.ou.~:: conv:ktions involved :Ln tlc cla::>:-.dfication "p~:ychop:.Lthic di~~order 11 • A hi~;tory of offendinD behaviour r:ill inerea:1o 'L:iin :U.k..::lihood of a elr.t::>:;ification ot' psychopathy being u:Jed .. ·rhm ;;gain, tbe oJ·ie:Lnal of'fiJncc and ti~D form of n.d:ni:.;~.d.on aru l->oth h:i.chly rL~lntt.Hl to outcomo: thoso who couHn:i.t ho:1rj.ci(10 tt:ncl not to l.'iJ-

of'.Cc!id, unl:Jkc: tiw~Jo who eom~Hit oth\.';1' ~;ort:> of' ufl'cnce. Howuvor, whe:::·r.::as tho oi'i'cnct! on Gd:rti.ssion i0 ~celatct1 to outco1:1u regardless of tho ~hn·i;:~ble of prdv:i.o~w conviction:~:, (t:tnd :i.n f'a.ct this i.'J the only [SL~n.o_l"'<-t1 criterion varin.blv that i.'-~ indepl!ndc.nt of prcviou.s convictions), tho f'onn of' udwiss.ion, hy coni:ras·-c; .L> vory much depcndc nt upon prev:Lous conviction.s, Thono on. a fixod sont.,__.nce h~1ve co;no on tran~Jfor from pri0on und tend to bv tho:jo with worn pro vi ous 1;onvi ctions; they then t<.md ~Llso to hrtvo f'ur·thor convictions. ·rhos8 in tJ1 J. nixt:Les on an in~hd:t:rminato ~H;ntuncv tended to huvc been ad.wittod Ucfo:ce thu Montul I-I-;;;aJ.th Act of ·J9?9 and th<~r.:d'or~.; to have been 1dctuined at l!cl' Maje0tyt s Plc~J..suro 1 ie, to include most of the homicidGs who tend to bo first of'J.\~ndors.. 1!Gnco thn re la timwhip be tween form of' ndmis sion and subf;)Oquont ou teo me Uinappca1's v1hen proviou::; his tory is controlled for.

Unliko the f'inclingn of ~:;omo studic:.~s in \'lhich social class frwtors aro founil to be related to relliilivism, the datu on educational and oceup.:~..tional baekground in this [;ample wero araont;s t those which shor!ed no rulationship with outccmn. Tho relationship of victim, howover, was ~~tronely us~ocintod, homicides 1 victims tending to be well known, friomln or family, whereaG otho1~ offend2rs' victims tend to be ca>;ual acquaintancus or strn;gei·s., 1rhe vc.riab1c of 11 Uelationship of victim 11 , agu.in, yield~; a st1~o:1g sta'Cis tical rcl(;t tionship with outcorrhJ w-hich disappears when controllinG for previous convictions; tho sroup \'lho offend again~t someone they know well t'Jnds to include most of tho homicides who tend to have no conviction history whereas tle other group who offend a0n.inst casUal acquaintances or· strru1g0rs tends to include both homicides and non-homicide aggressive of'fondor.s who _?._o .. hn,vo pruviout' convictions.,

Significantly more nbnol'Jnal scores on psychological variables occur vthcn tho 'fa.il 1 Lmd 1 succeed 1 groupn are compared by means .. of t tests of significance of' cFff'ernnccs bo tweon' means but the so differences fail to reach s:lgnit'Icanco when previous convictions are controlled fo<' in category based contingoncy tables. It soc nul that many of tho psychological vo.ri.n.bles aru in f'J.ct, indt:pend:-.n t of previous convictions as they do not shovt a sifllificant statistical relationship under ei thor condition of' proviouB convictions -positive or noeativo:-I£ may therefore be worth looking further at those variables under tho moro powerful conditions of interval measurement \'then attur.J Iting to irnprov~ on 'previous history• as a predictor. i'he discrepancy betwoon two of tlk JQ measures, namely the J.laven' s Matricos and tho Mill Hill vocabulary (in contrast to tho non-si~_;nificant discr0pancy between the vorb.:tl and pcrformMce scores of tho Wechsler IQ test), shows a significMt relationship • with success'of discharge outcome. 1'his needs to be examined lll)l'8

closely yet as it seems that 11 hi~;hor lf.atricos score, relntivo to J,lill Hill, is associated with failure anil that Uw scores are closer together in the success group. '!'his may be a rcsul t of better vocabulary in tho success group, or loss good Matrices ability (io abntract •practical' reo.sonine;)(> This discrepancy meusu:re is less strai~;hti'orwarct to interpret than tho t'lochsl or Verbal discropancy.

(

~iUCGESS rl'Ef'JDENCII~S --·-·-~~--~~ ~~~'~ -~~-

No Previou" 'JUstory' (offending or psychiatl'ic) Cun·ont Ol'i'onco Homicido 01c10r .l:Soen in Broa..Jmoor Longo:r Din..enosod nt> 'Ai'f.'co ti vo Di sorclot" Undt_:r Indo:~:a·urinate t Sontonoe' (Hospital Orcler now) Victim f'amL!.y m· well known

on Pnychol.og:Lcal As so ssmon t Pd. or to Di:>chargo:I,osa Emoti.onal Disturbnnco J.!o1·o Sodnl Conformity nncl Control Moro uncortccinty on non-verbnJ. problom solving tasks

TABLE 8 ---·

\lith Provioua Convictions Currently Property Offender or non-homicidal Assault Younger Boon in Broad moo!" shorter thn9 Glassi:Ciod arJ 1 Pnychopathic Disorder' Undor Fixed Sentence (Section 72 of Mll Act now) Victim Stro.n03 r or Casuo.l Acrtna.into.nco

on Pi;ycbolog:Lcal Assess mont Prior to Discharge:-a) Psychiatric n.o-o.dmiss:Lons: .

- More thinking and sensory disturbance ('psychotic') More hostile atti tudos

b) Ho-off'onrlors in gonoral: More impulsiv<J nrr.l extraverted ('psychopathic 1 )

c) Subsoquon tly Conuni ttetl Assaults: More impulsive AiiD emotionally, dis turbod

'l'a.blos 7 and 8 summarise tho chnraotoristica of thoso who succood und tho so who fail. Success is associated with a lack of' previous history; with tho current offencu for which they are in Broa.dmoor being homicide; with boine older; Md wi tl1 having boon in Brow:lmoor loneor. Some would use this last finding to argue that patien ta should stay in Broadmoor longer but, of course, this is another artifact of previous history. People who havo tended to stay in Broa.dmoor lon&cr arc these who, hn vo been thought to be more da.nge rous, namely the homicides when, in fact, this study suggosts they are less likely to re-ot'fond than tho non-homicide group ci thor gcnern..lly or in u more spocifio personally us saul ti ve way. 'I'hose who are discharged rather enrlior tunil to be tho loss serious offenders whooo. ro-offonding teuds also to be less serious and which thoroforo does not give riso to tho oort of' public concern which attaches to a homicide or other violent

' . •

or soxunl UBf3aul t. So thoy are d:isclJal'g(~d earlier, continuing tll8ir losn nnriou;; 1't;-off(:;'ncLi.n{·.~, und longnr 0tay thercfor·o figures ni~1ong the 1 Huccoou 1 c11~~1'i:ictoJ.•.'u:;t:i.c:3. V/horn p~:.ycholoc;icaJ. ii.SDOSf:~ment is concerned, tho 1 succusn' group ( 'l'able 7 ngain) tcndFJ to nhow scores towardD tho moro Omotionally stnhlr., nocir.dly confrrtming and cont:rollod cndc ot Lhd r::caJ.os, w1th u nlicht suggestion of' less confidunt han(ll:i_n~ of practical non-verbal ta~Jks (BaY en' B ]ja tr:l.cou and Portc.:us MazBH) ~ ·

'11able 8 suwmaris(1fl tho characterJ.E>tics in tho tfail' g"l~oup. These tend to bo tho converso, of courso, of the 1 uucccss' group. In this ({roup there is n gl'catcr incidence of previous convictiom< and of pcoplo who a1·o curruntly con:mit tod (or n propct·ty offence. 1l1hO.Y tend to ho younger, to havo Gtaycd in llroadmoor a zhortor time and to bo ol:..ssifind 1\D p~;ychopathic di:wrdor, eithor in their diagnonis or in their Mental Health Act category. 'l'hoy also tend to bo on a fixod rwntcnce ( i. o. a tl~an:3fer from prison); ancl their victims are st:rangm:s or casuu1 acquaintancos. On pGychological assessment three different typ0s are to be seen:

i) those ·'who rocoi vo further psychiatric attontion tend to havo shown on their diBcl:fU'ge assesm.uent slightly more thinking nnd r;ensory disturbunco (which psychologicully defines the p!3ychotic) and more hostile attitudes;

ii) those who re-offeqd tend to have shown, on disch'lrge ao::wssmcnt, Jr.Ol'O impulsive ancl extraverted trni t·s ( wh1ch is more or less definitive of the psychopath);

iii) those who commit further assaults, although they are only a smell group, do suggest some interesting differences. 'l'hey show scores on discharge assessment sug{~estive of both emotional disturbance ~ more impulsivity.

,.

6. CO?ICLUDJ no 001/L:f.:t/'PS -~-~---~-~-~----~-~--·-

'flwne l'oeult::i :rcqn·oscnt tho picture to havo cme1·gcd from the. work dono duri.ng tho :five month" poJ·iod of lilY Cropwood I•'ollowship. In tho context of th:is conforonco, it is probably appropriate to havo boon ablo to go no further bociTUf.J0 1 fl'Or.l what I have pl'onontod, tho methodologists and :c:tnhnti.cinns among yon may be able to suggest what could beut be done noxto I•10l' inetunce, you may :::haro my hope that, dosp:ite tho best predictor hewing once again p:rovod to bo pant ruco:cd, tho in.:lopendcnce of somo of tho v::nio.blos, eGpccial1y some of the psychological meurml'os, might mako it worthwhj.lo try:ing to dorive a predictive index in which past record. is rcngrnonted by tho addition of other variables. I hopa we cnn rt;pei.1t studies such ns this one to seo which, if c.ny, of the gonor<Jlisod relationships are replicated amongst samples discharged according to prevailing c:ci toria. If u special bonrital like Ilroadmoor i.D to continuo to function as H i>J intended, to rocdvo new put-i.entn and to movn those who respond to treatment on to another se·~ti.ng, then it irc: clearly incumbent upon uc; to scrutin'Lsc the cri tori.a upon which discllllrge decisions arc made. In this way it may at least be possible to l'eusGuro public c.nxioties ths:t tho.::;e pntients who 'moVE:.'-On 1 aro fJolected' uccol'tling to the best avuilablo criteria ..

Aside from the topic of thi.s conf~rcnco, this much overdue study has, at any rate, given us some indication of the degroo of success enj oyctl by our discharged (male) pati.onts and a kind of thumbnail fJketch of the 1 succccclorG 1 and t h0 1 failcrs 1 • If prediction is not sil'rvnd bj• this study' then may.bo at least an improved ,iob can bo done of identifying and explaining our patients 1 offending and psychiatrl.o behaviours and lwnoo treating them more appropriately and ofi'octivolj'. ~'his, in turn, might thon lead to DlOl'O precise and better timed discharge proposals which, in their turn too, \'IOUld supply n hotter data lase for futnro prediction studies.

•

\

,.

HJo:F'ElU·::'T C J.~S ---·-~----

BLAGK.DUim, n. (1968). Jlo1·::wnality ).n relation to extreme aggro;;sion in psychiatric offondr;rG. B~~~-·?§1£b.:~i~-~~ 114, 1321-ll?G.

lJLA CKBUHif, H. ( 1971 a). P orsonali ty typos among n hnorm:;l homid.dos,

,llrt !.:} ._G_~i~:J!Jol. _1J., Hv- )1.

BIJ\CKilUHH, H. cont1·ol.

( 19'l1b). T.!UPI dimensions of sociability and impulsB J.connult.olin.PHychol., ~~. 166. ··---------~-------------~ ,.. __

DAIILS'l'HOM, \'/.G., & WELSH, G.S. (1960). _!l_1.1_li0:!P;J~-£and_!Jook. Uinnoapolic: Univer::d.ty of M:i.nncsotn Pross.

JeOliLDS, G. A. 1 CADlE, T.M. & CHEASY, J.l. A. ( 1960). Aspects of extrq.- und intl~o-ptmitivo c:::prefwion in mental illnesfi. J .Lient. Sc:i. 106 599-610. ·------ ----'

GIED1', F. H. 1 & IX)\':HIHO, L. ( 1961 ). An extraversion scale for tho MMPI. J. oli11_.PsychoJ. J.l, 156--159.

HATHAWAY, S.R., & lflclaHLEY, J.O. ( 1967). !-!<mual_f2_r the Mi,,~nesota l:fu}_:t,i_l'_h;.t_r;_:L_<:_Pcr>J£1:1.a li_t;[. I·~~'cntory: (revised). !few York: the l' Gychol ogi"tal Corporation.

l'OR'l'EUS, S.D. ( 1959). Tl~!)_!'azo ~'et;t & Cpnical l'sych~_logy. l'alo Alto: Pacific Bookn.

HAVEI-I, J.C. ( 1956). Guide to Using the l'rog:rcssive Matrices_l1938). London: H. r;, I,o"ii8~-------

RAVEN, J. C. ( 191,8). _()lC~_:ld£_:f;.,2_U_iljl1P'-tho Mill Hill Vocabulary Scale with 11 ror~rf~~-w\~~:rd;:r.i~<2§.· I~onflOl-H l-L K. Lewis.

WECHSLEH, D., ·1955. l.bnual for the Vlcchslor Adult Intolligenco Scale, Now Yorlo tho l'sychologic~lCorporation.

WELSH, G. S. ( ·1956). Factor dimensions A & R. In G. S. Welsh and. VI. G. l,lahlstl·om ( Eds,), Basic readings on the ln.IPI in psychology and rn£dicin_::. Minncapolin: Univcrsi ty of Minnesota Pross.

If) ........ c (\)

........ 0 0..

0> ~

0 E

-0

(/) I.... Q)

..a E ::J z

150 . l .

140 I . !

130 l i

120 l l 110 l .

100 I . I I

90 I I I

80+ I I

i\ \ I : X\ 70\/: ~ . I

._ I

60 .'..:. X I

50 I

+ I

\ ~\ \ I X \ I \ I \ I \[ +

X

\

F\GURF 1

I

i l

' / \ \ I \ ! \ I

\ I \I +

•

.+· ..

motes j Annual admissions x x

only 1 and departures +--- -+

including 36 in each of ) years 1974 & 75 transferred]+··· ... +

! to the new Park Lane j Specie! Hospital.

··+

~~~~--~--~--~--~--~--~~~~---~·--~--~--~--~--~~

1959 so. 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76

YGar

'

FIGURE 2

All the 1,127 male patients who left Broadmoor during the decade:: 1960-69

Transf .•rred to

Discharged to the community

' ' '

247

!22%]

other sr;ecial hospitals 92

Transferred

Retur · ed to country of

origin

Died 111 hospital

to other psychiatric hospitals

565.

[50%]

FIGURE 3

Mate admissions 1963-70

, Ma!es resident t 1 1 '70 ~ 1 1 "6 a1. .. 1 Gt~..J

Offences against Persons

64°/o

Offences against property

29°/a

. '

20°/c

37°/o

7°/o

22

7°/o

-------------------

--

Homicide'S I -------- I

~--------- I --. --r-----~-

Other personal

violence ------___ sexucn--------

-------_of fences-- --r----1---Pro perty: ---------- 11°/0 - _ ... ___ acquisitive --~---0-o_/___,("

33~/o

' OCJt ...1 0 3·:)%.

14°/o

1

I I I I I

l i

j I

I 7°/o

..etoi;_e;t_y:-cfamaa-e---- 7~ C-1 oj b9I .s. -___ :_ ~-_-:::: ::::::. -_:-.:-_-_-_, ·--- -.!..-----':'-'· ,=;,:....-....<

2o/c/

I - i:"'o

] 17 5%

• Annual average

N =116 Total N::: 675

801 ~~= :\jurnbers 0f,,r

j of '70·~- ~~ F)otiGnts

(rna!G

only)

10

none 1 (ie: 11SUccess")

..

FIGUHE /,

2

Nurnbc;:r of 'fait' events in follow- up period

l<ey:

Q

m-ad miss ions to other psychiatric hospitals

re-admissions to Broad moor

'[]·'" : ·. ·.: ,, ' . . court appeararances

Ej imprisonments

'.

0 ~·: 0

3 4 5 or more

(

/ --,_ {

30--

Numbers of 20

patients ( N=125)

10

1st

Year

'

F!GUF~E 5

Time I apse be? tween d isdlai:ge and fir:.;t 'fail' <?vent occurring

..

2nd

1'\1 psychiatric n::-admission. bJ (Broad moor or elsewhGre)

!] court appoorance

~. imprisonment

3rd 4th 5th

in which first 'fail' ev,mt occurred

I I ~ t

70~

60

50 Numbers

of patients4o (N =125)

30

20

10

~ \ \ \ \ 1\

"

~ /

/

v v 2. v 1-

..._

FIGURE 6

Where the . :; Y'wrs of the follow-up period were spent

~ In other psychiotric hospitals

§ In Broad rnoor agam

fj In pr1 son ...

D 1n the commu·nity

..

.

12 11 v~ 9 9v·· ~ :::

-:-: ,.;... . . 1-v .· .

•,' 1- ·: 4 s .. . ~

. . . 2 f:=V ·.· 2!=C:.: 1R2 . . v ·.· .;: . . \Q· . . 1\ .. "\L,_v . . .-£

.. '" 0

~ .. . . .

. . . ..

. '

. '

. . . . ' " ..

..

.. '. .. . . ..

0 0 0 ••

<1 yr. 1-2yrs 2-3yrs 3-4yrs 4-5yrs 5yrs

Periods of time

., ~: l' Ll_;) ..

(/) H z

d'l w ..... ~ f:-<

< ~-j ~ ··' <V (;'"~'1

~ H (~ - z G'P'l ... w (c) "~ >-l

0 '~~~ ~ (/) .... "f// I"" ;..

C'-:::1 > ~(!:' (; : ::1-:. w '\ •Z<•:;-o•;- :J ~

E'":1 ~ :/".; ·'l-t_'",, - - ._ 1 ~l,,,l•~v ,_ 0 -::-~:~~:.J-dr. 0 @ >.:1 + "'--~~ \.\

[J~ .. C''"'3 p f:-< l<:kl ,_, %;

::::> f;:;.l (?/2) ~ ""' r. G'0l w (G) ~

..:(j t:";:l z ('> ~ 4t: .,.. ,.-';

1 .. Hi~or a-::ts of violanca by patients Eos:Jitsl are relatively frequent ..

of vioienc•3 t~cugh less so are a real ~d a conti:.:sency for which all ata.J~'f s~culd b~ p~efared~

in Hess Side Serio:.:s acts possibility vorking here

2 .. Hc.st natien't:s a.d:-Jitted to this hospital have hi.stc~iGs of violer..ce and, therefore, it is

l.;l~n"'l~- r~ ... ~t 1'""!-'""x·e ~'>"l'""ir:z.:'"!to of v-iolence '.Jill occur ..... : .. ,.;.. "'-.j .... ~r,;;;. ''""'""' ... -~ """ ..... ·- ~

,..-c.·rc. -rh,-,'l" ..;: Y'l ,...,(,,':':.;. ?-p.:r_c:: 'b-::::s·aits.l.s. As ::l')St 'ta::~ents ... ~ ..... - ....... <.;;...;..\. --· ......... _ .... "~........ " - • • • ...

axe aloo a::L::i tt-:::i as:ri::.st theJ..r o·.,ln \'llsr.es as a con..s::.:.-cruence of thair d.s.::lgerous, violent or crisi~-'21 propor.si tias, th-e~s is also a 1~\elihocd O t ;:;-.; ,. .. , o,...,r-~ ;.,._"'.; .J::!J7 '.l·~~d .; n i:n,::;id.ents of P.Lc..n.ned - ·-~~~~--~ ~-- ~ -~ - -violence~ :E::<T;c:rio-::;,c·.3d <:.1.9 ~:lGll as jw~o:- 5taff shcul'i cc:::.t:.n.~cEJlly VJ3-rd ag:-S;.irt..st being teo ' '. · .. ~ ,~.,.. .:;n ..,.he.-i..,. "'"'"~tr-.,...::t·"'t~O'"'S \rlt}l ";r1..::s"c.l.r~z o:.."" .;c-::-:p.L-...CE-·n"" ..... '.... ... .,._... .J.~- ..,.., ~'"' - .......

-c.o.tier:ts as a violent incident ca.'! ta.~:~ p..~.ace

~;l:.c:1 it is thou.ght: least likely to happen.. It is oi'~er:. only the appropriata action ·:Jf staff th:J.t r:.;;..y prevent: a serious incident becoci:c.g a

7 ~<,....r . .,..--;+-;...,..-.:-.:.7"',..::.:.-,.7' all th-is '*t should eJ:,:eys be _;o ~,....,., '"..i- -l~-' .... c::.....:.._-. ..... ~-o ~ t -

y.,,..,Y" .... .!:'> .: ·"\ o---:; . .,;: ..... ,.,a~ a -c~ti.=.,.,.+ revard.less cf ............ ~- -·.0 ~J.;,'-i. !_,*'~" ......... ,., ........ ' v • •

his be:hz:.tim.:.J:."", cl.f:.Ss, colou.-o: or creed~ .. ,l.s ::.n "-- · · .., + ~ 'bol ':"\~...:; ~.;.. .- +'-r"' ~""',..,uJ.d nc . .:::p;..z:..:;:_..t e..s a pG:'.."'S0.3 ,.,o ce ~~--..:.-e'-"-"' ..... •·~- .... -~~ ..... :;..ai:-.tair.:. a ":.::-D£>.::s3:.o::.~l atti t·,.:de at all tJ..::.as e·~·:;:::. t:..--:d.cr ~o1:d.itio.23 of extre:c.ie provocation .. Tl'..is r:.z.:y ·..,:.::11 d.B::;L.'1d high levels of p3:rsor:.al c-:J'::1.trol,

• .,

II~ PREi/ENTION OF VI0:E:·:CE

lo Ward at:nosnhere is to a larg<: e:-:tent determined Cy the qtiaii ty of the living a.z;..l 1Nor:cing

conO.i tions under which patients fi:.-~d tt:c.r:!selves .. The 'oe:tter the conditior .. s err tht: v,T:;:ole, the better the atrr:os-ohere.. Hoss Side compe.res fav·::nttably with othe~ h'ospi tals from the point of ~;ieY! of p:ty.=tical facilities.. This ca."'l ba eapi tali sed upon by a]prcpriate staff proce~ures~

2 .. As far as possible, all staff e.:·*J ~atients should b8 r;;E.de a ... :are of the r-:>1 ~.cy p·:;rtaining

to a particular ward; this being a1 important part of staff/patient cor:J.,;;u!licatic::. ..

3 .. The prevention of violence rcp.'.ires observation, .k::o'rJledge and understanding ty .G'Caff oi

ind'i vidual patients a:."ld a quiet Stu.'·veilla...-lce of those factor-s which may- precede a '"ericd of disturbed behavio-ur.. Talking ar;:i ],iste::::ing s.~o't.:..id be the first line of approach ar:.:i it should b~ remembered that sorr.e patients r:;.::...y net be able adeq;.:.ately to express their needs~ and indeed may have learned else;.Jhere that the only ,,.,a~I to att.r--::.ct ~ttention to these is tc- exhibi:.: violence. One of the ai~=•s of staff 1 theraf:;re, sh:>uld be to educ;:;.te patients in r.::ore accep·ts.'::,lf..: for~s of socic~l behaviour<> Staff sho-:..tld co~::.tinu.:Uly be~

in mind in the prevention of vicle.~2ce t:1ey are fulfilli:r;:/3 their obligation to the::--:selYes a."rJ.d the c c~:-;;.:~:· .• un. t y ..

4 .. U?.Ll'lecessary physical cor.. tact 1.n -....n patients, h·:n,.,'ever jocular~ should be av-Ji::.~~ed as firstly

this roay teach patients that this i.s no=al he{l....a·~~iour, and secondly it ::nay b.a 1nisinterpreted

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by ct~er staff t:t;.;.s leadi::1.~ :£'roc:: a joke to a s,~rious i!"~:ident"' 2o·.1ever: it is not al1.days poss:~ble to p:::'edict the cccurc::ce of a violent respo::1se ar..d. staff faced. with a violer..t situation ~hot:.ld tr~~ to 'be cal:::~ cor~fidf:::lt, objective, ts.~~-:ful and. o:..<.~hcri ~at'i ·:e,.

5~ ?h:rsic.s.l inter"Ie!ltion should be avoided if possible bat :::ay be necessa:y if it seems

t"::'.at s~:~;,.:;o:-.e 1·1i ll be h·.:.!"'t.. I::1 the i:1sta.r~ce of a C8ccs~t8~ a~te~pt to breach securityt it is the S1:aff' S r23}JC!"~Gibility to a:.te:r.:;;t to ir:,p,;:;d.e the '.:.:c-eg_:;:: of security, bu:: r~ot to s\..:.-:h an exter~t *"'~- .... .;:,. .,......... . .. 1·~ I ,....._o. ........ ~ '"''"''..t..lG. eac:-.ar.:..;er n1.s _l. ... e.. n arJ.y event, -.,--~ ':7.!>.·":--.- ..... of ,....t:::. .. :-: T-i)"\-4. - ..,..,. ., "' l ' d ~~ ................ ~... - ..;:. ~ ........ _.._ __ .... lrk<:::. ~;:..:;:se.._.;. a c::e raqe

. ~-::.r~ a ·n.oler..": Sl t1.:2.tion .sl':ould. not a·:tcm';Jt

~:;;";~:; ;.~~~;;:~c;~~e~=f~~e i:d=~~~i:t:~;ista::ce easer:.t:.al tt:-~t ··:tcy do so.. Sta.:f ha""~~a a :rea;on.si"cility to zo to the assLsta"lce of any victi:J of the viol,~nt patient 1 s attack no rr.atter

' 6 .. z-:r;t2.c3.l assistance cay be va?:y i~-:::portar:.t in _ ?~a2.ir:r;, ef:!.>::ctivel:r ~;ith certa;.n kir:ds of l.r1c:..:.e:nt, particu2..2...::--ly i:Jhere the use oi medica:tion is calJ..,~d for,

III~ HEE~1 PEYSICAL INTI.:.R'!ENTION IS UNAVOIDABLE ~- ---

l. wnere physical intervention is ~~avoidable, the follG'.vins points should be borne in mind:

Firstly As a eeneral principle clothing rather tha~ limbs should be held to effect restraint and if limbs have to be grasped they should be held near a major joint in order to reduce the danger of fracture or dislocaticno Every effort cust be ~ade to safeguard the patient;s vulnerable areas, for exa~ple, the neck, throat, chest or abdo:cen •

Secondly- A patient w·ho has to be restrained should, t--/hen nos:si ble, not be .o-ri cned by the head, throat or fingers: A.bear hug from behind to pinion the arrr.s to the side is valuable a~d it is better to grip the lees together just above the kD.ees and a=our..d the calves rather tha~ separately. If the natient is brout::;ht to the grou..""ld 1 he-: ca.'l be very quickly subdued if sufficient roeml::ars of staff lie \Vith their \•!e-ight ucross his legs and trunk and thus irr..llobilise hi::: U..."ltil further action is decided upon~ In exceptional circwT.stances 1 as for exa:;iple, tvhen. a patient is biting, the hair T-ay have to be firmly heldG

Thirdly - If an intra-muscular injection is given great care must be ta<en in its ad:::inistration ..

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1, It is essential to have 3.n a::::ic:;quo..te rccardin.; a..'"'l.d repo:::-tine: s:rster::., Raaso:;;.s for t:l.is

include the t:eed fer goo~ {::s.nag·er;ent a.:.""l::l tC:.e n0cd to er.:sv..re that a"'2y .subsequc:-:t co.::vlaintu cn-.'1 be a::eq:..:ately dealt ·t-.rith" It .r.ay alSo be :::::1:-::ul ~.::o the p:e.tie:::.ts: futu1~e trea~r::~.n1t '.;)y SUG1£esti:c.g p:-e· .. ~·3:""~t.i ve action o..gain.st f"J.ture out 'uu.:-.sts"

2" T:Se rep:.::;rtir"~t:: a:~r·~--:ge~,Br~ts in the hr:;pi tal are ·:hcre:fo:-e desig::-:ed to meet both pro::;ssional

~d ~~~acc=ial req~ire~ents.

3" 1Ihe :t'ollcwi::.g i::dications should lec~.d to a full · .. :ri t ten re::_:.crt:-

A':"Y incident i:-l·,.·::::lvi!',g :(::ysical viol-::r.cc a:."ld/or ir:j,_:ry by a patier:t to hi.r::self, cth·:::-~· :p.s.',:;ic!lts, to r..e:::Ser.s of st.aff or to ar::.j.~ otter ::cr.sor~, ~ or a:1y allesc.tion. of S"'-lch 2-"1 inciden·;:.

Any irr;:;ide:."!.t ·,.;hid: r..ecessi tates the use of :9:-:y:si.::al restrs.ir:t by me:nbers of staff.. ·r:ni::; also i::..cl·J.des tl:.e '.l.se o:· restrai::dng sar:r,ents ..

Any ir"cidant in \~Ihich is"Jlation for::~=; p::.rt o.: the I:".a:.."!2tger:ie:rlt of the di,"Sturbed pe:ti~·:r.;.t ...

:'".-:-~:.-~ incidex;.t cal__:sir.g da:::s.ge to hosp:..·::a: prapr:;rty or tc the :.9::-'0pc:rty cf p~tier:ts or st::.'.ff"

4 .. ':he ::-f.:cordi::;g a:f a.·' .. y iJ:.cide::t is the res.:-::cr:s:..r,ility of the pcrso:1 iD. char!):: of

t'::a \-;a:.·:: or C.ep.s.rt::-:e:-~t Q :Ur~ ~ails sl" .. o'C.:d ba·"~

~~~~~~~yi~0 ~~= ~:~~~y ~-~?~Y~~~~~~s a~1~~,:~~n~s ort

~~;~~~.~;::~~:a h:~l!~~~~;~~~t~: ~~n;~;~:;:rog~~c:~:m~s of staff i:1volve.J. :.n a .sarious incidant :::::1ould ~~e

e::te:rsd ir. <.:::-~.e 2ai:_y R.eport'" All st3.ff .-:;;:.c.uld. ;:,a acq\..:2-i:-:tyd ~\,.:, tl::_-~.t~e .·~·;CJ!'C.::.r:g of tf,_a 1·c -;0r't, a .. -::d

•

any staff dissatisfied with the report should see his Nursing Officcro

5. The principal contents of the report should include when and •<here the incident tool':

place, a :factual accm..1r~t of the incident t.>~hich should include t~e general activity occur~ing at the ti;.;e of the incident, the na-nes of those i:r:n:ediately involved or i;li tnesses, any action taken· a.rtd \\1hen.. A list of injury or drur:age should also be included~

6. Staff are stron~ly advised to JO~n the appropriate professional or representative

body. Such bodies can offer considerable assistance to staff if there is an enquiry follo'.·ii:ng an ir..cid.ent,

VI. LEARN EriCH YOUR EY..PERIENCES ----All staff 'dhO bave been involved in an incident \-Ji th a violent patient sho'-lld try to learn frcm t!:le experience.. This would ':Je a r.tajor contribution tc;.:ards developing a high sta.'rldard of care in the hospital ..

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Al'F'<':'Jl 10:

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Abbotsford) Brl tish Columbia

Creatine:: nne! 11olco::w to tho !'aci Ci.c lleGiona 1 Psych la tdc Con lt·c

of' !ll'i tbh Columbia. Tho next few !'"!;''" have been carefully outlined

to euide yoll on som0 of Lht~ main re(~iilaLionD \.Jhi.clJ \.Ji.ll concern yon

durine your :;tny here. It i~; of iwporLat!CU and to your 7tdvantaf~l~ Uw~.

you read thorn and apply yonr;;clf' accordingly, and if' there is anythin['.

y<>u do not understand, plo:,::e do not he:;ilat.o to a::k.

lie sincerely hope to be able to offer J'OU ;;m::r: help, no matter how

sm:,ll and to hdp you help youn:olf and trust. you will have derived ,;omo

bone fit from your stay >~i th us . ..

Tho Admicsion Team

Nova Ward

•

/Hl!ili s ~;ion:; I

At1iro /\fl ~>:£: ::; ;; r:1e n LD

I C;tJ{U:cn 2

Con.lrab::tnd ., ,,

Conn t~.; C• '·

Corre ~_; poncl~:n cc J

r}r:i 1:vanc:c~> j

!-l<Jdical. 3

t·ie;a] ~; !,

t-led:ication !,

tlurncs '. 5

Puns en 5 Psyeh:ialrl.r: t:; r

)

Hcercation .. .. 5

Hequcr:ts 6

}looms 6

Telephone Calls 6

Visits 7

Hork 7

t

All ndmir;f>ions unJ readm.i ssions ace usually accepted on Nova Hnrd

en a thirty, ~;ixty or ninety day· uarrant. During your stay on thi~:; \.mrd

nr1d Uli;·l Jn~:tituLion, you will l;u expected to pnrt.i.cipatc in proc1·wamec

offurnd, nnd on Hova \hu·d Lh0~';c are cowpr:i.:c.;cd c!1i~::fly o(' interv.iew~;

nnd nssos::;u·,\!nts Hith variowJ department~> of the lnf;ti..t.ution. Aftr.n~ a

minimum ~>tay of three \·H.::el<s or thereabouts .. a PJaccmenl Conferenee of

you1· crew >J.ill be hcl.d in order to detormi.no your r;uiLabllity to a

purticubr prograrm:w, r;cnrc'd to your srccific problem:: and needs. lf

for certain reo.~;on~1 you are found to bo un w1suituble cnnrlidute for

treatment you will be> returned to your parent institution. Dt1rinc the '

.::u.i~~ossnv~~nt pcl'iod, plea so o.:l.\-1ay~3 notify Adnd.~;:.don [)tuff of your \.Jhcl·e

ttbouLn in c1.Wn you nrc needed for· a:1:1n~::>rncntr;/inLerv.iewr; .

..

Green:; n;u[::t bu \.Jol·n during working hout·s of 8 a.m. - /"p.m. on a

ucokday and casual clothinc is acceptable after hours, ucckends and

holiday:;, hoHcycr, nwnn badt;cs mw:;t bo \.Jorn nt all ti1::cs. ~n1on being

visited, formal or ca~Jual attire is acceptable >~i th shoos (no slippers

please). Shorts to be 11orn for recreation purpope only. All whit<Js

to be >~Orn for kltchen duties only.

Ansen~•men ts n t thi fl i1n:Li Lution are conducted by qualifiect per~>onno l

from the l'ollo••ing JopurtmcnLs.

P:Jychia try: Interviews and tents

P:;ychol.ovx: Interviews and tests

Education

Nurrd ne

t·~cd:i cal

Intr:rvicH:> und t.czLn

Interviews, counscllina nenniotlA, tnnts, ohncrvation

Phyooi"nl examination and blood work and E.E.(}.

1\-leoholie:: Anonymou~; : Jntc!·vicH:l

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::J_ip:; (if!Ou1d l;l: C;;!:.p.l(:Lr:d auJ i'or·~Jal'dt!d t.o tltn rep;·.-~:·-;~nLtLiv!; or Lhc

]rlfh'tLc Cr.;m;r,~.~-L•.:c Lhrnnr~h a co}]nctine p;,):iL 011 thl; un-it., Lllr: ~·;unrl~ty aft.t:~r

r J•

It :i~> a chnq;~._~ablc! of'i'enel) to ~.-rL11'ully and kno·,.,inely ubet, retain

and or COJH.:cnl any tl!l:Jutlio.ri ;.~ed pornon£11 offcc~ts, provJ~dona1 food i Lf_:n;.:~

or ally objc~et Lha L conf_; Li. LuL(:G :.1. cbngorow.; 1.-mapon. Ar..c~cpb.ng G.i f't:::;,

tokenu one! ;nonoy fy·om r·elutiv~s anrl fr·ic11ds dttring vifJlLs al:;o is conLr~t-

bn.nd to rcguLtLion~ at th.is ln;_;L"i\tutjor~.

\varcl counts nrc done by the nurses everyday of the week at the follo•,,ing

times:

Hcekduys: 0001 hourc>, 0610 hours, 0800 hours, 11 JO hours, ' 1300 hour·s, 1530 hours, 2100 hours and 2330 hours.

Hcckend~J <:tr;d hol:td::!.y~;: The 1300 hour colmL "is omitted hecan~>e

of an extension of recreation pcrio~l.

During tile :::;w:t~:K!l' monthn evening recreation i:J extended bccau~;o of day

light time. In this cn;;c ·the 2100 hours count is done nt 211.5 hours.

You are reque:;tcd to stand to for tho count at this time nlld nt other

Limo:.; wht:n npeciully rcquc:;tud. In ordei' to nvoid a mi!;cotmt, you nrc t.o

remain 11hero you arc \Jhile the count is in progress. •

7. : .c~_lJ~li!·;_~~x~r~iJ.rr:r.t~:;1~:

I All eorre::ponckncc t·ceeivcd uL tid:; L::;Li.tulion <olll be scncenud

f'tn~· contr<'-d):i!vl. I m:~a t·~:~ en Lvri rq:, in Lo corrc;:;io,·d r.·!1('0 n rt! t·eque:; Led Lo

do l~_;o on ~;t:tL-loJJcry (c~.u·d:_;, J,.,'fi.tine- p:_tper, cnvl:lop._::~) i'1i!'•'!ta[_;cd from

lLu canlc!en. ln1::tit.ution ~3VtL.ioih':I'Y \-l.i.lJ not h(J acc··-~pt.cd. J\ll nnL--

t:o.int~ 1:1ail vJll be left un::r;alc:d except for privi]f;;~"~d ::1ai.l i.e. Lo

tll!.! ~-~oJiciLor Gt:neral, tlw CommiHsioner and Hll'l:-tL'r~r:> oC parliamo::-::nL. All

Hill be coJJ.ceted i'l'Otl n collr:cL.ing po:;t en the \Jard.

LrihuLio!J,

Jf you ('eel you have valid gruund:3 for rai:_;'ing a grievance ae:tinst

an of'fondin1'. purty, you nrc, ad;:'isc<l t.o di.::cu:'" Lhl:: f'it·::tly >lith your

JJUl'}iC· S~wuld you derive no sul.isfaction tht~n the m~1ttcr will be dc'1lt

\lith by Ute N:lrsing Sup\,rvi,;or. If it remain:; unrosDlv,"l, the Nursing

Supervisor vJ.ill issue you Hi.th the n .. :!cc~::.:ury forms for you to complete.

'!'hi:; vill then be sent to the Social Hork Department for investigation

and action.

Your medical needs "ill be attended to in the l·ledicnl \linr, of this

Institution. Initially upon your arri. val· hero you vil.l be given a complete

physical examination. Please notify the Doctor if you rcqu.i.rc cont.i.nuod

modi cations for any physical pro b lams you m:1Y hn vc, n t the time of exam

ination. If you vish to see the doctor for further m"dical reasons, an

appointment is required. Timcn are as follo~>s:

Heckdays only: 1045 to 1120 hour,;

11,15 to 1515 hotu's

For dental problem:;, Lite metlicul wine wlll. handle nppo.i.ntmcnts.

:_;fJJn your· ;1)~f'i'J:.t1 ot this rnsLiLulion, tnr~:Jl tray:::: i.Ji.l.l IH: =~t:nt

Ult: Jdtchr!n :::.o that you may dine on t!1n \·l:H•d, until an .i.niLlal

:;::::;(·nt of ycu by Nur~.J ing ~ ta ff t :~ ;."'omp l(:Lerl ~

071~ on wcckd~ys

Lunch: 111!~) hout·~· on weekday:~, v:eek1~!Hb itlH.i l10liday:•

1615 hotw~; \·Wekday:t, \.Jt:(~kcllri:; :1nd lJol:id<lY:~.

<:r·~~ r·cquir·ed to p1·oce:cd Lo L!Jc kiLciH:rl a:; :1 HaJ~d t~I';,)Up. t·k~:ll tr·<:~y:;

-..i<ll'd d.inin[~ Hill be or·d:Crt:d for phystc.:t'lly ill p;ltjf}nt:>. Night t.r.ny~::

be· pt•ovjded by Lhe kilchen for communal u:-;e.

H' yo!l ;-n·e I'C2(!i.Ving medication pt?e:Jl!I'ibc:d by the P~::yclli:ll·.t'ist or

:r ;_11 IJoctor', you aJ'e o~liged to call aL the medication HL-:ket upon an

·J•corn <\TH!Ounccmcnt, made usually aftet~ brcdkfat;l: 1 lunci) :~.nd :ll.:. 2200

.·:;. On ;wel<day:;, Lhc afternoon medication will be di:;pen'"'d at 1300

r·:1:. Un oeear;.ion, medication may be prescr·ibcd bc.for·c meal!;. It is

_:.r·tanl to be puncLual Hhen receiving medication. Please do not wait

r:c:minded repeatedly. It is in your· best intcr'csLs to accept medication

··c;i:tlly prescribed f'cr you, althoue,h it is not compulsor·y. It becomes• ' only if you are cer·tificd. Insti(utional standing orde~s such as aspirins,

·;oJ. sunpcnsi.on, vitar.1ii'1 C, medicated throat lozqngcs, Dimetapp, etc.

: be dispensed for medical complaints, for short pcdod:; only, and

1!'di ng to Lhc discr·ction of' your mwsc. If by then your "'ctlical problem

"tir1s unresolved, you arc expected to see the Doctor iri tl1e Medical Wing

~he c~t'li.c~t convenience. Loitel'ing in front of the medication wicket

in a queue while mniting medication i:; str·ongly prohibited. Lute telcvi::;ion

··"'''"will not receive liS or liS PRN mcdicalion after 0200. Should they

i:Jcst and receive nieht sedhtion before or during the viewing time, they are

n obliged to retire to their rooms.

/ '

,.

:md the ] i vi llj~ uni t:1 ? !+ holll'D of evorydny. rn 1,) II , P(•di c:d. YHng t}J,>'/ n rt~

:1 vai1ab.l n during office hour:> on weokd:!y~>. On the n (:1:1 i :>:-;ton wn.rd yon t..ri 11

bn~:iTJ Hi th an u~~~d.gned prl!:tary and secondary nH!':>c Lhcrap·i_gt, to lwl !1 yon

h lonE with lhu pro~cawmc and. your problems \-!hiJ(~ you I'f~!rnin here.

The:Jc are is:~awd fo~· uso within Lhe instiLuti.on only. Passes aro Lo

ilo obtained r,·om th}l nursinG station and must he presented upon arrival

at one' r; deGt.ination. 'l'imos of arrivals and ,doiJarLuro.~> nre noted 011 Ui(~;;o.

I L i:; all orrr~nco to taw per w1 Lh the pn:;~_:C~l. Pa;;:;cD are nccc~:;snry for

de,Jtl.nniionn detached fro1n the m11in building of the Institution eg. the

CJjnical ~;dencc'J llulldint; (C.3'.1J.), laundry, tile~ hobby dtop. Pa:;:oo:;

.arc not rcqui.rcd for t·cc-ulnr work ttl'C£W.

Soon after being ndmi ttcd you uill he intcrvicwcrl by your attending

{ pn,·chiatrLJI,. If you require to sec him further, you must notify n nurse

so that this may be arranged.

!lccrention periodu nrc held usually ':'fter lunch and supper evorycby

of' the ;~cck in the [,')'lllmtnium or in the ynrd, the choice dependent on

weather conditions. Closure of the ya.l'd will and does depend on f.i ve !'acton;.

(1) Heather (2) Daylieht (3) Spocial events (/,) Staff situation

(5) Patient participation (there must be a lcant six i.nmatcs in the yard).

Holoasc from the wards are timed upon the hour and half-hour only. If you •

wi:;h to tl:}(' the muni.cn'l inntrumcnt'J in the nnwi.e room, written conn<ont. i:1

J'ir~t necessary and 0btainable from the Chief or Occupational Training.

La to television viewing till 0200 hours is allowed on Fridny and Saturday

evr:nines and ;;unday evening iC followed hy n::Latutory holidny.

.L ~~() ..

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'l11r.: ut:c: of a n~quc::t form i.r; tH~C~~~;::ary \-:JH~n, CnJ' c:x:u!lple, you •..;\:-;h to

1ard:n n tnlcr)hono ca]J, nt· to ohtai.n npeei,fi.c Ltum:; f'rom your pcr:,;o:ul eft\}ct:;,

OJ' l.o ~l\){! a particular ol'fiecr from ee. Lho :ldmLni.:;LraL.ion off_iee' thn

~:r~cur:i t,y dL·p;lrtmcnL Ol' the 0oeiul Work !kpar·Lmc:JL. A cou~plcted l't,)qlH~::L

f'nr a ld'an~:rer out of thi:J in:~Lit.HLl.on J't:mntn:; in l.lll! nur·:;.Lng ~iktL\ntl·f'or .:;- J).q c\ ,

[l J::i.n:i::nuu ruriod of '.(~1--l~~JJ.,.; before neLi.vati-on. You mny j f YOlt \-Jidl, l'UVOkd

! . t · tl ' 'I .,.?~PA'\ . d 1 I' ' !' '1 \ 1 .ne rnqnen, ~.-n .un ~.< 1c ·t¢---ttvH-j per1o on y. tl~quP:~\-. o;·c1~> arc a vat .-·t L_(~

on the h'ard.

17. HOQl:LC> :

Roolh~1 are occnpi.ed singly. The tidiness and gcnnra l cloanlincs::; of

Uw room beeo:ncn your rc~ipon;libilily. If you have to"i]ut and w:1shi.ng

facilities illstu11ed, plear:;e ~nDure these a.re kent '

clc~nn. You are nxpcc Led

to arrnng-e r;Landurd furniture only for cnch room, in r.:uch a \.:ay ~lo n.:; not.

to i nterfcrc: Hi. th nurr. i.ng ob~;crvation or obn tru~.~ t t.hn doorway for ft l'()

exit purposes. Furthermore it is deemed forbidden by the Security. Department.

to drape tho \l.lndow of yow' room, whatever the rcauon. \lhen smoking i.n

your room, ensure that ci[aretto ends are properly H>:ti.nguishcd. If you

wi:oh to llst.w to the wcclio during periods or lock-up, you arc requested

to exercise some consideration for those wishing to sleep, by ke!"ping the

volur:1e low. Entering a room during the occupa'ilts' absence without prior

permission from him is forbidden. At 2300 ho~tn; yot: are expected to either

return to your room or stay in the lounge till lock-up time. Lingering

in the corridors or kilchen is prohibited after this time.

1 S. 'l'ELEPHOt-fE C}.l.LS:

As a rule, t11o personal telephone calls are allowed each month. There

arc exceptions to th,i,s rule in cases of emergency. This is determined by

the Nursing Staff. Telephone calls to your li1Hyer, parole officer are

e xe] urlcd from the pen; onal cal b. 'l'e le phone call:; :; hould h•l made colic c L

or through 1w:·sonal funds, processed t.hrour,h tho Tnmntn Trust Fund. In

fa~.rneBD to overyono, Uw u:ie of Uw telephone l.;.t av~d.lnhle at :Jp(:cific~_-1

U hof; for each \.Janl unlcns arranged ot.hcrvliac. A f1peal-:ing time of fi.vtJ

Jrdlutc~; ha:1 been rccoJmncndcd. On occn:.iion LelDphone eal.l.:.i may be monitored. I

!I :il(oifll>er of :;Luff i1; nlways pre1:enL whi.le you are u:.:Lng t.he telephone. !

Ab[;oluLely no vh;iting from tho admi~;sion Hacd to the livine unit.:> and

vice verna, unJ.ess on a pu!3~:; for a kd.rcut only. \.Jhi le on the ward tlh~rt.~

shou1d not be more than two inma tc:3 to a room i.e. tho occupant and one

vi~litor. lf' you ha.:.vu relatives and friends l!i::>lli.ng t.o v.ir;j t, you r;hould

~~ond them Uw required number of viniting fomns - one ?Cr adulL. The

J·er:ulalion:; cuvcrnine Lho:;o arc ouLUnod on Lh'' i'or:ns. External vl,;lt:;

t:Jre conductf~d in tho visiting lounge three times \-Jeddy, statutory hol tdny!_>

nnd nea~;onal open house day~l, e"he latter hold in tho yard or r;ymnnsiwn.

You arc expected to conduct yourself wl.Lh decot·um when vi:;itcd. A di.spby

or overly intimate and sexually suggosLivo behaviour is forbidden.

20. VIOHK:

You arc expected to enlist for some form of emploYJnent, preferably

of your choice, while here. Initially on the adml.ssion programme. you will

be excused from your area of vork so as to complct<).your assessments and

tests. \·lagos earned arc handled through your trust· fund, canteen and com

pulsory r;uvinr,s. Upgrading is hold pcrl.o.dically and is determined by an

l.tr;sus:;men t of your \.Jork re eord, for example, punctuality, consistency, dcgrco

of interest in tho job, quality of work, etc. and your overall performance

in your particular programme.

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/\1~ patients

EJh patient as \follows:

N/\l>1E:

are expected to be courteous und respectful at ull times.

in expected to kec·p lii.s h~,'gienc dt a soci&lly acceptable standard

- q minimum of 011e shower on alternate days - tlo f;have daily or i [ \'leur i nq a .beard, the bc,nd should be kept tr immcd - teeth cleaned daily - hair groomed and cut in a acceptable style. Clothing to be clean and in good

3.

repair.

Pirst wake up at 0645. Patients are expected to b~ up by 0800. - JJeds must be n1~de prior to 0830 - If a patient is ill and considers that he requires medical attention, he

should, if possible, make the staff awnre of his condition prior to 0615 hours.

4. All patients wir:.hin(J breakfa~Jt must proceed to the dining t:OOHt when the breakfust call is m'ade~

5. Nedientions nrc to be taken at the prescribed times.

6. 1\ll patic,nts ~<ill be ready to go to their 1vork, group ot appointments at the time stoted. ..

7. 1\t count time patients should be at their ward or scheduled work area unless otherwise detained for medical appointments or escorts. In the event o[ stand-to counts, all patients ~<ill return to their wards and will stand at the of their room.

D. Each request for a phone call to a relative or for an interview with resource or nwnagcment personnel must be made on the official request form. '!'his must be submitted to the '!'cam Leader in charge of your ward.

9. Social visiting between wards will only be permitted with permission of the ' staff on botl1 wards.

!. \Vhen a patient is confined to his room,, no other patient is to interfere with him, e.g./ passing food or cigarettes,

1. No more than two patients dn one room at any time and room door must be wide open with both men in full view.

1\bsolutely no gambling allowed. Card and table games to be played in full view on nursing station.

Plastic glasses are not to be taken out of the kitchen. No food out of the kitchen ex~ept that which is on the evening trays.

can be taken

' . '.

T.V. may only be viewed during leisure hours.

The auditorium or the yard ~<ill be open for recre,'ltion from noon until 1255 hours.

..

16. Ar1y sport cCJllipmcnt or unJt1t!1orized electrical ~Ptlli~J1C0G found in patient 1S rooms v;ill be rc1oovcd inm1ediatcly nnd trc,.Jted as contraband.

17 ~ rl'hcre will be no lHHlCCC'D~~ary noise at any time and enpt?cially after 2200 hours. P.:Jtients must shoh' consideration to p(~ers in keeping radio noi~H:~

to a minimum ~-~(ten 2300 hours.

18. No movement between floors after 2100 hours.

19. No movement during late night viewing. noth barriers to be closed on late nhjht '1\V. Door!:.; of rooms Hho~;e occupant is yo \\'Cltching 'f.V. to be left closed. /Ill empty rooms (including interview rooms) should ue locked ilt 2300 hours. Patients to be citl10r watching T.V. or in their rooms. No t111ncccssary wandering about after 2300 hours, otl1erwise T.V. viewing may be suspended. _

20. Hoom doors locked at 2300 hours. Only those \-Jutching 'LV. :_:,~wr-: may remcdn up until 2325 hours. Requests to view special late programs must be processed for permission through nursing anJ security 48 hours in advance.

21. Curtains must leave ro.om uisiblt~ for outside observation.

22. Furniture must bJ2' placed to one 'of the thrCe HPC suggested layouts. Permit must be posted for extra furniture other tl1a11 locker, 1 cl1air, 1 desklamp, 1 garbage cdn.

23. No hanging plants under night light or in window.

24. /Ill wiring is to be approve~ and installed by a qualified electrician.

Patients residing on Nova Ward are not permitted to visit on the Living Unit. 'I'his rule will be strictly enforced.

Nova patients can JOln and interact with. the patients from the living unit during recreational periods.

Hecreational periods are held usually after lunch and supper every day of the <~eek.

Nova'.paticnts 'dishing to take part in recreational activities in the E_vc~_ing must inform the nursing staff, 11ho ;till contact Central Control to obtain clearance and have the barrier opened. Departures both for going to recreatio!Y and for return '" "'" "'-'l;;:~'"'"''' "" "' ''"" ""'' "" """" Unit Dire~

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(i(Nl!frHrtenl of C;tn:Kiil

Gouverr·l(~flh:i ll Clu C~1: l~Kl;t

/\11 Dcp.nuuunt /leads

I Ncdical Director

~:.vuJL cr 01\Jt.:T

MEMOfli\NDUM ,. tJOTC DE SERVICE

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, __ __,19 1/ovembct 1979 ,. -·-----------------

1. Working dress is .issue green JXInts, shirts, and parkas ..

;1, l1or!dng hours ilr<J bei:h•ecn 0700 and 1700 hrs. 1-lorking dress will l>e 1¥01·n NO-nday throoyh Friday until 1700 hrs.

3. Patients mwy h'ear c:u;;ual clot:hing ddily c1[t('-r 1700 hrs.,on weekends, designated pul>lic IJoli(l.'JYs ,1nd t-l/Jilc visiting rcldtives or friends Juri ny wo,t.king hours .

. J. Kitchen lv/Jitct< ,,·ill o~Jy }J<} h'ot·n while ir the kitchen.

5. l?t'.'Cre,ltivnnl ~..-·.l11thiJJ;I m.1y })(_, h'orn l'lllilc ctHJd']Cd in· sports activities only.

ti. Jl~lticnts h•orkiu~; in tlw ~n·ound5 muy be p('rmittcd to remove shirts.

Til is lll<}tnO supcrccVPs .·11.1 ]JJ'flV i ous wcnlDl\:lndums rcla ting to c loth1ng regu-lations. foJ: furt./Jel· inforw,-~t.ioll 011 lJJmate Groom_ing and J/ygiena refer to C.D.208

Cli:jl

Ncferunce: C.D.208

Division: l\dmin.istration JJ;.ttc: 19th Novc•miJ<!t' 197<! u~~vit.}l" D~te: NOy(~llliJt'l' l'll10 •

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i'..iec'ica! Direc:cr D C. · . R "R C "' (r-) r. nunt oy . .. . ·' . '-' Memcer ln:err:att'onai Academy cf Medicolegal Sciences. •

Regional Psychiatric Centre· Abbotsford, British Columbia, Canada

Solicitor General Canada

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introduction

Psycr--.:atr:c services \l'..'ere introduced :nto the Canadian Ccrrec::ona~ Service in 194 7 - the out coNe of radical pen a! re7or:-n fo:~ov,.;::g Vv'orld \Nar i L Char;ges were necessary tc rerr.edy a s:tuaticn \Vhicli had been unsatisfactory during t:"ie pre:v!o~_;s 1 00 years. Treatrr:ent of the menta\1y iH at that' time, including ir.rn2tes. varied from "nonex:;s~e:-t t'J ··.vhaU:;vcr w2s avJ,!iabie."' Records of Canadian penal r.isto..-y at Kingsro:; Penitentiary'. Ontar~c. show that sirce ::-:e ec.riy 12.80's prisons ard jatis (ia.:er called penite:~tia.ries) hcussd ir::-r.etes. v:s.g~ely descr:bed as "feeb:emi0ded. e~:/e;Jtics. incor:igit·:e, and luna~ics." But knov/ledge cf t!"'~e!r ~xist?nce. bro:..1ght iy~e n.e:p, if ar:y at ~:1. The (';";ed:ca: S!t:..:ct:cn 1n pr!son;;, at :nat !:me, 2RC. the 1ssues aris~:n:J fro:;~ pcoriy p!en..-~ed treatment, concerned the acimir.:s:rators of penal instit"Jtions as far back as 1865 and were stili a source of concern a hundred years later.

!n 1971 the Sol:c:itor General of CanaCa ap,Jo!nted an Advisc<y Beard of Psychi2tric Consultar':ts from nor:,tr:atio;,s r:.ade by tile Board of Directors cf the Canad~e.n Psych:atri<:: Associe::cn. V'Jith Dr. F.C.R. Chal~e, Associate De2n of the Facu!ty of Med::cine, Univer.s;:y of Ot!a"va, as chairrnan, r.eg!cr:2i represer,tatives of the board carried out extens)\/8: consultations with tne:r co:lecgues in prov:::c!a! governr:.ents, ur,i'vers;ties and vvith ether interested ir:-jiv>:~ua!s end 2ge:1c!es. The board's report, subm:tted to the Mi:.ister in 1972, cor-.ta:ned recomme:1d2tions defining the :·cle of psych!arry in the ccrrectcnal setti~g and stated the act:on required to fu!f:l! this ~ole in Canada. The outcoi'Tie of one ;:-,ajcr recon:cl:enc'a:ion, concern:·ng inade-

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usin-g existing facilities as psychiatric hospitals - the

• Regional Psychiatric Centre in Abbotsford, British Columbia. being the result

The building now housing the Regional Psychiatric Centre in British Co>umbia w2.s originally designed 2.s a treatment unit for female drug addicts. lt was handed over to the Medical and Health Care department of the Canadian Correctional SeNice in 1972 to treat mentaily ill inmates in the VVestern Region. Structural changes required to adapt the 6-year-oid complex to its new use included installation of nursing statio;-,s in the living units an:J an admission unit. In planning a correctional psychiatric centre, a dual responsib'lity is evident - treatment and security. It was decided the therapeutic milieu would rec;uire the same level of security as a maximum penal institution. A medical director would have euthor~y to determine the degree of security consistent with the treatment program.

In 1974 the Centre was designated a legal hospitel within the meaning of the British Columbia Hospital Act, Section 2, and under Section 4 (2) of the British Columbia Mental Health Act. The same year the Centre became formally associated with the University of British Colurr.b:a.

Despite the Centre's relationship with the Canadian Correctional Service, its internal administration reflects the basic structure of any accredited hospital in the country. The medica! staff organized itself into various democratlcal!y elected committees to discharge its pro·fessiona! responsibilities. Tr:e main objectives of the medical staff are as fo!lovJs:

( 1) To ensure that all patients admitted to the hospital or assessed in their institutions by the stafi of the Centre prior

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to admission to the hospita!, receive the best possible me8~ca.i car&. (2) To en:--:&:::::e the qua:ity of meCica! care in :he hcsp;tal t·y organizing specia1:zed commit~ees and by pro'1iding iTea:-is of ccrn';""lunica:!on 'i:vith the 0.-·ieCicaJ Di:ec~or. (3) To i:::tiate and enact rules and reg..;~ations to govern t\"'.e med:.cal staff and to enforce compliance \Nith these regu1at!c.:s. (4) io initiate meetings and co-operate on research pro;Jrarrs.

A. fv:edicar Advisory body, democratically e·lected by the medical sta{f, reports to the t.,~edi::a: Director, who is the Chief Exscutive of t:-,e Centre and who reports direct!y to the Boe.rd of Governo:-s.

Admission !o !he Cenire

The 138-bed institu!ion is not a centre providing for the treatment of criminality b1...;t rather a hos;Jila1 for the assessm·er:t and/or treat:-ner:t of offenders w~o show evidence of psychiatric disorder. Patients are referred to the Centre by psychia~.r!sts of Federal penitentiaries ;n Bri1ish Columbia and occasionally by physicians.

Fono·Nir:g c.dmiss':on, eac:'l cz:se is caref:..:;!y assessed by a ;";l:_.:<-disc!piir:ary team and >.·vit:;in th:ee V·,'Be!<s a clinical c2se co;:ference is heid under \he cr.airrr:anship of the C~inics! Director. Our:ng the initiai assessment phase, problems are ider~tified ar.d &pproprlate gca.!s an~ set if it is Cecl:::ed it \r;cu~·d be in tr.e pa:;ent's best interesfto remain a; :~e Cen:re. H::y,v·:?'~·er, d:.:rir~:; the 2Ssessr:,ent stage, ;r :.r.e p.a::er:: Cccid.es he 'Ncu:d rather ret:...:rn to !"lis parent instltutior:, t:'ie reql!est is promptly adhered to.

During the initial phase the patient is assessed by the follawlng discipllr.es:

Department oi PsycholOGY (neuropsychological tests are used)

Department of Occupational Therapy and Training Department of Psychiatric Socia' Work Department of Nursing Oepart,ment of Psychiatry

Categories of Patlen!s

Inmates are admiaed to the Centre not because of their crimes but on the basis of an assessment of their mental status. At the hospital treatment is provided for all categories of psychiatr!c patients but recent experience has prompted the development of.two unique programs:

(i) Treatment for Sex Deviants (ii) Treatment for Violent Offenders

Treatment is not contingent upon early release and patients can term:.r,ate therapy at any time according to their own choice. Psychosurgery, electric shock therapy and experimental treatments are not used at the Centre.

9bjeciives o! the Cenlre

The fo\iowing objectives ha·Je been clearly defined for the Centre:

(a) To provide up to cate, ethical treatment for mentally il! or emot'ona!iy disturbed offenders.

(b) To engage in research benefiting the Canadian Correctiona1 Service in generaL

(o) To ensure the security cf inmate patients, staff and the genera! public.

(d) To expand and strengthen the total Canadian

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forensic psyct::ctric progrc:n. ) To att2!n anC retair: accreditation status v;!th the

Ca:Jadicn Co0ncr~ on Hosplta! Accreditation.

To achit:;/e ihese ob]ect1ves t:--,e hcsp;tc.J has different ds-~z:::-t:r;er:ts c:1d a nurr,ber of ur:!ts ct servi:::es. These Ce;:H::;:;-;~ents are as fo:l::;ws:

:'~'.Jrsing Occupat;onal Training Psycho!ogy Research Psychia~ric Social \..York Psychs try Security Medicci Ad;;;infs~ration

There are ni::e \Vards in the hospital divided into four units of services .under four psychiatrists. NJrses are ied by a Team Leader -,vho essentially works as a case manager for each patient

Apc.rt from providing c!lnica! services, the Centre also offers:

(1) Out-pa::e::t services to various federal institutions. (2) .Advisory services to various prison officials as

required. (3) Training services including on the job 1raining tor

st2ff and t~ai~ing for se!ec;ed prison officiais as the need arises.

The traming program cf the Centre attracts students fiom various disciplines end visitors irom other countries are received 0:1 a regulcr basis. As part of the tra:ning centre

icr :he Wor!d Health Oroanization in Vancouver. the hoso:tai is also co.-nmitted to provide training for appropriately selected Fellows from abroad.

?.n integral part of cli.nical activity is the research service. All reseerch proposals are screened by the Hospital Research Committee end forwarded to the Ethics Committee of the Uhiversity of British Columbia for their scrutiny. The proposals are then forwarded by the Director Genera!, Medical and Health Care Services to the Commissioner of Corrections tor approval. The Centre has developed research programs in the following areas:

4 (a) Evaluation of individual treatment using Goal -Atlainment Scaling.

(b) Application of behavioural medicine in the treatment of psychosomatic conditions.

(c) Basic research on medical information systems. The department is currently preparing extensive proposals to investigate the bio1ogicaf basis of some forms of crimi~ nality and devising ways and means to predict future behaviour of patients.

The Regionat Psychiatric Centre in Abbotsford, British Co'.uP.'lbia was considered a prototype from which valuable experience cot.:!d be gained when planning staffing patterns, building design, and treatment programs for future hospitals of this type in Canada. These expectations have been realized. \t also became obvious that runnino a hospitai for offenders poses a number of problems. fhe criteria for admission, the issue of informed consent. the eihica1 conslderation in the practice of medicine amana coniined inmates, and public expectation are only a few of the probiems encountered. '--

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builds HOPE

"it's a Kind of magical place, wonderfu/iy sp1ri:ed, almost re!:Jious in Its medical commitment.! watched the Recional 1'-k,:;dicai Cer,tre and its sta~f tame and heal some Of the """"'"' t r-""~"'' .,..,,-!~'/ d~m-::,...,.:=:.4 ·n.,m··~ns I 'h'~; ... ;~ =s o.~on~ •·ne ::.·,.,.,S: p.v.v'"':'''-;'·: ~···v.::::~._..u ,~..,; .. c,1 .• t ,,j,.., ". t ._....,\, ::;:: u" most rema:;;:ac:s p.aces in Canada and on tne contw,ent.

~A~·.:ton H. fv!i/ier, lv1.D. Professor and Vice-chairrnan Depf. of Psychjai/Y UC.LA.

• "There is a unique hospital fn Canada and perhaps in the wocld -because it is bui:t outside prison walls and it exists specifica:!y for the psychiatric treatment oi prisoners. It is on the one hand a hospital and on the other a prison. Moreover it has to provide the same quality and standard of care which is expected of a hospital associated with a university.''

Journal of Medical Ethics (UK.) 1976,2, p 180

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-IN THE NETHEHLANDS

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Contents

I. Origin of the present treatment II. The nature o!T.B.R. Ill. Some figures IV. The offender ~·

V. Execution of the T.B.R. order VI. T.S.R. viewed as a process

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Treatment of Criminal Psychopaths in the Netherlands

I. Origin ofthe present treatment 'Detention at the Government's p!easure~y as it is officially known in the Netherlands, is a measure' which may be applied by the criminal COt.;rt. Statutory regulations governing this type of detention (herlnatter give!} the Dutch abbreviation of T.B.R.) are therefo;e included in the Criminal Code and in implementary acts and decrees based on the Criminal Code. T.B.R. is statutorily classified under the heading relatiGg to the 'lack of, diminished and increased responsibility for criminal behaviour'. Section 37, para 1 of the Criminal Code provides that

'no one shall be punished for a crime for which he cannot be held responsible due to defective development or impairment of his mental faculties"'.

Cases in which this provision apptles are not subject to criminal jurisdiction. Thus the court refrains from sentencing the accused because he has been found to sufferfrom mental distqbance so severe that there can be no question of crimina! responsibility. Under criminal law the accused can in no way be regarded as gu!lty.ln such cases the court may order the accused to be committed to a mental hospital for a period not exceeding one year, though this period may be extended as often as required out of court under the lunacy Act.

1 in Dutch crimin.:;llaw ·measures' are contrasted wirh punishment.

Soon after the Criminal Code carne ir:to force ;n 1886 it bee~ me epoa..-~~r:t that further provisions for r:1entally d:scrdered of'.:'.er..ders \Nere n·~eded. The main ot)je(:tion to existing legislation wes that a:il off'enders vvere placed squ3reiy in o:1e of t\.vO cateaories, viz. those h.e\d fui!y ;-espoilsib!e and those not held rc:s:J;r.s\b!e a~ all fo: criminal offences. Pe:sons fa:iing into the first c;;tegory vJere punished 'vvhile those in the second might be ccmmi·ttc;d to psych:atric hc~ .. -·ltals. The :-igld division betv;ee;~ the t\'JC grcc:ps gave rise -::o p~actica! di7'ficu!ties from the very first. Cour~s f;ec;;_;entiv found -:h£:mselves in difficulties \Nhen deallng 'Ni:h perso~s -.vh~, though not insane, had, at least ln some Ceg;ee, '·jefective development or imp3irment o'f their mental fc:c:u':t:es'. c;') the or.e hand such offe.:Ce:-s cou!d hardly be held fu:ly :-::.?:.;poi!sibi-3 fer ~neir cr::T'.GS but on the other there \Noutd a!\,v2l'/S be a fE:'.N dangerous, recalcitrant crimii:a1s amor:g them v ... ~··:or ... ::. s.:·ciety hed to be adequot-2!y protected. The !2w as it stood did not pre vide for this. tn '1925 a number of new provisions were me de 'f.:n :ha 'pa.:t!ai!y responsible' group of offenders in the Cri:-:-..:'.:cl Cocie. T:1e :-r:ost !;::.portar:.t of these pro\lisitns wcs that c7·,:e>:\Jers v·~r-:o had 'def;.:.ctive deve:o;:~r"'snt or impairmer;t of their rt,2i't3! faculties' at the tirne of the cr!r:-:e, cou1d be deta!ned at the Government's p;easure a:td ordered to undergo treat:nent. Hovvever, this oena! measure r;;ust always be definitely in the 'i:~tcrests of p~biic order'. The deten:ion order is.for a perlod of t· .. -;o y8 :a:-s b'_.:: may ~-e extended any number of times by one or tV.'O ye.;rs Oy :he courts as rGquired. The detention order may also b·e suspended.

The fo:iov~·ing s0nter.c2s car: now be passed on c:ienders found to b"S' r-;c:. resoor:sib!e at a!! kr their cri.T;es:

d:schGt£)2 2. ciisch;:;g.8 and corn:nitta! ·to a r:~.e;;tal hospita1 2

3. d~s.-:hJrge 2nd T.B.R. 4. Ciscr.arge, committal to a menta! hospital and T.B.R.

Cf7e:--:de:-s .,.,..;:h Cimi:-tished :esponsibiiity for t::eir crimes must be civsn a oenal sente::1ce. The jt.:dge may order T.S.R. as wall, if the P:-otecti~n of society warr.::nts it. :=or each separate case lt must be

2 T;o;; Crirr.i:::;d Ccc~ s~~~' ::::o;:<:ai:ls :hs oc.:td;.:ned r:ame. Nowad.3ys :tis called a ;;.s·1·c:-:i:;.~:-ic \:osp::.::! or co::::tre.

•

ascertained to what extent the offender's mental disorder admits of responsibility for the crime and what punishment will apply. Punishment must be irrrposed according to the degree of guilt. However, whi!e the 'Psychopath Acts' were stil! being prfipared protests were already being lodged against the compulsory imposition of punishment in addition to the T.B.R. It was held that either a punishment or a committal order should be imposed and that the choice shouid be goven1ed by considerations of effectiveness. ln 1972 the Minister of Jt.:stice presented to the Second Chamber of the States General a 'Memorandum on Detention at the Government's Pleasure', proposing that courts be granted statutory authority to refrain from imposing an addlt:iona! punitive sentence when a committal order is to be made. In practice comp1icct!ons are currently arising, particularly when the committai follows a tong prison sentence. Such situations are of no benefit to the mentally disturbed offender in need of help.

H. ThenstureofT.S.R. As the foregoing ir:dlcates, T.B,R. meets two distinct needs, the protection of society from sometimes serious crimes committed by mentally disturbed offenders, and.the right of the mentally ill to suitable treatment. The two interests are united in the execution of a committal order. At any rate it has become obvious that punishment alone is not an effective means of preventing crime by menta;ly disordered offenders, as no regard ls had for cause or motivation. T.B.R. is speclf!cally aimed at the 'special prevention' of criminal behaviour, since it endeavours by therapeutic means to set processes in motion that wi!l a !low the offender eventua!iy to find a place in society. These processes re:ate not only to the offender himself but also to the environment from which he came and to which it is hoped hewil! return 6ne day. Obviously, treatment usually begins by the admission of the offender to an institution. This is indicated on both therapeutic and social grounds. As wi!l be contended at greater length later~ it is most important that during the entire treatment contact with the outside vvor\d be mair:tained as much ns possible. After all, the main purpose of a committal order- this is !aid down in the Act- is :o prepare the offender for his return to normal society. A prolonged stay in an institution is not conduicive to this, but unfortunately, in serious cases it cannot at present be· avoided.

liL Somef1gures About 40 .. 000 crimina! sente11ces are passed annua!!y, and ap_sroxima~ely 12,CCO prison sentences are carried out. !n recent vez;s about i CO persons a ye3r have been o:-dered to await the Go~.re:-:-:;;-1ent's p!ea.su;:s, ir.cludiiig a rn..rmber of suspended co:--r-;r:~~:tai orde<s subsequently exec:..;ted. Considerably· r:Iore T.B.R. orders vvere made in the period betwee!'11S47 and 1960 tha:t tf:ere have been since.

:; ~~s::. -:4 '.:-CJO -:c ; c1·37 '16 : .;ss 25 <S£:9 23 13/;) '14

'9~'"i :c '1'3}2 11 ~S7J 12 ~c..,,. tv/-. 16 iS75 19 i976 '8

iV. Th-::= OUer:C:2r

pt::n:;lity

i23 1 • ' " '' 9 123

27 S4

1" ,, 89 73 70 63 73

susper'IC::.:d T.S.R. orc'c~s

41 •? -~ ?' _, 25 19 22 15 14 10 14 10 s

Total

083 173 164 173 129 130 140 114

95 100 97

104

Off.;;r.d::.~:;; z-::;.:tair.ed under a committal order may be divided into ~· .. vo ca:s;;:orics ac::ord\r;g to t!;e;r crirni:-!2! pest. On tl":e one hand th:::--·8 a:e: the h::.';·hud o.ffanders~ receivir.g a T.B.R. order 0.ot only or, zr:-cc:.~;:: cf ~he!;- latest crir:--.,;-s but 3!so for a strhg of prev;o\}s :Jrf:~.:.,:.::;s:. nv:: otr:ar group compr:s.as the lirst offe.nders, those corr~m;::.:;G af'ter thsir first offence; they are in the minority. Both g~~o~ps consist almost exc!tJsfve!y of aggressive offenders guilty of se<ct..:s crir.;e. The g.rcu;::;- of habitual offenders a(so contains offc;-:GB:-s 2·;?sinst pr·:·pe~y c -.s. sexual offenders, giving us three s.;:-o~;ps a:tc-g-ethet. Tab!s 2 co:-r.pares the co~nposition of the categories. Ot shou~C be :~o:ed :hat the ffgu.:-es ar:e·-Graw;rup on the basis of the crimina!

•

offences for which the T.B.R. order was imposed. The offenders' 'criminality' is actually many~sided.}

Table 2. Qffe:"lders on committal orders detained i."' insrirurions frof7l 7971 to 7975,

classified according to the offence

Offences Crimes of Sexual Other Total against violence offences offences property

No. ' o/c,. No. % No. % No. % No. %

Er.d 1971 311 43 185 25 190 25 39 5 725 100 E"d 1972 238 33 193 31 151 24 37 6 619 100 End 1973 182 35 191 37 130 25 16 3 519 100 Er.d 1974 132 30 185 42 104 24 16 4 437 100 End 1975 100 25 193 47 98 24 16 4 407 100

lt is clear from the foregoing that many a:f the offenders committed on a T.B.R. order have already served other sentences, including imprisonment. This fact often hampers effective therapy. A checkered criminal record, frequently going back to the offander's youth, does not make him pre-eminently disposed to cooperate In 'compulsory treatment"' imposed, once more, by a criminal ccurt. The offender wli! usually have a great aversion to the strong arm of the law and he will have to be won over before any treatment can produce results. Moreover many offenders committed for treatment find it very difficult to accept the role of patient and to admi~ that here is anything wrong with the~. From the point of view of tceattnent and crime prevention it would be more efficient not to wait until other measures have proved ineffective befo;e committing offenders for treatmer.t. Such action would scarcely be possible, however, while the law retains the condit!on that the interest of public order must dema~d it. This imposes obvious restrictions. The law regards T.S.R. as a drastic measure and does not w~sh to see it treated lightly. The term 'psychopath' is used in common par!ance to denote those made subject to a T.B.R. order. Apart from its various emotlona! connotations this usa of the word is not covered by any medlca1 definition of the term 'psychopath'. At most the leg a! use of the \·vord can be justified as denoting any offender to whom the Psychopath Acts are deciared applicable, thus including those made subject to a T.B.R. order suffering from a mental disorder

otr.er than vvhat could be medically diagnosed as psychopathy, such as mental defectives, psychotics, neurotics, epi1ept!cs, etc. Co~'-''Gtse!y there are mcny psych·~pcths in the medica! sense vvho arc nc;t c!elinqusr.t, or ot leas~ have not neen committed for treZ::~:1ent. A ve:--y considerable proportio:'. of offenders Coilln-:ittt;d ~~nder a T.3.R. order ~ave developed behavioural disorders es a oesu!t of character disorders stemming from serious emotional neglect in early chi1dhocd.

V. Excc'Ytion cf the T.B.8. orde:-.L,itGg·::ther ~h:-ee authorities are concerned wlth the execution of a T.S.M. order: the court, the Government a:1d the institution giving uaatrr:ent. To ensure the smoothest possibi8 execution of the order each ::~...:thc:-;-:y must have an a;:;preciation of the functions of the others.

.. The!'"e ccn he r:o e·f-fective cooperation vvithout 1t.

Tile }:.;-diclary T!->2: cc·:..::-t has sole right of 'handing ove( the offender. Ordy by a d;;cisior: ·of the coL.:rt can an offender be subJected to cornpu!so;-y ~r-.:;:::rr"'::n:: snd the co'..:rt wUl reach thet decision on:y after carefut c::;:-:::ic·.:::ration cf :he relevant f.scts. A~ least once every two years, for e;;.ch case, the court hz,:- to C:ecids whether "d:e order is to be ex~er:deG. ln prlnC:ple, the same criteria app!'{ as were used in the initial decision. ~JeeC(ess to say the offe:1der's condition wiii be a n~ajC<r cor.sideration a::d the opinion of the institution treatir.g h;:;";. V:i:J C8:"r'y' mt;Ch VJt;ight.

The 3·fo:-en;,sntior:ed 8iH propos~J-s sever.2l modificztior.s to the exi.st:ng sys::sm of prolonging the order. The regulations at presen! in 'force contain some obvious shortcomings, particulary 1tihe:-e ·::-:e m::chir:ery for consult2ticn on T.S.R. extens:on is

T~e co·..;:-t v.r:-:;ch :T;ad:: tf~B c:igina1 ord·S:"r is, as a permanent ' 2-!.J~hor~:'/, s!so res;::vns!t;8 for periodlc dec!sions on whether or n<::~ t0 ex:end t!"':e t9rm of the order. The place of deten:ion, on the oth~r he::-.d, is a variE;b:::·fcctcr, O\Ving to freq;,.;ent transfers from one insti:ution t:) 2no:h2r. The court has to deal 'l'/ith different 2::-:v:sers a:i :~e time, often ct. a coi:Siderab!e distar:ce. This scr:-.e:::-~"125 hampers effec~ive communication~ w;,ich is necessa;y, especiaiiy i;1 the :i"!Ore comp:~cated cases, in which a varie~y of interests .:!nd responsibiiities must be given careful

l I '

consideration. The present proposal, therefore, is to heve the District Court of the area in which the patient is being treated at the time dee I with the matter of prolonging the detention, so that there wili be c!oser coope:-atlon between public pros?C'Litor and court on the one hand and the institutions treating the patient on the other. ln determining whether or not the order should be extended by a year or two, essentially the same interests are at stake as when the order was initially made. If the order is to serve a useful purpose, treatment wlH generally have to be continued until it can be assumed with a reasonable degree of certainty that the patlentwi!J be able to live a norma! !ife in society without undue risk. Nor must we be b!tnd to the magnitude of every new decision to extend an order. A basic human right is also at stake: that of individual freedom. Extensions to committal orders must therefore be accompanied by the necessary legal safeguards. With this in view the aforementioned Bill on Detention at the Gcverment's Pleasure proposes that offenders in institutions, if they so wish, be ailowe.d the services of a legal adviser when the public prosecutor applies to the court for an extension of the order. In addition, the Bi!! empowers the court to assign a legal adviser if the offender is without on.,. If the app;ication is granted and the court orders an extended term the offender would then be abie to appeal to a higher court which wi!l centraiise such appeal cases. Of course, the public prosecutor would then in his turn be able to appeal against a court decision which rejected an application that had already been granted.

The Government The Government is solely responsible for the execution of a T.B.R. order. The task is deiegated to the Minister of Justice, and special departments of the Ministry, T.B.R. Policy and the Management and Staff Affairs sector, assist him in this. This Srahch, together with the Prison Service and the Probation and After-Care Branch, is part of the organisational structure of the Directorate for the Application of Criminal Law. The Minister also uses the services of a psychiatric adviser for the treatment of criminal psychopaths.

The organfsat.ionaf chart of the Ministry, in so far as it is of importar;ce, is shov.rn bslov;:

T.2.?. ?o':cy 5<3:'.;.~.:;~

-------------------------------------

; S :••]1CWf G~:"t,,r::;i i ---·----, -----

C>~p·.:cyS:~~r;;::.~y·::!r;:-;:-;(a; -----

'-----~----

i 1

! i PcGiJ:;.!:Cln :H't:; . ~i:2r Cart:! ?:):·cy Sec: or

·'•1an::.g·~l":"e~t :::"ld S:~;fi .. ;tf<:::s Sec: or

Th.:; ~.1:r:istr'(s res;:;,onsib:!t:y is rna:n;y an adm;nistra:ive one. The '~"n''"'', directs and cor:tro\s pc!icy-mak:ng and implementation, is res:,)onsi':Jle for continui't'/ i:: :h-e i;;:plementetlon cf policy, takes dcccisions regc::-ding the se~ection, adiliissicn and discharge of '"''''''""'~and j:<:ovid~s the necessary financial resc(..:r:::es. !n a:dC:i::.-;,-,, ;;h:::: i"v~i.'l1s::r; ·~;e-:=ps z: re::c.~d' of an th·? a.ct;vities :~~~s:;c::::":.::C with the process of ex,2cutin•J T.B.R. orders.ln short, it :s :r.e rr:;::ch;ne;y crea:tir:g the :-lght ir.te:-:"\al and external ccndi~:o::s to ens:Jre the succ2ss of t;:e measure. The f'v1inister bs<:rs ;:::o\itic2! respons\bi!ity for :.vhatever is done on his orders in

"!"h-e ':-:st:t:..:t;on3 treating the o·ffende: are the rea~ rmplementers of 2 "T"S.?. ;.-:e-s.st;:-e. Jt is their job to make the trect;'"';.ie:;t meaningful, '3;"";ij t.~e.:<::---:1ent !s n-e:::r!y c\'.vsys 8sgun. w;th institutional care. The hs~it:.r::ons should be ~·e·;J2rded as a specizi type of ps·y'ch:at;:.; :nstlt.ution. They mav be ter1""0ed institutions of 'fc:~~;;.s.ic psych~s:t;y'.

r'\f:er h.;;ving been se:ected, oft-.J:-:Cers in detention may be p!aced

'•

in one of these special institutions. Selection generally takes place at the Selection Institute in Utrecht.

There are two State institutions: the 'Dr. S. van Mesdag Crinic' in Groningen, which is the most heavily guarded centre for offenders in detention, and the 'Vefdzicht' institution ln Avereest There are also five private institutions which under an agreement with the Government reserve most of their capacity for offenders on u nconditionai detention: the 'Dr. Henri van der Hoeven Ci!nic' in Utrecht (the most 'doSed' of the private institutions); the 'Prof. mr. W. P. J. Pompe Clinic' in Nijmegen; the 'Oidenkotte' Division of the Association of Institutions in Rekken (Vereniging Rekkense lnrlchtingen} at Rekken; the 'Hoeve Boschoord' !nstitutlon for the Mer.taHy disabled in Boschoord in the municipality of Vledder and the 'Groot Batelaar' Probation and AfterwCare Community which is an ope0 centre. The Ministry of Justice meets in fu!! the c~sts of running these establishments . The private institutions may also accept other types of patients: tho sa conditionally pardoned or released and those sentenced by a Juveni:e Court. . Sections 47 and 120 of the Prisons Act allow lor those sentenced to a tenn in prison to be admitted to the State and private TBR establishments on the grounds of their being mentally disturbed. In addition, offenders detained unconditionally may. also be assigned to psychiatric institutions in the field of genera! mental hea!th care. Numerous patients are being kept at the cost of the !'vH nistry of Justice at the state Psychiatric lnstitution -in Eindhoven. The cepacity of the private TBR establishments i.e. the total number of beds minus the capacity of the sick bay and the separation and isoLation units, ranges between 35 and 85. All centres fo.rT8R detair.ees have been provisionaity designated as institut!or{s within the meaning of the Exceptiona! Medical Expenses (Compensation) Act, whilst the 'Dr. mr. W. P. J. Pompe Ciinic' in Nijmegen have been designated 'appointed institutions' within the meaning of Section 7, sub-section 2 of the Lunacy Act of 1884. Until recently the St2te !r:stitutions took the majorl~y of patients a!though the !aw expresses a preference for private care. Nowadays the balance has shifted and siightly more than 50o/o of those in care are in private institutions. Architecturally State institutfons are reminiscent of outdated prisons. However,

extsnsi\!e reconstruction and modern\sation is currently taking o1sce. 1rl the or!\,., ate sector the 'Dr. Henri V3!l der Hoeven Clinic' and tne '?rof. mr: VV. P. J. Pompe Clinic' are new buiidlr:gs designed to tcke mentally disturbed offenders and the:efo:-e meet arl the rec:ui:ements of modern treatmer:t.

\N'r:e,l lnstit:.rti0:--.el tre2tn:ent is no ior:ger required, care of the o:fender becomes the respor:sibillty of a rehabifitatjon and afrsr-care organisation. ,.6,s far as the Government is concerned ti'"'.'e comrr.ittai o;der has then been suspended, but in fact ex:r2-rnural treatr.ent is continued for a time under the guidance of ths Nat:cnai Probat:on ar:d .~.fter-Cc.re Association which has n::eJionai rsh:::~ili:a~ion unlts specialised !n socio-psychiatric guid2nce.

'ii. T.B.R. vi·2W8d 3S n process .4s soon os a comrn!:ta! orde:- beccmes final; the most suitable ir:st!t:.Jtion 'for the off8n.j:sr is decided upon. Full particuL:rs of e:::.ch o~~t\:;n.t must :.=9 availab\a, and since 1952 the Selection l;nst'rt~·:e in Utrecht h2.S per7cr;LH3:d a cornp\2~e clinical p-ersonality test. On the tasis of its report, the ~/iinister of Justice decides in wha: institution :he oTfender shaii be ptaced. There are no fixed no;r:-:s though a ;1umber of factors are always carefully conskerad. They are, fori:tstance, th·e diagnOsis of the . pe:-son3iity disorder, ~he history of the social confl;cts at work, the . -;r:~::es commi:t<::d, the da:oger O"f escape, the threat to the co en 771L:n.!!y and, of ccu rse, the most suitable treatment.

?c.:t\;;;nts -vvbo s"',\\1 cor\s!itut_e a s-:::r\ous danger to the community are>: the r:-.ain a laced ln the high~secvrlty State institutions. PG~ie.r.ts .:sre re-~ssesscd end t;ansferred at regular intervals for various reasons.

'A therE:peutic enviror;rnent' T:-,:;.:::'.::-r:<?r:: Ir: an ~ns·::it'...:;:ion ls a particular:y G1fficul~ and cc'7"!p!~ca·~ed bu.si;-,e.ss, to which a brochure SLch as the present ca:;r:o: rea~!'! do jc:stice. One or t1.vo general remarks are perhaps caf:ed fer. The principle is ~hat forensic psychiatry provides the f12mework \Nithin which treatment is to take p!aca. This means th2~ the med1cc1 diagnosis of behaviou<ai and personality c:scrders determines the therapy.

(.

I

Psychiatry is continually developing and the institutions for offenders use some of the more modern methods oftreatmef!t. including various types of psycho-therapy, drug therapy, social therapy, creative therapy and movement therapy. The organisational pattern of the institut1ons as a sociai System, and the role assigned therein to the patients, are becoming increasingly important. The behaviourar sciences, such as psychology and sociology, have been prime movers in the creation of instituti-onal cor.ditlons usually termed 'therapeutic environment'. ln th~ daily routine of the l nstitutions the concepts of free activity, responsibility, social awareness, etc. are applied as much as possible. Understandably enough, heavy demands are made on aii the staff, parHcularly those known as group leaders or social theraptsts, 'front line' workers in charge of the continuous supervision of groups of patients. Such staff are therefore carefully trained. They received their training in the schools of Social Work where they study psychology, psychiatry, sociology and criminology to give them a wide knowledge of the behaviouraf scienceS which enable them to cope with their difficult work.

Progressive freedom Working with offenders committed for treatment requires much tact and patience. Rapid results are rarely obtained. Ali owe nee must be made for resistance on the part of the patient and repeated disappointments must not result in discouragement . Treatment is often a long process of trlal and error. In accordance with the purpose of the T.B.R. order, treatment is designed systematica!iy to achieve so cia! rehabilitation and the returr1 of. the pa:tient to a norma! independent life. Obviously return to norma! life cannot be achieved from one moment to the next. Many of the offenders have been cut off from the" outside world for years and it is highly improbable that they would be able to maintain themselves if sudde!'"l!y released from the institution. For this reason a system of progressive freedom is regarded as part of the treatment, and is used according to the individua! progress of the patient The amount of freedom granted is gradually increased and the success or failure is checked at every stage. The possibilities include escorted leave into town or to visit relations, attending sporting or other events,. visits to ~adopted' famities, leave of several days' duration for

visiting frfends and acqualntcnces. transfer to the 'open department' of the ir:stituticn, emp~oyment in industry during the d2.'f, etc. !"f favourab!e oesu!ts are obtained application may be m:de to the Ministry to authorise the granting of a 'provisional rei.9ase', \Vhe:eby a !ink vvlth the ins:itution ls maintained but the pn:ier:t lives r:-;·::::H·e or less ind-s:;:;endent1y in the communily. lf:he pr:)visional :-el,.:;.s3e proves successful U-;e con:mi·ttcl period ls cc·r;c;·~iona;;y ·:eiminated and the sl7er-care stage begins, in which the pa \ant receives further support and assistance from the pic bat o:t :and aft·:1r-care service unti! such time as the judicia! au tho ties decide :hat the order :-:eed r.o longer be extended.

•

SJ~.etch of Du 1,.r·lt ne>ctd lT~t~:t.~ce ,. In-·tE~;-c;;l_i~.Y~; __ ,i,;~~l:(-of·-F;·j !.;··;·~- iJlC Du Lr.li popu1h t ion · r;t_;_mbcrc:d over 13.5 million - a very h:tgh J:\)JAd ation rh~n;:,i ty, uverEt():l ug 399 p-.~:N;ons per U(iUfL!~e kilo;r,.-::·t:re. 1.i'I::!~) dcH~iity r·iu;ure: (:.O!Jt·rt:~;-;ts ~:J~~1r·ply H:i.th thu..t of the })utch correcLicnLl.l en trcatn:cnt. iu~;tituLic_;u;~ Ju tllf~ nwne period) ~~)CWG :people \!Cr(: ck:tainc:U, ::-:,503 o.f them in correctional en 3f.IJ in tr(::ntwent inntitutionn, l!l-1-.1 pel~ cent of' tht:: former category \<e.t·c remand pri:1oner1_1.

rrtw trt:atment institutions compriL:e five private and two s b1te institutions a::_:; ve11 c1s the Sele~t:ion Institute nt Utrecht. 'l'he Seleetion InBtitutc if: a state institution \.:hich decideG on the institution that is most appropei nte fo1· a mentally disturl·lccl offender v11o hu::; been ~-;cntcnced. 'Jlhe ~l;:cision i::1 t.nk(::n of the ba:.-d.s of very comprehc:nt:d.ve ruportG, compiled by the utai'f' oi' the institution, and o1' intensive observation carried out over u period of at lea~;t six we<')l-:s. An :inst.itution of this lci.nd iB ncccssury Lu-.; the treat.went inetit.u1-.iono do not yet ope~ rate regionally, and algo vnry widely in treatment methods and facilities and in grades of' security.

More than Bo per cent of the mentally disturbed offenders committed to the treatment ir;Dtitutions have gone there under· a special penal mem;urc, which came into foree in 1929. Ylhen this HH::e..:::-ure in orclered, the offender l.S "placed at the disposal of the Government 11 (the literal translation of the relevant Act) for the purpose of treut.Hient. ln common parlance this meusu:re i~ called 11 r:PBR 11

, the abbreviation of the Dutch phruoe. 1Jlhe Court may impose a TDH v1hen it p:re:.1umcs 11 diminished responsibilityu

of, in excepti(mal cases, 11 n,o rec.ponsibili ty 11 on the part of the accused. Pnychiatric reports prov).de the basis for a judgement like this. But diminished responsibility is nag enough for imposing a 1PBH: a serious crime (or u. series of crimes) u.~st have been commi ttcd and there must be an obvious rislt of further criminnli ty

Under the present legal sygtem the Court mu~Jt impose a prison sentence if it presumes diminished responsibility. In addition the Court may order a TBH. 'I'he prison sentence 'lltust be served first. Or,ly then, after the selection stage, does the treatment follow that was considered to be ncce::wary. 1:Ph~re is a Bill before Parlia.'nent at present which proposes to do away vith this ambiguous system by dropping the obligation on the Court to impose a punitive sentence~

A ~'BH t.erm lasts two years. At the end of this period -·and, if applicable, at least every t1w years after that - the Court must decide vhcther to extend the order. Irrespective of the duration of the 'l'BR term, the Goverrunent, i.e. the t1inistry of Justice, has the right to terminate the order at any time. If they do so, a period of probationary leave and a period of conditional discharge precede the unconditional discharge from the ~'B!L During both periods supervisio.n of' the pEttient' by a rehabilitation and nf10er-cnre orgunis€ttion is oblieatory.

Overview of the treatment; centre ----·l'iie-iie\;-j)y::--ITcnri-viiii-i:Ier-iioeven Clinic is situated near the centre of Utrecht, a tovn in the. central part of' Holland vith approximtttely 275,000 inhabitants. 'J'he clinic is one of the. five private institutions for the treatment of mentally disturbed offenders. 'l'he new premises carne into use in December 19"{4. Previously the clinic had been housed in a converted soft drink factory, a wooden prefabricated l:uilding and the inadequate ving of the Willem Arntsz Hospital, a large mental institution. ·

'l'he Van der Hoeven CLinic, which was set up in 1955, is an autonomous unit of the Will em Arnts?. Stichting, a non-profit making corporation thfl.t has been active in, the field of mental health for more than 500 years now, The corporation operated in the city of Utrecht and its surroundings.

In 19)) the HiJ.Jcm AJ'nt.nz f~tichting cc~ncluJcd a cor:. tract '.1i th t,hc; Dutch_ Govurm:Jcr,t to erJtabJiflll a l'linic for t:10 trr:11tmc:ntof mentally cti _:_;tu:cbed of'f()!'idcr~.:. O;lt~ ht:n,]:u~d !d.L2(::J v/er'C: m:_tJ::.; n.--h~:l_-la-L:J::' tc -cl:e Hin}.r;tx:y of Justice. 1Jlhe cont.;·._tc:t, is :.:-Li.ll in force. It give~> the ;:1in:i:~tr:; the r~g1.t to <1.;siguate the p(:n_;()li:> to b0 tr::.:ntcd; the \·lil1cJ;l Arnt:;z. ;_:;tichti:r11_,; i.s oblif',(':d to admit. tht:ne pcJ'·-~on~: ur~J.t~~~;,.~ t-hey ljudge r.hcm ul·~·ri-;:, r'or tl~cat~;ir:.;;;·:" in tfH: VcJl der Hoeven Clinic. Altllough the Jccisi.on of ·t11~ dir·ector of tl1e clinic ~s fjnal she ~e~dom excrci;_F!:\ Lcr l'ight tot rei\u:;e admi~H-d..on. 1.l'i'le contract nlso 1nc.ludes prov1s1ons conccrnin[~ the c:ust:·:; of, buildinr;, fitting ou-t and running the clinic; these costs ur~..-, bol'ne by the Governm£.mt.

1J.lhnL the clinie if: autonomous in demonstrated by t.he fact that the clinic is not co:1trolJed di:cectly by the gov-ernine board Of the corpvrhtion; since 1963 it ha:~ hucl u bourcl of its o;.;n. A grcn0 den .. 1 or n.uthority he.D bct:n vested in the board of the clinic. Dr.J\nne-Plnrie 1-\oosenbtn·g) a p~>ye:hiatr:i.:jt,, is the hend of' the clinic; her cieputy is 1·1r.H.L.\·!itJrt:;emo. 1 an economist~

At the moment so 1~1e '(0 in~_pnticntn are being treutt'!d in the Van der Hoeven Clinic, vhich can accommodate 90 pc:rsorw. rrhe mu,iority (80 per cent) of them have received un tmconditional rrHH order. The ler,al :ccaBons for the admission of the l.~emninder VD.l'Y. IJ.'herc is no age ceiling:. Uut at present tbe oldest pn.tit:nt in 50 yee,rs old. 75 per cent o.f the patients arc within the age range of' 20 to :35; of this group o.rJOthor T5 per cent ure 20 to 30 years old. rrhc lO\JeBt uce for ndmiusion is 18 (sometimes 1'() years. 111he criminal records of the p;,._~ticnts ndmitted include r-n-Tindle, burgla:rJ, violence, sexual offences, infm1ticide, mo.nslaughter, murder ttnd other off'ence:J. l·ifu!Y of the patients hnve u record of combined offences such as burglary vlith indecent assault and stealing vri th arson.

'l'he patiGnts - at the motiwnt sonP 60 men and 10 women - are divided into groups of u:l gh-t to t\.,rel ve. 1l'he nwmberB o:f each group hav-e close contact v1i th four group vorkcrs of both sexes. Nost .Of the group VH,_1t'kers ure qualified personnel) sociu.l vwrkers or general Hnd/ or psychiatric nurses.

In the nei1 premises the groups are houf.'iCd in units. 111here are four different units, three of them ucconunodating two groups each nne! one embodying three small groups. In tt1! w1its the patients have their own bed- ;itting rooms, ;rhich cnn be locked from the inside (in an emergency, the grollp workers can enter ;;i th the aid of' e. master key, though other patients have no "ccess). 'l'he patients and group workers have a key to the door of their P"rt of the unit; other persons ;rishing to enter have to ring the door-bell.

1'here is a regular staff of ·110, both full-timers and nart-timers. 1'hey help uncl stimulate the patients to curry out their individual treatment programmes. In addition there is a small group of persons, among them four sessional P'Jychotherapi sts and some ten teachers (students from the w1i versi ty of Utrecht) Hho are paid for their services on an hourly basis.

'l'he staf'f' also includes those not directly involved in the treatment of the patients, such as the personnel officer, the accountant, four research vrorkers, receptionists, ·secretaries, typists, two domestic superintendents, the gardener, the librariar. (\lld the public relations officer. 'Phere is no security staff. Although both internal and external security is given the utmost priority, it mainly finds its expression in a cautious hun ding-over of -responsibilities to the patients and: in prudent persom:C. contacts with them. The ne;r, purpose-built building makes security efforts easier: in any case it prevents the patients from absconding on impulse. Noreover, it is possible by me ana of a television monitor-system to lock the main inside doors elec·~r6-nically. 'rhe possibility of creating varying physical limitations increases the internal security and enables the staff to 1wrk efficiently. In the old clinic the stan· had to carry a great number of keys about with them, and locking nnd unlocking doors was a very time-conswning business. ·

Df~ve:lo:,",en\·. 0\'i'l' ·t)1(-; !_.r~~~t- ';\;cntv Ye:Lr;:; ~--~«~1 ;: •• --~,-,.::·~_·---~,-,-~·::···_ -~--:~ ;::··--,-~---~~~~·-·-•·,-:;-~·-,·:··;-~:~... '· -l ' ,._, C 0 )'.n ('.], rl '.·.· _(J f_, C'. 0 ·.f t.) ,· (.~ Hi :3 he~ U

c;, .. _ ;L'l.t u:;.J: Jl0L~•.;,., L~.<.J.lC vl~.tJlL~~<..t;;( lrCl:\, L '"- -

and idea.ln o.f' three :intc0 t·~~3·t.ed puxtiQ:::. In 1Siit) the _P;.:;yclJintric Ob;::c:rV-~ltion Cliui.c or Lhe: L'ri!.;c.n De~:axt;n,;nt lwJi lloen net Hp ir. lJt.rccnt. It \,·a;.,; no long bcf'on; the: thC:ll JrK~i.tLca1 ~;uperirrte:Jde.:llt) the p:>ych:i tJ.J,J·ict-Ju'-':_'/e"L· D.2nn, and hiB clo~;e~>L n:;s:i.rJtnnts, Hoot> en burg, n p::;yehintr.i ~•t) ttlHi VaL 1\r •. Lingt.!n ~ a pnycho1ogi3t

1 ~}tnt~ted Jooir.:i.ng f\):t 'days in 1 .. 'hich they cO';_l1il th.C:Jr:;:elves cu.rry

out the tr(:ai.:.m~:nt reco:::mendutions t.hey made in Llwi:c l'c~ports for the Court. a. l·1edi cal ;; uperir;tcntlcn-t l~ngclhu:::·d 0 f t !1(! Hi llem 1\rnt~L', r;ti ch ting \nillted

n 1'o:t·0nsie p~ychiut:ry unit ndded. to his int.;titution; it fittc::d in vith his idenl to eoncentrate u rwrvice for a vnxieiy of needs in a single orga1.1i~~a~tion. 1l1hc t•i:i.ui;jtl'y of Justice l'oJ.' itt> JX<.rt v:tts faced \·lith both a shnx·t.ne;e of places in exint:i.ng ir.r.titutions and a shortnce of :i.n::;titutions ·vtit.h ell-round treatment fncilitien~ 1l 1ho concurrence of these de;::i:ees resulted in tne fouadu:tion of the Van dcr Hoeven Clinic in 195).

Before the ne\·1 institution bcgfU1 to operate, the management ancl sttd'f familia:rined themselvcj~' thoroughly v1ith the experiences of' forcir,n pioneers. fl)hey vi5Jited Dr.Main 's Cn.sf.;el Hospital nnd Ha,~·..tell J'ones''s institution in Englund; in liJ:·,r;.nce they sa11 Si vadon, Daumezon and Henry Ey.

lni tio.lly there ';ere less than 20 pn.tient~J n..rHl about 35 1~toJf members. 1l1he clinic H<:W only partly in w .. orking condition then. Intensive talks vere conducted \lith the p<Clients be fore they settled in. The tulles 1H:re meant to invOlve the patients as much us possible in the mnnagem0nt of the institution, in each other 1 s welfr:~re u.nd in the setting up and co.rrying out their own trea;l:.ment prO£jl'nmmcs, ~n~c emphasis on their OlAn re~:;ponsibility ¥H.\.S something nm,; n.nd dr.\-urrtrin.g to the pnticnts. l•!ost of them had had vide insti -LLltional. experience fl'C::l l(.'lng :$ta;/3 in children 1 s homes, borsta.ls und prisons. 1l'hoir rt::opon:Jiuilit.y had been completely tnkCn away from them in these institutions 11

the u.n-e,nd-them-c,ttitude had been rigorously maintained and thece had been no personaL r·:-:l .. at:i cn~;l!lpH ut all.

1.Phe tu.lh:g \·:ith the pa.tienta produced a m.unber of house ruJ.tf.J a consul-t at:: ·vd CO!f:rol t ~,0 1;; t·:as {j,J.sO se't up to represent the patients at regular meetings ,.,ith th\~ stti!'f • .4 . .,.,.;_u_e vn:riety of coJL.t.~ttees, composed of' patients and staff', ~<ere ct:tned: cLe financial committee for the mru1ugement of the individun.l patient 1s ir.c<Jmt~s; the C!lot.bing committee which saw to it that t!1e patients built up a ):cason able \.ftlrdrolJc; the axbi tration eomnti ttee, which acted as ""~ peuc~ma.Ker in co:d.'.licr,s between staff and patients and among patients themselves; the committee for culture and recreation, which wan in charge of plunning und financing cultural a..t1d other leisure activities; the workshop committee, for consult at.ions on the atmosphere and conditions in the workshop ar.d the domestic service, and on po.y, merit-rating and the allocation of the jobs available. r11h0 llouse rules (r.{1apted according to experience and ne'v Circumstan0eS), a reeular cons·-,tJtutive committee (which has changed several times as regu.rds composition, terms. of office and tasks; it no~< includes staff) and the COllum ttees ar~ still Opf:r<tting. At f'irsc on:'.y the restricted, traditional means of treatment of those duys, L e. psy~hotherapy "'"d 1wrlc therapy, uere used. Actunlly it vas not long before the phrase ''work thcra:py" was replaced by 11 worl{ training" because the aim uus to t1·uin :~;utients in proper skills instead of' keeping them busy 1<i th simple ~<ork on the pretext of giving them thero.py. 'l'he premises, which had been dedscned v:ithout consulting the originators of the treatment project, did not contain ndeq_urtte roota for work training. Accordingly the first oxmex was built as early as 1956. Ac; regards psychothe' apy, during the first few years ind.i vidual psychotherapy was coo1pulsory for everJ patient. 'l'here 1-ms .also some group therapy t in which role-ple.ying was used.

I I !

~·lith~.n u fc\-; y:.:v.r:;, education· and ;.>port:; \·Jel·t_~ nctdt';~l t.o the l · 1 1 j t -, t . ' t· . · J 1 ~- ·o ·1 ,-, !,!>'"' puye.1ot.oernpy nnf__ i,_,,te '.10l'Jt ·rn.1nu1r;~ Lou~~n on a :~wa .... . )c , .. ; • .._ .....

range: of trou.tm\':nL ru.ci1itit:::; v;n~; to be cxten(_1cd ov(~r the yc:.J.r:·; ~

not or:Jy be:ctPJsc o:f' th~; GJ.'O':!th CJf the e:-:i.st.iof:~ t:;cctoJ.'8 (tt.dC:itJ.c:l vf judo n.nd ! .. nrlnuning to the sports uct.iv.i.·t,ic:;;) of t.rZLin:i.ng in :~ocial ~Jkillu nnd sex inutruction to the edu,~·tJ..t.ion depa:rtn;():!r~. and of rnn.rrie<l couple·;; 1md family thernpy to tho type~;. ot· therapy uvailubJ.e), but alno hecn;nne of' the adoption of rW\I mcthodG. '.rhe 11 creutive f:iUh~)ects

11

, espeeiully, have cxran{tt-;d ro.pidly: at prt·:!!3Cnt there (>Te teachers: ol modelling, sculpt u:re # dre.:TJa t f'ref: cxpres~~ ion~ mi:-:!!.:! ~ crafts } mur; i c nnd draving. Hole-pln.yin\:;, p~'lychod:cama and r .. Li.ml.d .. utio!t· .. pls.y have become mucb. used lllCH11G of treatment. rn1ough j --'c ht .. d been considered ithpO_t'tant right i'rom the beginning to :involve the relative~; Etnd close friencb of the prll:icnts, a ..larger stn.ff and an incrc~w.;e in knou···how mu.de :i. t possible to adopt a mer(! efficient approach. A Protestant. und u Homan Cn.tholic mir:istt::r of' religion hnve o.lso been on the staff from the very first.

'l'hc gro11ing number of patie~,ts (from 20 to 70), the ~ridening range of treatment facilitic::.; uncl accompnnyil)g increa.;;;e in stct.i'f soon caused a serious 1n.ck of spaee. rl1he pu1·chase of the soft drink fucto:cy ndjacl:mt. to the existing building, \vhich brought forth u confercr.ce :room, a gynmu:-.d.um and a creativity room, relieved the situation r;omcwha.t. Further, part of the staff had their offices in a voorlen prefab building during the years immediately px·cceding the move to the nevr clinic. Apart form thC lack. of space o.s nuch, the lack of space to satiB fy the ever-grO\Iing dc1aand Has an obstacl8 to treatment. 1l'he original building contained, for example, open dormitories for 25 patient[; eo.ch; af'ter so:ae time ther;e dormitories 11ere divided into t>ro, and lat0r on they \Jere cub divided up into small v/ooden cubicles to meet the Justified claim of the patients to more privacy.

Slo\Jly, the idea to Set up u nev, ptn·pose-buil t clinic received a definite shape. !\ thoroughgoing process of thinking, organising and negotiating 1.;ras started. IJ.1he fine result is here be fore us today·, and it offers on abundance of ne~< possibilities, difficulties and incentives.

Ideas nnd beliefs of our Treatment Credo

I. "Society is a prereQuisi tc for any progrmmne of resocialise.tion." The implications of this idea, as expressed by Dr. noosenburg arer -'rhat tul institution which aims to bring its patients back into society in the proper ~my should be situated 11ithin this ,society. In other vords, no idyllic setting in the· countryside, but a location in a. town of some size. rrhis guarantees enough potential er1~ployers and "contact fv.milies" (families that voltmteer to entertain a patient in their homes £rt regular intervals) to cope with the turnover of putients. It also guarantees a rea~onable variety of clubs and youth centres.

-'!'hat running an institution me011s informing 1ociety about 11hat you are doing a!1d 1rhy you are doing it. The V011 der Hoeven Clinic has from the very first been willing to receive visitors both from Holland 011d from abroa<l, it has MS1Hored numerous questions by letter, it has obliged broadcasting companies and the press and it has participated actively in congresses. both national and international. 'rhe Clinic >~as also the first institution to engage a special public relations officer.

All the~H~ uctiv.itie~> have bL~e:n bused on tJ:e belief that r·.:::>oeio.lisution ct~n GuJ.y be e.cl.~.leYr:d th:r·ouc;h the society in vhich the pe:tient iH to be placed. 'L'hi" society mast he taken seriow1ly if it is to show s ufi':i. eient tolt~ ranee and unders te . .nding. '_Llh is n:ukes nn eJ:~tru demand on in.sti tutions \i'hich tend to alienate themscl ve:_~ from their environment by meawJ of an immrd-looltine policy.

II. 11 rl1he staff of un institution mu:Jt onl:t bear those reBponsi 1ilities \rhich the patient:J cn.nnot bear· thcn;selvcs 11 It in the tcsk of '~n insti-tution like the Van der Hocvcn Clinic to allow people who have sho;m i1-responsible or noxious behaviour to develop in such a Hay thu.t they ·Hill bo nble to take their places in society uguin without being a danger to others. To do this the institution :nnst teach patients to bear responsil,i:Li ties, both for themselves and for otherr> ~ 1)his is a most importn.nt point) to whj ch conste.nt attention should Ue given. r11he stuff~ influenced by tradition and conventional atti tuden, l'i.cep vanting to p1t\V cnring a.nd protecting roles. 1J~his fits in iii th thE: net'!d of many patient to be cured for and to get Uusic thing::; in life done for them by others~ Even i 1.' some patients do not_ feel such o, need, many of them are ace us tamed to infantil:i. zing treatment from previous stay8 in institutions. 'l1he staff's tendency to nurse and the patients 1 need to be nursed produce an infantile, hospitalizing atmosphere.' rrhis does not help patients to achieve an independent position in aoc:i.cty. ''

Practical conse<J.uences of the second preposition are that:

'rho patients are very much involved in the setting-up of their own treatment progrrunmes and in evaluating the progress they make;

They sit, us state'a above, on a varie1iy of co~1sulte:ti ve > advisory and decision ... making comrni ttee:s, vrhich tuke responsibility for the proper functioning of the whole clinic or part of' it;

~'he groups have to do their O\ffi household chorer; and obtain a housekeeping ellowance in cash;

The mending of broken windows or damaged furniture and the replacement of household utensils are automatically charged to the patients' accounts.

III. "To keep the harmful side-effects of the intramural treatment to a minimtun the normal desires in life mus.t. as far us possible be kept intact. 11 1'his means to us:

That contact with the opposite sex is an everydag affair because of the composition not on.ly of the staff but also of the patients in their house groups, the committees, therapy groups and workshop groups;

That handling real money (i.e. no credit coupons and such like) is part of the daily life of the patients;

- 'l'hat in the treatment sector more ru1d more stress is put on the avareness of tin:e; the fact that the 'J'BR is actually of indefinite duration makes dividing the treatment programmes into phases especially important;

I I I I

I ' i I ' ~ f I ~

rr::vir;ion 1

the :·:trong de;s:i.:ce of..' both n tnff and. pnt.ic:n t:.; fen· peace tendD to create Et red te.pt'! orgn.nization ~ e:.::cltt.J:lng all <::Vl:nt~; tUhi Jen.ving no J,~oom fol· inJ.ivic_lucd iniLio.tive.

sine:~ OJ'(k:r

Ul1expt::ctc:d

IV. ";;ixty pet.ic:nl~s arc the ideal number for un innti tut:i.on fo.t.• the treatmr:::r1t of J;:c~ntuJ.ly tli~.rLurbed offcndcr~a. 11 Economi::.;ts) filWJ1C:tc:rr.; and the builcl"i_l!g trade strongly urge the bui1din,r~ of institutions thut cnn accot;;;~odutc hundt'(··Js of pntients. 11'11-::: HLt:umen-t that c.:ertnin e~onomie;> of scn.}.e increase efficiency is valid for normal in~;ti tnt.i.ons, but not for t:c<:at:nent ccntrcn., since lexge rn.:H;bt..:t~:_; of pntient.B '\>Iould be d:i.snstrons for tlicir trentlr1c11t, 'riley lfOUld reinforce the existing 11 us und thCH1 11 at.titude and diminish the chnnct.:!s of buildir.g up the neces~:;ary pe:cscr~al relationships. In nddition the difficulty of superviJing the institution \-/ou.ld 1'0du.ce internal und ex:Le:cnnl ~Jecurity. '.Phc impe:t·sona.l ~ f.'nctory-like climate \-rould increase the duration of the treatment; this \-TOUld result in a decline: in dischtn·ges ~ On the other ha.r1d, an institution for some 20 or 30 patientn would bc equally inudequu.te, since there \lould not be enough money to pay for lt.u•ge buildingn oi' staff' with u sufficient \'tl.},~iety ol' ;:;kills.

( 'ro the board of' gover·nors and the directors oi' the Van der lioeven Clinic sticking to proposition IV has meant a lwxcl fight with the subzidizinr;'luthorities, \Iho bud oeen inDtructcd by their financial and economic advisers. J~.t lust a conn:romiBe between 11 at least ~!00 11 and "no more; thun :'Go" has been reached: 9o permn.ncnt placen and tvclvc places for interwivc care and isolation,

..

Dr. Henri van cler Hoeven Kliniek Willcm Dreeslaan 2, Post bun 1'(1;, lPrHEClfl'. (tel.: (030) - 716822)

Peter A.M. Hendriks former staffco-operator for ~nformation ond documentation

also in: "InternatiortLl Journal of Offender 'rherapy and Comparative Criminology", 1976, vol.20 no. 3

..

I

(

AI'} 'lS i'PJ IX 1 1~~): ·~"··---~-·---~~~---'--

The Dr. 1knri VD.n! der llof~ven-clinic, Utnc;chl, The Netherlunds-;. 'I1H~ nev1 building uud the ickas \-;hich und .. ~rli(: it. A.~I.ROO!Jenburg, Director.

A new clinic: Why? ·~~----~--·---~-~-~-~~-

In 1955 at tbe titHe Hhen the first bt ilding of the Dr. Iic:nri van der lloevenclinic V-HiG established none of the methods of trcatment,Hhich \,,ere slO\>Tly developing after World War 11, l1aJ been opplied to delinquent• not voluntarily seeking trentmcnt. Hcithe1· the Institute for g·couptherapy 11Groot Batelaar

11, opened in 1953

by the f>nlvat:ion Anny> nor the Van der: Hoc-:ven-clinic hud therefore been ohln to t,rofit from tl1e experience of otl1ers. As a consequence both institutioru: ~Jhowed from the .':tart shortcomings in the design of th-e building 1

distribution of sp<:lce; and fu1·nishings. These shortcomingu increased with th6 development of tl'eatment possibilities nnd Hith the higher living standard clemandcd gencrlLlly by society-at-large. In the 7.0 years which followed, these shortcomings ~-1cre pt~rtially uttt!nded to and many plans \verd made. At first: it \vns thought that n ne\V building could be erected in the grounds of tl1e Willem Arntsz touudation in the centre of tile old town. It waa hoped that both the Willcm Arntsz House (a wcntal hospital) and the Van der Hoevcn-clinic would get ne1-1 buildings there. llmvever the Local Authority of Utrecht dreH up redevelopment plans for the inner city in whiCh the end of 'the Liit1ge Niem.:straat vws rerouted. This made Lhe previous plan impossible and a nmv building site hud to be found.

The neH clinic; \'!here? ""

With Dr. Engelhard and Dr.Hut, the medical directors of the Willem Arntsz Foundation under whose directorship in the 1950's the plans for the Van

1: dcr Hocvcn-clinic were successively finalised and realised, Dr.Baan shared the conviction that the clinic should be placed in the middle of the everyday cormnunity6 Although the Hillem Arntsz Foundation had ample grounds at i·ta disposal in Den Dolder, building did not start before a small area behind the \Villem Arntsz House could be c:eared. In practice the situation of the building has proved to be ideal. \Vhile looking for a new site the board and we - the staff invo 1 ved -stubbornly rejected all offers of "attractive sites" in pplders and even in a fort.. He were vigorously supported by the section "Psychopatenzorg" and the psychiatric advisor of the Department of Justice. It goes without saying that it was .no easy tosk for the Local Authority to find a sitb that could compare favourably with that behind the old hospital, He are thankful for the place in which the. clinic is nm; situated. Although industrial and office buildings are now our nextdoor neighbours and we are pretty isolated in the evenings, at nights and at_weekends, we have an easy access to the different city districts. For someone who looks at the building today it will he a rather amazing thought thot the Department of Justice hesitated to give its approval to the site on the grounds that it would be too sinall.

'II ' ' d 1 ' ' t The JUrllt an psyc••atrlB Baan was one of the founders and the first director of the clinic.

The nc\t clinic~ For \Yhor.~? ~h---- -~--~----~---·~-·~-~---"---·-

Dr.C.F.Engelllarcl, llJt:Jical-dit·(!ctor of the Willem Arntfiz Foundation from 1926··1952, \JilB of the opinion that the subdivinion of psychiatt-y, which became more nnd more in vogue) in clinicnl puycltiatry; social psychifl_try, child 11sychiatry and nlso forensic paycl•latry was au artificial one and hannful. TI1c taak of a p~ychiatrist was 1 as he saw it) to assist people with p&ychic diffi.cultic:;, And he perceived Lhc 1-/ill.em Arntsz Foundation as a founJation \Vith the task of giving assistance in all nrea · of Public Mentul llealth. Tl1e out-patient tlepartment of tl1e Foundation recognioed therefore among thc:ir patients many dcl.lnquents who VH:!re in need of after .. cnre and several nfter-carc organisEttioitS l1ad u consultinghour in the \hllem !lrntsz lloune. When tltc Departmettt of Justice was looking for possible in-patient treatment facilities for offenders who th~y judged to need this type of care, it could convince the Board of Governoro that the Foundation had a Juty. Dutch law prefers private care above state care for tl1e treat1nent of people detained in Her Hajcsty's Pleasure (Psychopatenreglewent art. 2).* The Hillem Arntsz Foundation is one of the few privutc organisations which realised this preference. 11w· contract between the Hillem Arntsz Foundation and the Department not only guarantees therapy places for delinquenta detained in Her Hajeaty'a Pleasure, but also for all others for Hhom the Department of Juotice 'nmtu treatment facilities. So it is poaaibie to admit people sentenced to a penal institution or sentenced to undergo treatment with the .alternative of prison in dofault, young people ordered by the JuveniJ e Cou~~t ::1nd even those subject t:o deferred sentences, .. The neH clinic: H01;?

\Vhat. now is ~<rong Hith these people for ~<hom the Department wants treatment facilities and what: is needed to help them? It concerns people whose behaviour in the eyes of the courts has posed unacceptable risks; about whom there is the expectation that their behaviour will not be corrected through the usual sentences, but will go on endangering persons or property, These expectations are normally based on a social and psychiatric, or. psychological report covering the history of the patient and the present situation. He have never set eyes on a report in wh·ichthe offence'leading to the rc9ognation that treatment was necessary suddenly seemed to emerge within a reasonable harmonious life. On the contrary, the reports almost without exception describe very unsettled living-patterns frequently with a strange monotonous repetition of behaviour and fnilurea; and, as response, an often na monotonous reaction by,other individuals and agencies, Ar,ain and again when we try to discuss

* In the Nethedands this type of measure Hith which the State receives the task to treat special delinquents ~an be used by the court in case of declared diminished responsibility or irresponsibility for the crime committed,

I

this witl1 the !l~tie11t~ we find'att illC3p~tcit~ to cll~tngc ::t1is l;ei)avi0ttr, tll<> inability to .-,:;k for lu~lp Hith thi:;, or f!\1 t:n the inability to recog,nizo tl1i::.; bchuvi\)Uf and iLs consequence~;; al t:houl:h foL~ Ltll ouL:;.idct· it" BCl'i;w t:'O clear. In general it 8CCu:; that patir,nts have not bee11 able to achieve Hatis-

f.:lctory pcroonal t'elat:ionship;,, and the crimes a1·(~ often the result of a11 inaJcquate effort to realize tl1cse or the result of all kinds of emotions when Ll)ese cffort6 fail. The· aim of the tn:atment cannot only be to stop the intcn.1ction harmful both for the patient. and for otheri;. If one does not succeed to reach a for him more saLi.sf:ying inter .::tion, then it v;ill be inevitable that the patie1'.t. Hho \\1 il1 attempt all the came to occupy ;Jn O\·Jn place among others, Hill J:elrtpse into his old and thus disl·uptive behaviour. NoH his rcmovul from t-he b:el•. community is thour;ht nccesB£n·y, the clinic \vill have to offc1: him the elwnce to face up to his share in the dcvelopmertt of the collisi.ons in soci.cty wl1icl\ hove led to his ndlnission. And l1c will only be able co loolt at l1imself scriou~ly wt1ctl l1c feels reasonably safe. If it is not possible to achieve this 1 then all that can be ezpected in nelf-dcfence and egocentric selfpreservation. It is exactly tt1e feeling of bei11g safe wl1icl1 seems to be missiog in tl1esc pnt:iciJts. Again and again one hears the complnint that they cannot trust anyone in spite of the longing to do so. One difficulty is that they cannot cope with the con~ sequence of S\JC}l trust 1 namely to be trtlstworthy themselves. For those \olho have a .Jlong experience 'of institutionalisation this can be a t~ather unusual frame of tnind, used as tl1ey are to conforming to the expectations of the staff anJ to displaying a sort of sham-reliability among thenwelves Hithin the ~wbculture of the institution. The ilhwion of t\VO '140rlds, namely that of the puh'erless patient and that of the po"erfull. staff is a seductive illusion, especially when the coHsequcnces of Horkinf! together on a basis of trust b_ecome heavy to bear and demnnd a ne\V at t i tudt?. 0 f mind. Res carcher s 1 ike cor fman havt! made it clear that the classic institutions offer little suitable space to develop new personal be!1aviour. The institution is a necessary evil, it is necessary but also evil, We were bound therefore to try and minimize tlte harmful side effects of ad1nission to an institution and not to exclude, through the manner of organiz;.ng ourselves, tl1e possibilities for varied bel1aviour au are offered in society. This has led to a·rchitectural provisions in which there are trainiug grounds for the development of personal) mental and physical talents, and this han also led to the creation of a living area in ~;hich together one can learn to live \vith others \~hile preserving one's o\vn personal sphere. Hut, however well designed the architectural provisions, the climate of a 11 total institution11 could in our opinion only be avoided if we HOuld take our conviction seriour.ly that members of staff should not do more for patients than that 1;hich they can not do themselves. To achieve this we made changes in the day to day living arrangements, Out of the nursing coats were set aside those amounts v1hich tverc earmarked for cold meals, cleaning and upkeep of living and sleeping quarters, depreciation of the furniture of the patients 1

01111 rooms etc, These sums have been placed at d1e disposal of the patients with the instruction to provide themselves with the items ~;hii:h the money was intended for.

•

f

Of cour~;e cettnin requiren'.Ents h~V(~ to he met tls to furniuhing and care of the house, nud thct·e are cht::cks \.rhich hav~.- con~;c,lucn(:er> att~tcheJ to them~ For a w~\¥ pat:ient this m~nns thnt the room 'd1ich is a.lluLLt·:G Lo him i~; unfurnit;hed. and has no curtains. In;:r:..:~diately on the ct:.~y of hiv .\lrrivnl i.t in up t:o him hov; llc HanU_; to .;HTLmgt>. his room. Does he uant to usc the available fund[; to btJY fun1iture on hire'"put:ciH:WC, nnd if no Hhat kind of furniture'~ Or \.Jill he huve furniture send f:o him from home and put the

I:wney aside for something else? For the. cold lJle[d.:J one hns the choice of buying food Hi th u group or individually. In this one has to balance the consequences of having to truot otl1ers and maybe granting nomcone a bit more.J against the advantages of buyine cl1cap,:r in bulk. The fact thttt each patient can lock the door of his 0\.Jll room from the inside is one of tit~ factors wl1ich made it at lel&St possible for men and Homen to live together~ in a group. Nm.J it is not anymore the staff, but the patients themr.r~lves v,rho have to see to it: tlwt no undesiraClc visitors can come in the ni.ght. And ~>ith that it hun become clear hoH difficulc it is to Jef:inc one's position about this., Of course learning to deal witla otl1ers more carefully than one used toJ includes ll continuous concern \vith the safety of patients and staff tvithin the clinic, just us with the safety for the outside community. Especially in tl1is clinic the attention of patients and staff is often focuosed on that issue. Haybe it is intel,~esting to note that our principle that staff should only d'o that Hhich can not be fruitfully done by patients has led to a larger choice of tvork~training plqcc1:a::nts for the patients. This means that in the kitchen there is only one cook ,,,ho rn<Htages all the meals and the budgeting uith the patients and uho also plans the r.wnucs ~;ith the patiento. The nwintenunce staff, the domestic service, the administration, the storeroo1n and tl1~ gardener also provide jobs for patients. TI1e shop .. ~;ithin the house is partially managed by a·patient.

Design of the ne;, c1 inic.

Only after the situation and shape of the building site became knoHn it Has poosible to convert the program of demands into a design for a neH building. It makes n big difference if a site possesses in part a natural boundary, if it is enclosed by houses or, as is the case in question) lies free to all directions and borders on an estate Hith industrial and office buildings. It has been especially the sociologist Jessen Hho in the last years of his life, first Hhile Harking in the clinic,later in additioa to his lectorahip in Groningen, has acted as adviser to the architects and assisted tl1em in finding appropriate designs. T(1e buildings are situated along the outside of the grounds. In this 11ay a spacious inner garden is created ;,hich is not hroken up and is surrounded quite naturally by buildings ~;ith a minimum height of 6 tneter. This is necessary in our opinion because the behaviour of some of tl1e patients constitutes for a considerable time, even during treatment, a risk too great for the society outside. In the old, so much more cramped, building ~;e

experienced the oppression ;,hich lack of space and Hant of privacy give, eopecially to those ;,ho are totally dependant on facilities ;,ithin the clinic. There it ~>as rathereasy for the patients t0 escape from that oppreosion, Keys Here copied and circulated and it Has a trifle to open a ~;indow .•

" ln tid.::.: tJet.; building ~~e 1wvc- tried to prevent thito impuh~ive ruwung n.v;uy \vit:houL ain1ing for <Jbsolute secu1:ity. Breakin;~ out htb ln:en made mor·e difficult, not· jwpvs:~iblc, by fitt.in;: n~infurc(•d ~lau_; on the outr>i . .:..\(;, of tllose bt&ill!ings whicll patients use 1 accompani.cd or alonti. One has to wait awl uee if t:hc~_;e solutions give the be;.ol: re.sult;-o; it i.s pot.;si.hle that

improvcmdnts have to be made.

The building contains lr parts: a) The p.:n~t i'n \·lhieh the patients normally move freely '"i thout encountering locked doors. '!here arc /1

11 l!ouscs 111 3 vf \Jhich are occupied by t'i.·lO nroups in each of

which 11 or 12 patients live togctlter. Euch g1·oup lJas at its disposal 2 sitting rooms Hith doot·s opening to the gar,len

1 .kitchen facilities, cloakroo1n a11d toilets. Hcsides tl1is each group has

a first floor unit with a single room for each patient. [ach p~ticnt has a key which fits the frontdoot· of his group and the door of his etvn personal room, The ltth 11house 11 has the same faciliticn but then for 3 smaller groups of 7 pat.:i.cnts living together. The a:.cea in which the patients can move freely also irtcludes. the enclosed garden and the wing in whiclt are situated meeting-roomu ior tltc council of r>atients, space for leisure activitieo, tlte ltairdresser and tlte sl1op. 11tis is the first layer of building; garden 1

11houses 11 unn 1n betHecn 'vhat is called t,he social tvi.ng, the \ving in \vhich there are all kind ot leisure provit;ions: In normal ·circumstances nothitlg is lc,cked here.· If it bccomcA necesHary for reasons of safety tl•cn,it is possible to sectionaJ.ize this area at several points.

b) 111e second part. This is the part in t1hi.ch the patients with the assistance of the staff work at their trelltment programs of develOpment. In this category belong the sportscomplex, the different craftworkshops, the recreation hall with side roomo, the education depar·t:ment, the room for pastoral care, the room of the carreer guidance couttcillor, those of the psychothet·api.s ts, rooms for group therapy ~<i th or without one-~;ay screens and possibility of vir~eo recording, the trade workshops, the kitchen and the doctors' surgery. Apart, above the wing for leisure activities, lies the intensive care unit for patients ~;hose behaviour shows a pattern of repetition ~;hich is maintained because the reactions which they provoke in others with ;,hom they come into contact, are precisely those ~hich again strQnghthen and confirm their mm. If in the group in ;,hich they live the other patients keep showing the expected reactions then it might be necessary to take them into a much more controlled environment in which this can be avoided, The unit does not only offer the opportunity to introduce 11ithin the livingl'pace of a patient those limits which are necessary for his treatment but aloo to enlarge this livingspace aguin in a controlled 1nanner. Patients admitted there sometimes seem to be able.to go through a very t·apid phase of development when they are not able to provoke their surroundings into the usual reactions to their behaviour; provided that there is an intensive program specially tailored to their capabilities. Besides these patients it is possible to admit to this unit those for whom living in a group is too disorientating and confusing; for instance.a new patient.

,, Finally thc1-·(.;- is a Bi:;all vanl fo;: LhE c~',re of the phynic.ally ill,

c) The third p~nt of th.:_! clinic i~; that in \>'hjc.h no pntL~nc should come; the pa-ct in ~,,hich is located tile n:.:l:es~tary otJ:ic.c. t~i~ace Lye stafi'wembero.

d) The fchrrth part 1 finally, could he called "betHeen inside and outside". Here are situated the ro•Jnw of those staffwen~bern vtho li!iliHtain and Gtimul:ttc contact: with the outside Y:orld, and it i:.> possible to receive here thoae relatives \.JhCH;e presence is not desirable where patients have freedom of Jnovcnwnt. llt:re al8o are the small flats and guestroonw \Yhich i:or us in this clinic are a novelty. It offers tl1o pittientu the pos~ibility to receiVQ their relations in a much rnore personal manne:r LJu-n. tvould be ponuible within the group they live with. Jul';t imagine a couple th.-:tt has to live apart because one of the partilel.~s has to receive in-patient treatment. In u flat) perhaps witl1 children and other f.omily members for whom one can rent a gueatroom} they are able to cook for t:h::.mselves, m:-~ybe receive visi t:orB by thenwelves, uccupy themselves vith their chilch:en; in ~;hort> experience what being together really means. If intensive ~,uperviHion or treatment of the fami1y is neeessar:yt tl1en there Jre all tl1e other facilitieu of the clinic r1ear ut l1and. For patit:ntr. Hho possess a long history of institutionalisc.tion and a poor kn01,1lcdge of society the tln·eshold to this society is often a very high one. TI1ese patients so used to institutions find it hard to J.ive witl1out the oupervi~ion and continuous pr~s0nce nf others. ~·ev are ~ot t•PP~1 tn taking part in other forms of companionship and £mnily 1 ifc. A temporary stay in a guest:room or fLat as halt-vay house can for them be a useful transition. ' Haybe it seems that some parts have been desip,ned rather too !;paciously for the 90 patients \.Jho are being treLited here.. That is quite true, and it rnieht provoke an1ilZCnJent that those parts have become so beautiful exactly because we did not '.:an'!! to push up the nu.rsing cost higher than necessary. We found that it: is very important for the treatment of our patients to have a large choice of poosible lessons in creative subjects and in sport. He thought i.t necessary to provide an own S\Vimmimgpool} a gymrwsium and a judohnll. He also needed a recreation hall \vhere, on occasions, a)l those who are treated in the clinic and those who ,,,orl< there can come together 11ith or without relations. Ofcourse provisions like these '!ill make any building expensive for such a small number of patients. Besides one does not use them 7 days a week, all working hours of the day. As a con· sequence they frequently stand en~ty. We lookerl into the poosibility of making them useful for the neighbourhood in 11hich the building would be situated and so justify their construction. He found a'great shortage of teaching pools, gymnasia and of halls suitable for different types of meetings. By taking into account the demands of future patrons these rooms turned out more beautiful andbetter equipped lhan might have been justifiable for the vse of our patient's alone. At the same time the income out of rent sees to it that the nursing cost is less burdened than would have been the case if the design 11as more modest. The sceptics in the Depart· ment of Health 11ho suspected that 118 ~Jere just trying to press through a rather too fancy clinic are without doubt reassured by the knowledge that we have been able to let the swimmingpool already to O.A.P.'s, a neigh·

bourhood club, a swimming club and 11 teacher-training-college. The gymnasium has been let for a large number of hours to two primary schools nearby,

{

The u:.;\.~fulncf.>D of th\~ buildiug f}oJ: the nC>iglibourhood h.:J.!> 1 ofcom .. ~Ge) ll

totull.y differetlt aspect bcvidcs the financial one, Decau~c of it it htt8 bt":comc ensier LO disctws the v1ork 'vhich He do Hit.h our patients. YJc hope~ that OV(~rcnpacity of nny kind can be mndc. b.:.neficinl te>- the community we Hork :in. TalkH ,'JC thus in progreBn \vith diffcr<:nl.: bodies llbout poa"ible dny-nuraing nnd Hork-training facilities for otheru than our own patients.

The ftttncheJ map intends to e::ive a global impression o). the spacial dia~ tribution of all t:heHe elomentll ~;hich together rnuke the building of the Dr. ll. van der l{ocven"clitlic.

May 1975, (speech at the official opening of tho new building by dr. Roooenburg).

..

Dr. Henri' van der lloevenkliniek Willem Dreealaan 2 Utrecht Holland Tel. 030 - 716822

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1~ Pcrter 1 s lodse, central control atic~ 2. Receptior.:..rooms, corridor between' inside Cs...-:tcen

end outside social 1..~ork for outside ccntacts

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Factory ( :-:ete.l) Lau::Jdry (self-service) Church

3. F.all for £eneral neetings 4. Foyer 5. Pl:'.yz.ician and dentist 6. Shop j. Hairdresser 8. EobbyToon 9. Librexy

10. C~neral coordinator 11 .. l·~eetingroo::::l clinic-council.

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Tre;o!mcn! re,.tlis a! ll•e Netherlands

lkprintr,l fn •Ill I: H a pit/ Mn/i;_ !I I n;el!/flfictru( Cungros St'll<'~ No. l!·J

I'SYCI!IA"n<Y(Pan !) l'rol·~;~·dJJl):" •JIIlH: V \VrHhl Cnugrc:.~ oll')p:hwrr y

Moi,-,,, /)_(_ }) No•·otih(·r-·J lh-cnllba, 197[ Exl.:l'f pia f,!edi..:or, A rml¢1 d.rm ISBN I}() 2 I YO J {)1) 2

the Dr. Henri van dcr Jlocvcn Clinic, Utrecht,

J.i .. Jcssen 1 and A.M. J\;JOSCJ;i;urg 1

1 Fuculty {)f McJicint: and Fu!:ulty of Soda! Sd~nn':i, Stat\! University,

Gwnint;en and 2 ril. Hcnfi vom dec Hoevcn Clinic, U tn:dn and Faculty of Law, Statr Uuivcr:-;ity, Leyden, The NcthcrlaJHh

IN'I'J\0 llliCI'lON

The Ncthcrlauds ll<rs 2 State iustitutions <ri\IJ 5 private ones where criminals can be sent if they arc ~.:onsitlcred by a ...:ourt to be not at all or only partially rc::;pon:;ibk for their crin1cs. lksitlcs punishing suth person:>, it i~ possible to pi:Jcc them at the dispos<il of the (;ovcrnuH~nt for cornpuhory trcntuH'nt, although only if this mcilsurc is considered cs::.~.·nti~d in the inl~rcst of the safety_of socicty.t

The ~ourt is oblig~U to review the siluatwn ilt k<tst ('.very other ycur to dclcnninc wlldht'-f it i:i necc~sary to proloug the mcat;ure. It sech advke from the institution where tlu.: pcr:>Oil in que~! ion is undergoing trcalmt·ut. It is also po:-;f!iblc for a person who caunot

be held n!:-;ponsiblc LJ)r hi.s criwc to he st:nt Uircc!ly to a mcutal hospital without being punishcd in advu~tu: .. The following figures may give an idea of the position in The Ncthcdands;

The toLd population !Hllllhcrs over 13 million. The prison and renwnd prison popula~ lion from dily to {by b approxilllatcly 2,900, some I ,250 of these being dct;tim~tl pend* ing triJI. Kuu,~IJI}' .speakint~. 70 persons placed at the disposal of the Govern ~~tent receive

lfcatnwnt in mcuHd ho::;pilab, 250 arc t:an:U for <~t State Asylums and 300 at p1ivatt! institutions. SotHC of !he IJ!tcr institutions. induding the Dr. van ch:r llueven Clinic, liikC flot only pJtit'uts who lwve been conuuiih'd to Cuvc.rnJnent care um.:onditionally, but also patient~ who arc utHkt :>uspcndt~d sentence or subject to a suspcmh:J measure and even, should it ill'· ucceS:lary, persons sent en red to prison.

There arc usually 70 to 80 patients <Jl the Dr. vun dcr Hocvcn Clinic, about H of whom arc women. It is it rather open inslihtlll.Hl <~IH1 patients can wulk out fairly t•asily. The hospital offers a wide variety of trcatmmt! and an ex tcnsivc resocralization progrummc.

The tnw:;ition fro1i1 being under complete instifutionul care to having unlimited freedom _in the community Cilll he arranged in various forms by the hospital. If a patient who is ahout W 1cturn to !he community not only works outside the hospital but lives outs.idc as well, the hospital may advise the MinistcJ !o grant him probationary leave. From then onward::.:, although llw lhl:>pital retuina ultimate responsibility for him, !he patient will be cared for by u pro hilt ion and aflcr~carc m>stx.:iation. f[ all goes well during, his probation· iHY leave, the palicul will then he dischart:1:d t:unditionally at the recommendation of the prob;tlion and ufl.~.:r·<:i.ln.: ll:i!!Ociation 1 which lakl'S Over responsibility from the hospital.

(

If lloll:illt illvprurtunt: OL'C!H!'. d;iting (h.; pniud of 1;ondi>i.nn:d dh:ILlr:;,:, lht prulJ~·

lio11 uHd aft::r·(iiH' a.·.·,o..::ialion may tlltim:ddy H~t'tl!!lii\C/~<1 th;it he tH; £1<:nted lllli di:Y

chatgc fwm GovunultlH ran;. A q\a~:illt}n n:p~atcdly a:d.nl by vJ:;ltm:; to !h..: Dr. vnn dd I!O¢Vtll Clink, and probtibly

to any o!h~r ilhtilulion loJ 1Heut;1ily dLturiJ(jd ._·Jilllinals, is: \Vllat :He ti1L: rc:;ulls of ta:atm~nt'! It i:-> one of tlu~ lllo~t diltkutl que:.:.! ions to aJJSVICI.

l<t:SULTS OF T/UiATM LNT

When i!.i !1Tat1H~nt ::;ucn:ssrul'! ObviOII$Iy the cflleJion :.llnuld 1HJt be whetha or not couuuitlal to rht. c:.lle of tht; Covem~ncot c;m b-.: fi:nnin.Jted~ ut what point thb measure. Will ht: {tflllill;lh'd depends largely Oil tJt~. ad\'iC\; or 1!11.;. :lUperinfcndcn! of lhe imtituti\>H c.:ont:..;!llt:tl. As a mit:, the court follow;; tile :idvicc or !he in:.lituti(Jns. The. p01icy regarding advict: is apl to differ from t>llc in:;tiiuliun to <tHothcr; SlHlH: advise tcnnin<dion much ~tJO!ICJ tlnw others. Thi~ mc:Hl$ lhat, if lhc crilcriun for :>!lct.:c:>s of treatment wen: to be whcllwr or not the IJJ\:.asmc WJS termitlided, the institutions wou!\1, to a t:cflt:in ex lent, be ;Jhlc lo dctctmim: tlwul~d·,res whether or not the-If fr\'.;ltmenl IJ;Hibccn succc:;~ful.

However, it WtJU!d nut always be the case, :duet~ thew UPfh:ars to be a tcndtmcy for C\~rtuin cCJUrts to comJnil e1iminab lo Government C<J!C for no longt·r than tlw prison krm lo whidi thuy would oU;envisc have bc~n :;cnienc~~u for the offt.:nce for which tile m~~tt-'iUH: j;; impo~cd. Some J;Ourl:; uppear to b!.' lc:;s :1fraid of !he 1i::.h involved in teuniua

lion than others. This m<:uns that if one of the~::: (.:(llllts has to t.h:cidc on prolon~<.\tiou, the lll$<l:illrt J:.; Jib:ly to bt: lcrminrlicd while a paticnl b siillundcrgoin~ treatment or shortly uftt;r he has bt~cn given probationary leave (l'L) or is di:..dwre:t:d ~,;oJJUilionally {C!J). J!cn.~ again, !here would be little point in applying the above criterion.

It b lliOJC u.!>ual, and bcitcT we think, to base the choict\ of criterion on data co1H.:~rn· iug the occurrence of new crimes. Trt!atmcnt can then he rceankd <t:> successful if a flitlicnt kaving an institution commits no new offence within a ct:.rtain pt~fiod after his departure. The only question lllcn hi how long the test pcrioU should h1:;t. It could he a fixed period, e.g, ~years. llut the tendency !O n:pcat an offnlcc flf)p~;u:\ to vary. f·or example, oo the whole crinh~s against property arc likely to be rcp~iited sooner than sexual off~.-~nccs, although obviou!;ly we only know of the offences that come to light. In dcridilq~ on the length of the test period we shall l.hcrcfore huvc to tilkt· inlu account the vurying tlcgrcc to which diffl!rcnt typi.~:> of criminuls urc Jikdy to Jcpc;It their offences. Too little is known in this rcspcct. On the other hand, the fact th<lt a patit~nf repeals an offc.ncc does not necessarily mean tlwt treatment has bcl"n a failurC. Pcrhap::; tbc offcn,;c he commits will l.w less st.:rious, Perhaps his relapses will be less frequent and perhaps_ on the whole he will be bdtcr able to fit into lht~ community.

Another point i.s that if a patient dot~s not ,elapse afla lrcatnH:nt, we cannot auto4

mutkally regard !his oo being it result of lht.! trcntmcnt ilscH. He may simply be 1.1 little older and wiser. Or pcrhapli the duration of the treatmcllt is a decisive faclur, and particuliuly the dcpri\'ation of liberty if inv.plve:s:. Morcovt'T, we It1ust remember, tlwt, on the one hand, a con5idcrablc number of patients will alrc;tdy havl! lH:~:n lrt:atl'd cbewhen:,

· uml, on the otlll.'.r, lfH1ny arc likely to go on to other institutions before 1cturning to th1..· ~.:ommunily. llcnt.:c in many case:~ the result of trcalm1..~nt is likely to dqh:nd on the comhiucd efforts of .:.cveral institutions. This will certainly have to he taken into consid· Cfiltion when i!S:>essing anti comparjng rc:;ults i.lt the various institulion!l.

Obviou:;ly it would be possible for the time being to confine our cnmparativc uscarch on tr~atmcnt rl.!sults to patients who have undergone trcutmcnt at one institution only.

·,,,·) .:.. ,,,.

I I I

ltt:;·J 1"1 IJl IONAI 'lliLA I M ua ()F VIOLLI'IT OFFENI>EHS

Wt' ..:ould try I•; lind 1Hil ho\Y ntan} ui !hal p.~rlkul:u gloUp tcp>::Jted theh ofknrr:-: ltftn

l!t'idtliClil. llul v.ht·tllt~l o1 not uffnu.:.c:> ;11<: !ept::a!t''!,_ .. tqn~nds on, a JHll!~btr uf f.tdots

\-'ih~t.:h, f;u the trmc b\'l!ll\ ah~ l;t!Fd)' untJJO\'ill.

II Wl'- vn~h !1> compar~~ tht; i.k!~H . .'...: of :;uc(t:s~ .n-hit'vl.Cd by llk·ill!H'ni ill ilu~ v:niou:;

jn:;(illllhlll~. v.-r sh,tll Ht;;l hav~.· tu eJJSii!l' that tb· pilli~:ot jHiplll<dion ul each Ol!t~ is

cqu.dly hkdy to h'.pl'al it::; nflclict::-;. Fot thh n:,tson t!ortc W(Juld .tppcar, til pn::>cnt, to ht' lillk Jbl: in (Otripaling rl·:sulb of trcaiBH~nl at the v.Jriow; in~iilutions.

SUCCESS 01' THFATI>Ii'NT AT AN INSTITUTION

Whether Ul IHII lrl'illl!lelll al ;1 parlicul:u inslilulwn is :suct·t:::.:sful docs not usu:JIIy mcHn

wh.,_·thcJ 01 lhil any ol il:s palknls succl..'ed in returning to the. community. The importunt thint~ in mm.t ca:-;t~ b:; how IJiifllY pati.:ol:-; suct:ccJ in relurniug, what is the pcrccnt<ig1.' and how t:all W(; l:;dciiLJ(C. it.

ln the pt:liod hnw 1955 to 19()H, 330-mak putknts were admitted to the Dr. van dct

lh•cvl'll Clink {;.t:-; wdl as 4H women, whom we shall di:;rcgard in fhis p<tpt!r), On 1.7.70, 11 b Ileal !Jt:Cll oii proh,tlionary k:n't: from the hospital <t{ some time or other. Th,crc Wt're

:dill J 9 il;.i!icnt.s of this gn.)up at !ht• ho~~pit~l. Two patients had died in the meantime. Of lhc IC1ll~1ining /01, Y wen.: given prululionary k:.vc later on. Tn:almeut of 21 patients wa:. te1minaltd by the cou1t hdotc we advi:,:cd pr~,lb:tlionary kitvc. 'J4 patients wcn:trausfencd to other inslilutio!~ti and 'rt left witlloul con:;cnt a11tl :;omchow did not \~omc h;Jd.

Suppming all 11 (J pal icnts who whcll' given probationar}' leave had remained <H libc!IY wlthoul tcpc;11ing thei1 offence::; (which in fat:! was not the ca~c). whal would haVl! been the pen.:cnli1ge ol ::~ucc~:;:.ful treatment'! Assuming the criterion tn be rc(:unencc of the uffc_pn:, 116 CJUt of J3H patients wnc stu:ccssful, i.t~. 34•/u. Perhaps il woultl he more at:r\~nHc to dh.Jcgard the 19 pi!lit:nts $lill nf I he hospital, as well as the: 1 who died. In I hat

Cil:iC, I J(l out of 317 v1cn: wcn:ssful, i.e. ~7%. Or pallaps we ~hould ulso disrcg<~nl the ')4 palit:uls who were lrunsf~~rrcd, mm;t of !hem fairly soon, uuJ the 77 patients who walked

out \Vithoul lCiurning. Jn thut c:we, 116 oul of J4ti Wt~re succ~s:;ful, i.e. 79%. If we ulso di~I~;J;;!lll paliruts wlio were \lis!llis:;cd' by the ~.:ourt, as well as those who were given probationary Jcav~ later on, the per..:c.utage of lhO:il! who were sucr.;::;sful rist::s to 100. l!uGh one of t ht:sc [ll...,n~nl age$ is cakubtcd COfll't'tl y.

A!l s!<~lcd uhovc, if we want to fiJHI out ·hoW succe~sful lrcalmt·nl is a! u particular inr:.filulion, il hi important to know who has hccn admiltcd to the institution ;~nd whose tr~atmcnt h;ts llcl'll ~·omplelcll ;;uccc~sfully. A:> we :-;h;1ll s~c later on, tlte I 16 palicnb who were given. prubaliunary leave from the clinic al :iOme lime or olhcJ formt:d a 'posiliv~·

~dl't:lion out ul >~II thl' patient:; admitted. In fact, the patients wbo were given prohali\lll·

;uy lc<~vt: from lhl' ho:.;pilill ~.Hffcrcd in numerous rc~pccls from thoae·wl!o walknl out or Wl'Jc tlilll::dcrrcd. This will have to be taken into n..:count whc11 mlef!Hl'ling the results vf lht h(t:->pit;d at giV\~11 below.

Tht! fl.!maiudn of llli:> art ide consists or a report (Hl the outcome of research into the n:::;ult:.; of trcatm~:nl ;it Uu; Dr. van d~~~ Uocvcn Clinic. In view of the foregoing, we need

not cmph:.~si?c th<~t it should he read wilh the necessary n:setve.

IS liW l'L t:IWUP A SI!Ll'CTION'!

In aHcmpliug to find nut whether or not treatment at the hospital was succc~sful we shall ha~c mu~clvc.s on the 116 patients who went on probationary h:avc. The first question lhttt arises is: Was tiJis g_ruup a selection out or all the pJtients admiUcU'!

J.L. Jl·.s;;LN /·.HD A.t.l. HUdSLN!JUJt<>

In a jHniOtl)) :-,(udr (J~~~~.o:.n, !'){}))on paitt.'H~~ who w;dk'..'tl 'uut, we fent:ill\t>d that

p;dkn!:; \Vho ll:ro·~.-· at MHII!.' tilll\> or u!hn b.:l'li 'long ;,bsl'ltl without k<l'il;' t.LA \VL) dtffcr f1o11\ lln: rl';;L 'Ah~enn~ witlanll leave' (i\ WL} indttdo:•; h:;,vntg tbc '!lni,; wnhou! J·ermi:.

~ion, L!J\ing i<J rdutn 011 tiliH~ IIUHI ~./!(1!\ k<i\<' t wcd,,·;:,l k.!v~ t'tL.} 01 :;pendinb leave

elsi.'-Whctc !\J;;II .ur.Htt~nl. Fut cx;wtpk., .1 p.tlu:ul \\·)Ju W<l:> a!lowt'.d tu t_;u humc might

~pnul his /cn·c :;tayiog with ftit:nd:-.. 'Lung ;J(l~,:n,·t• w!lhuut kav.::' wr.tu:> lhut :1 pa!JCIJ! i:>

~111! a bent <d 5 n't.:ll)c~ in t/i,~ mnHHnl~-

LAWL JMitcnts spent :.hoJI~:r pt;rirHJ:; al fht~ hcJ:c.pit.tl. ·1 he)' were tcan~ft:rrctl mote 1.1flen. A mtmher of them did no! !durn ;Jftl'l they had b1:l:n L1\WL fof till: fll:,tlim¢ .. As

st:cn from Tabk I, LAWL p;ltknts cvidl'nlly h<~tl k~~ dl:Hl1:c l)f conlpleling lla:tr lfc,lt·

tneut at tile hu:;piLd or of .:nding up wilh ptol-:diOIIilr}' lnVt~. \'r'e might well i.IS!)Uil!C th;tl if we wnc lo L"OIIlp;uc PL ;~nd IIOl!·PL patitub, we should lind dJfft;rt:JH.:n; ::iwi!Jr to

those. resulting frum a l'Omp;~ri:;on lw!wcetl f_:\ WI. and non·LA WL pallt'Hts.

ColtltJIIl i\ of Tahk ·1 gin:~ a list of til.._ difku.'n.:e.s bdw;:t•n the PL and non·PL groups

{iuJicllt.'d 11:1 f'L und NPJ.) lor ;I IHI!IIht:r of tht: lllilill variable:; in our invcstig;llion intu 'uh:;.;ncc \Vithout kavt:', Column A of Tahk 3 ::.:how:; the :;ignific<wl diffcn.!ncc~. i.t\ tho:;~

lh11t canuut bt: a!!rihutcJ lo cha!KC fat.:tor:i. This upplic:; in no fewer lh<lll 1.1 of the 22 va.riaUks dw~cn.

The com:lu!iillll b incvitatdo ~· then~ is J difft .. ·tcncc twlwccn the PL ;wd NPL groups.

Somdimrs individu;d variables :;how no {hffo.:Icnces, wllneas a comhinalion produ~e_;; a

very Jiffncnt pkturc. Pailly fo1 t!lis n:ilsoll, and ,tlso to fiud :>illlpk pr~~dic101s, we tried to find a few varbhlcs in aur 'ah:>~n..:e without kave' invc!ltigation which wouhl enable u::. to predict t!a\ di!fctcncc between tht- !.AWL i!!ld non-J.AWl. group:; as accuratdy as

pmsil>!c. Th~.: 4 ptcJictors w~.:: found <iHd their b wcit;hts (whid1 arc ll:iCd lo dctei!Hine tile weight of the variabl~~!i) were:

age at finit cummitLd to (Jovt~nlllll~Ul (:<lfl.' {UlHkr )0) 32 ,;.; crimes again:.! prupclty 22

running away from imlilutions ;.lfl~:r, lhc agl' of 17 19 ruuning <IW<IY frvm home 17 On the grounds of tllcsl~ 4 pit.:dicloJs <-1 tol:.d :-,:core was worked uul for cud1 palicnL A

patient pla(;cd at the tfisposut of the (iovennncnl hl'.forc lht~ age of 30 was given J:! points, a patient who Jwd run away frum home 17, etc .. The maxiwuf!l total ~coli! for one

person was 90. U-p comparing the PL unJ HUn-l'L 1~roups w\~ ohlainct! lht~ jli~iu!L' :-.hown

in Table~ 2, J <UH1 4, l'aticnts with a higher :icor~ and usually with a ks.'i f:1vourahk t;:.Jsc history have k~s clidJH.:l~ of going on proh<~tit.mar·y kave fro!H lht~ ho~pilal. Hence the PL !:Hlllp i:, dearly a sciCt.-"lion.

TAIIU\ I l.A It!/. and probationury !t·avt:

PL Non·fL Tot11l

LAWL.

70 167 2JT

v2 ""'"'.115, <. 0 OJ • v p ..

.,

NuH-LAWL

411 55

IOJ

'loiJI

116

•.

fA Ill 1-.}

0. JJ J-1 .. t>ll b9 -- 7J

~0

Tol~l

I'L

HbL

41 41 23 il

II&

';;,

47 41 2.1 :n 34

hi'L Total ·- -- ·---~~- al.n. ;;,ln. 1/i. --- .. -~-----------. ------------

47 53 ~M

59 SY 100 7Y '17 102 37 n 411

212 611 3Jil

TAhtt-: J /.U'/ ufJri!Ut'S fvund jot i ifl Tublt· 4

I 2 3 4 5 6 '/ II 9 IIJ 11 u I J

14 15 16 17 Ill 19 20 21 22

..

A

NI'L/1'L

0.34 us 2.68 Ill 0.07 tlli 4,25 X

s:n x

2.11 n:;:

2.46 JU

7.67 XX

0.17 ns J5.2/ )Ol.it

20,12 XXX

12.96 XXX

J3,49 XXX:

9A9xx 2.)9 liS

7.71 XX

0.07 ns 1.84 us J.liO ll.i

3.80 ns ?.OS XX

11.33 ""

11 l/NL

I.{J.44 XX

7.03 AX

4.70 X

0,07 tU

0.21 liS

9.73 '" 1.90'1u ).97 X

IJ.IJ x.xx 6.6U XX

\1,49 XX

12,5:4 X:<c;X

21l.U1 xx.x f 5.2H XXX

J3.tl7 XXX ].I.JU m

~.66 Ill

LIJ4 ns

J.22·n.s J .4•$ liS

IH.Jl XXX

·-- .~------ ---- ·--·--·-··· ------

c R/NH

0.1!9 llS

I.40HS l A6 m

3.63 ns 0.17 ns O.J 7 ns 0.21 liS

0.121u 1.90 ru 2.40 ll:i

0.04 liS

2.10 OS

2.59 tHi

O.l11U 1.71 ns 0.12 m 2.36 llil 4,04 X

0.42 IU

OS"" nut ~it;llifinilli, X"" p < 0.05, XX::: p < (l.{lj, X~X" j) < 0.001.

D }(/NI\

t. 20 liS

l-21 BS

1.'11 us

6.60 X

0.4 2 llS

0.99 liS

O.Sl IU

0.62 liS

3.74 liS

3.4 S liS

0.24 liS

4,3'/ ' 3.52 115.

0.2fln.s 2.09ns (}.(){) llS

2.2H 1\S

4.85 X OJWns

TAIJJ.J: 4 Sd,ilhnolup /niW<'L'IIll lllll!ll'cr ufJ•uri;JIJ/o• ill the C<llt' Justoli;.•s uj m:;/e fJ,Iftctllr;tl the

/Jt, l'!lll J, ,.- llin'l''-'il Cl1wc 111/d Jlw ;sunting oj ji!o!J,J/iOII;IfY /ml't' from !Itt' hOiJ'it!l!,

.:L;uccJ of l. -lll'r un,/ ,-h,illl'CS of !hcit H'f!!'ulf,•s f},,·ir ojjc-IJC<:->' ''" td~on/ lu Jlu· {'(J/11·

11/UIIi/)'

Mi~·kHH~IIItl\H .

Lttht:l

2 CJJilUB;d!ly

fHlht.:r J Mi~dcnP:.tnuuJ

mtl!ha 4 C'limia;llil y

mother 5 Misdcnic;•JWllr

1Jw1hcrs or ~hlclS 6 CwniH;tlit y

hr11thc1~ or ~istcn. 7 Runumg ;~way

frolll home H St:\'Oil!L.i!y sdwul

thplomas 9 ('!Jyifl)~ II U;ll!l

lO Cldlt!n:u·~ homes

II l'cnuancnt J~Jli\IVal hom humll

J 2 lhuwin~J uW.J}' !tom duld1cn 's !wmc

I J Ag~ wh~..·u ru~l ~<.:IIIC!JI;CJ

14 A~~ wh~n tiJSI~•HII· rniltnl hl

(;tlYCffiiJIC!ll t'i!ll~

15 NumiH'I ol \·uu· Vh:llllll'i

16 t'ri111n <~g;1imt

p!•JPO:II)-'

I "I :)c_\u.tl jllkuu.:~

20 l'u\';Lic tmlit!ltiuns

21 RuiHlllll~iLWilY from institutium. after th•: ugc of 17

22 Agt: when fit.sl udmi!ll'U lo the hospital

Sub·

Cll!..'i>•-HY

y.::. HU/'!

yes. no/'!

yes HO/?

yes HO/'!

)-'I:S

lh>/'! yes

no/'! yes lll)f!

}'C!'

JHlj'!

)'l~S

no/? yes

no/ yc~

no/ yes uo/

<IS > lU < Jll ;1- 30

~ 4 < ·I yes no/

no yes/?

lhl

yes/'! yes no/

yes

nu/ yos

no/

< 30 ;> JO

,,

NPL l'l

91 L!.tl 51

16B 37

IBS 12

210 52

1·17 37

162 57

165 ltH 38 66

156 143

'19 I Ul 121 7J

149 129 93

176 46

ISH 64

196 26

llB 64

llliJ 3J 1)9

IB 99

123 116 106

140 82

44 71 Ill lJ7 I B fJi)

I Ill

15 'Jl

ll 94 21 ')5 Bl H 32 B4

' 49

67 24 92 1"/ ')9 4) n 74 4?

7J 4.l B9

n HI 15

'12 ,!<!

_ll)

17 .19 1·7. 43 73

j(l

66

135 199 /)~

2£15 55

11l3 l.l

325 6"/

239 50

256 7H

260 265 7) 9H

219 191 146 115 213

9(1

"2-IB 1n 106

250 BB

~J I I 0"/ :n1s )}

lJ!J 9~

2HI 57

IJB 100 IJB 2UU 159 179

190 14H

' t'alu:u!\ uu ptob.Hiou,uy k.~ve

l. Nl. It

J5 J5 16 5·1 IS 55

69 liJ 58

9 59 19 51 5.\ 17 2-1 4ll

39 31 20 so II• 5·1 35 35 56 14

9 36

2 4.l

3 43

0 46

5 34

4

35 2

44 28 IH

11 Ju I~

36 4

42 l

45 B

JH 18 211

54 19 16 n 62 27

B 1; SJ 2H 17 IB 59 .1l II 13 27 11 4 J J.j 28 11 42 .35 29 14 41 3l

45 II 25 35

12 l•l 6

21) 6

2\_l

0 26 2

23 I

24 11

18 I~

7 8

IH 12 H 6

20 6

20 I)

I}

17 9

20 6

lJ J

I'J )

2J .l 11

IH 12 14 14 12

14 12

31 Yl 12 77 u n

I !J~ I)

b9 12 '/(J

I}

77 &2 2tl 24 66 )"f

53 IU .,2 11 'J')

)()

60 57 JJ

5)

.17 66 24 61 2M w 21 Jl 59 n b)

29 bl

42 48

l>{n----1 06)

12 14 ,, 2tl

b

20 II

26 ).

2J I

24 H

IB 19 .,

11 1a'

12 14 6

20

6 20 13 I)

17 9

21) 6

2l J

19 7

.!.l .l B

IH 12 14 14 12

14 12

Nit

l7 52 II

"" Ill

n 12 (!{)

II 61

11 72 53 27 17 63 29 51 13 67 7

7) H 56 411 Jl

4) J7 56 24 54 2{)

(I{J

20 25 55 24 56 24 56

35 45

IN~dl'!ll/lilN:\1 TJ!FAI"MLNTO/i V!tJI U•l'l ~Ji'fLNIJI·H~>

ll~t: tol!o\V!!tl,'. ,JH' :1 kw d,:t,, l'<'t·Hding knr!!l of tlclln;rnl ;nLl thl' tn'nd ;(-,regard::;

pll•h<~Jiun~liY tr.J'Il'. Avr..·Jdg~·:; and ~·,wg~:-; -.';Ill in: qunlt'd hul!l_as 11.:~:.nd~ t!n· dHJ;llion o!

J~t:;;Jmcol :ll\d !lie fallt'- t/Llt lhl' pn.-;ou-. runcl't!lnl rL"I!!;\Htcd :;1 Jibcfl)'. Tilt: :w-..'r;q.;e

dJtJ:,t:ll L; Ihc nwdi.:tl. t\ mt:di;J:l ul ·fO n;onihc-. Hlt'<l!·c·i th;J! equ:dly .i'.' l!loli!)i pill!t'l!l::; Vh'IC

ln:.iled 01 Jl'Jnainrd at lih\:1 ly fo1 k:.$ tl1;,n --10 l!HIIlll~::> a.s fo1 mort than •10 wonths. Tht: Jail!!,<..' gives the low~·;.t and highest v,dUl'S f'(;\liHL

DufiJIJui! it{ liLnty mc;JH.\ tht'- toLd lluu~:iun of Lhe pniod during which !he p:!li1~nt Wti:, :11 liberty. llc!ll'l' not nnly !lit: lt:itglh of Jl!Ob,ilioll;H-y kavt•. is iHlportant, hut ;1!$o tile

dnr:dion uf the enliJl' fh:rkJJ following {t'llllinati.~n of COIIJIIHILd lo til,:. Gue of the (JoY~r!IJn~·nl.

I{L'.Lidiri.~JH ocnu:> if a palit·-nt t:l)!llll!ll<:. J new (llknce dt,rinl! th1:> f-'niod ;d liln:rly. 26 of the lib palicnls were n;ciJi-.i~b. The i.tVt:L!gt' du~<ltion of lhciJ j{{'J{I!Jtllt had been sa nwntils (fii/Igc: ~J- 1:14). The avn,~~:~ lnwth of time bd<m~ thdr fil:o;t offence w;1~l JiYl Jll{,Jli!JS ( l I J s~e_;),{> I(_] of lhC~l' ){) p,dit:nls rcccin·d O!W 01 more unconJilioH<d ~t'llkft(C:i (14 once, I twkc :wd 4 thrice). 5 p,lficnt~ Jec~:ivc,l only sH-.;pcudnl :;;.:ott.'-liCc.:i and 2 ct~:.;:.s

WCil' sci u.'ii,k. 4 patittlt:-i wnc :>t'nteuc~d fof st'xual ofknc:es (J for ;Jhus .. ~ of mi1l0f:\ ant.!

1Hh' for indl'cclll ;,:;sault). The rem:tintkr hJd cnm!hiHeJ pnly I m 111ore ccooqmic of~

fenn·:;, wilh the exception of {. who abo couHHittcd .tt,i!J~!>!iiVc of(cnn:.s (11\i-lltrcatnH.::nt

and severe lll<d!n•.atment}.

10 of till; {_}1) JJOIH-cddivisJs had their k<~YC cancclk~d by the ho:.pd;d; 7 W\'fC !raw;~

fcnTd; J patkul faikd to return <tfln bdng absent without kav~:-; I patient is :::.till at tht: hu:.piti-11 ;wd I !Cl:.:nily went on pr!lbarion.u}' kave ag:dn.

'file avcrag~: duration of trcatul~'ut W<1S 46 month~ (JJ--90). '!he avcrarc lime a! liberty Wil!> 4 llhl!llh$ (I 3.1}, or the fCI!Iilinifll~ xo ptlfie.nls, 5Y wnlt on prob.ttinnary ll'Hvc OllL'C uud ) 1 more thiln OHLC. The average. duralion of thrir lrcalment was 49 month.s ( 12 ·152). The avcr,agc time at Jihl~fli' was {)(j~1J mvnths ( 12--~ I St:>IJJ).

IJIFFI'I<ENCI:~ IWIWEl'N llECIIlJVISTS',\ND NON-IUoCIDIVJSTS W!TJJJN TilE Pl. GROlJJ'

If we Wert~ lo com pan..: H~ciJivbts and nVIHt!t'idlvis(s, <:.houhl wt· fiud diffelcn~cs withUl thr- I'L group ibdf :;in'!iil;n W tl1o:-;,.: iound whtn c~l!IIJl~iliHg !he Pl. anJ non-PL group!> oc LAWL and uon-I.A WL group~? As will ht• set'fl in cn!uJI\11 l' in '[ahlcs 3 and 4, only one of the vari;Jhh:.!) ~hows <lily diffcJcncc wo1tll m~ntioning bd\VCell rcl'idivists and uon-rcdt.l.i· vist1:-, namdy the nulllbcr of pcopll' who rail awJ}' ;d!n th~~ ac•,c of 17. hlr the rest, the vuriabh:s thai ptTdid LA WL g.t•nnally :.pt•ai..ing tile unf<wourabk variJhks in the L">ISt.:

history wen! of liJJic_signifkancc {alleasl 111 o!lf mvestigafion) fo1 p!'n!iding wilh wh.al diitlll'C of Slh.:cc~s probationary ·k.avc from the hospital l:ould ht• t;Jantt:tL The Si!UlC applies if Wl~ t.:O!upa!i.' the tO !ill sco1cs for tccidivisls and IHlll·rccidivists {Tuhk 5}.

In the result~ sl~<JWil in Tahk 5 the /ut.'t !hat til~ nou-rcridivisls induJcd JO pi!licnts wlwsc prob<lliollMY kavc was ltrmiiHitcd l1y 1h~.: ho:-;pital or who were transfcncd else· where has bc~n di:>r~g:mJcd. It is worll1 fintling out whetlwr. if we di~r~:gard the ~asc~ in whkh probationary leave was a 'failure', lhnc arc any diffcrcnas ut till. The results arc found in column J) uf'Ltbles 3 and 4. A ilulllbl!r of rt•:;uJts differ fro1u those in column C.

Significunt Jiffcn:nccs occur unJei the lu:adii11~-": runuing away from home, number uf

c:unvictions :nHI running away after the •tgc of 17. Since 2 of lhc:;c variubks were ulso used as predictors for the hHal scores, it is not :aHpn3ing that on the grounds of the lola! ---+--~ .. ------ -----~-------~---~---.---------»· 11 Sec ALI,hmdum 1.

·!' '? .

u J .l H· (,i;

(,I) -; J

'J\1

H

5 9 ,, "

2{,

Nl{

~()

J: I 7 5

YU

To till '

41

•II :u II

116

!JI vil'W ol the hmit<.:tl nwnhn;,., th..: I<J'>I l H'orl':. \\l'll' •u!Hbhll·d iuou1 !c~t. Thl'/1: was !hell nu sJgHili·

c,mt Uillt:it.:lln: h~twt·en !hl.' gi•Hijl:>: x\ ·" :1.'11, p > 0.0.)_

S(Ofl!!i dilkJull:l'-'::i Wl'fC t1l.•i foUJhl bd'.VC\:1\ Jt.t:IUivisl~ tJHd 'successful' 1\0ll·fCt.:idivi:ib

(Table (Ji.

Condu:-.iuu: unlike lhl' situutitm with regan! to LAWL, mo•,l of the v~niah!t:s dto51!1l lihl ntH allow us to di:.crinlin;,tc with 1Cg.an.J to tcciJivi:>IIJ. Only one purdy \;rituina!' vari;Jhk bt.::-.itlc::; two ru!''lill!-:-aw;Jy v;triahk;.; ~huwcJ diffcn:-nccs hclwt:cn Jecidivi.'ib

aud ':;un·nsltil' non-!ccidivist~. (Stc Addendum 2J

IS TilE I'L CIWUI' A 'SC!!EENEJl' (;iWUI'?

The qut.:-.liun llfi)cs. wl!dhl·r, in rdatinu to the vuriahh.·s ~hoscn, those who Wl~nt on prob<ltiOililfY h:avt Wlm! not ovcJ~SCft'l~rtt;d. Suppo:-.ing, for inslaHcc, that patknts with_ red hair Wl!fC of! en LAWL but had pra~.:lkally 110 dlancc of being sent on prohaliuuMy ll'i.tve; we might !hen lind !hat lht.:rt) wc1c h-w or no patil·nls with 1·ed hau in the Pl. group.

)>hvitlllsl)' this dJi.lfiJ~ICJisti~: woultl haw- lust <Jll significanec for further difft.:n',I\!Ja!ion bd\\'CCll recidivist:-; and nu!l-rccidivi:->ls. llowcvcr, it was nol !he ca~c. ;~:-; we lt:HI antidp<llcd. We fouml that, as regards wmt of the variables chosen, LAWL and non-LAWL fWiil.'n!s differed, even within the l'L group.

As will bl.': SC\~H from column H ill Ttthh: 3, significant tliffcrcnces were fnund with 110 less llwll l3 t}f the ~2 vari<Jhlcs used for testing. Whcn Wl! t'Ompan~ the totul scon..:s we obtaiu IIi!.! pit..: tun.: seen in T;tbk 7.

We II!Ust lhcn!iorc t.:O!H;Iudc that, as far .~'s the UI<Jjori!y of the vuriablcs were. con~ ccrncJ, our in;thilily fo discriminate -within !he PL group applit·~J only !() tt.:ridivism and not to LAWL. The total score, on the ulhl:J hanJ, allowcd us to discrimiJwtc with rcg:wJ to rct:alivi.'>UJ.

TAIJLF b

NR TottJI

u - 33 35 40 J4 . 6H y JU 39 69 .. 7.1 6 14 20

90 6 7

TtH<Jl 26 HIJ 106 ···-· -·-------

llw tc:.:t w,J$ ~.:.udcd out anew, combinintt th~·l~sl 2 sctJtCs. There W.Js now a marked diffcJeucc, namcl ly X 1 "-H.%, p <U.Ol.

Coi,IJ·W,;fllT J(oit:,\ }or L-i h'/_ 1,,,,f noJt·l. ! h'/_ pMio;a ~;·ith!ll the I'L f:1tHtp

' (.; 1\L T~H<1I

" IJ I(, )I ·II J.l fdl .~h 1:·, 41 &Y 71 1'/ & 2J

') ll II II II

Tot;1l 70 4b I H!

We ;,g.llll Ullllhin~J th..: L1:>1 2 ,\core~ ami <lt;Jiu !hnt• wa.~ a m;dk~U diflefc*''-' l.H;IwtXII l.AWL illllllwll·

I.A\'iL patient:;: x\ '" I·U:U, p...; O.OUI.

StnlhiAHY ANI! IJlSCU~;SION

In thi:. rl'port lhe outromt~ of rcsear!.'h inlo !he !CSt!lts of the tll.!t.t{ment of lll!.'f!,lally

di~turbcd t:1ilnin.!l~ a! the lk van i.kr l!o,:vul t.'linic is surveyed. The crilciion for succc:.:->

of{lll' ~tdhet al!l'J) ltl';!l!llcnl was the iiVllidanct' of fl'l:idivi'>m uf!cr return to lhcnHtlliJUnity, aftc1 pfpb;!li(HJilfY kavc (PL) or conditinncd dischoHtt: fwm conunttlal to lht: care of !he (itH'd!llllc!lt (('!)),

TIH: unly doJt<J. we had as rl'gards ll't.:idivism w;J::; for patie-nts whu H~lun!l:d tu the ~uunuunity fwm thL' hospital !t~mpor,.trily (PL of CD}. The report a..:cotdlngly had to be t.'OHfJned to thi~ t';Jk)!,oJy. We WCJC ahh: It'! e.,lahli~h thatlht'St.: patients WCIC not a rauJtilll

group out of the tvlal 111;1IC populati{)ll of the ho~pital. Tht: less favout<tbk u ptdtenl':>

jllt'Viou:-. IIJ:.tory i:), tlw kss dli.lncc !here b 1.)f hi:lln.:atmcnl al tin: llo:-.pltal bt:ing !Outu.led off with PL or CD.

W!!llju this PL-CU group, patient:> whoSe t.:a:ic hbtory was less favoufahk were- 'loug ahs\:lil without !L't!VC' {LAWL) more oHen {i.e, they ran aW;Jy). In otlli.'r words, to n ccrtain ntt.'lll it was po:>!->ibh; to prcdkl thc1 likelihood of LA WL on tht~ grounds of a (I;Jrgc) tHIIIII>cr of variahks in I he patknt:>' t'J:iC histories.

On the oth~r h;wd, it W;1s less e-asy~· using the ~auw variables to predict tht• chan..:es of su~.:~~~ss or rccidivi.\m aflcr trc;J!mcnt. All Wl' could di.sl,'liminah~ in an UIIL'Orn•ctcll

group of rccidivhts wa,-;!unning away <lfkr the a1~c of 17. After coHc..:tiou, we found th;1t .. we ~:ou!tl abo di:-;t:rindn:.~k fnr tiH~ vari:abks: running away fi\)Jl\ home (tinder UO and the nuwhn of .>;t'lllt'lll.XS. Wt~ HillS I point oul tlwl our tt•;ulls in lhi.s invcslig.dion, conn:rning, 106 aHd llh JliJiicnb who went on proh.tlionary leave, diffcrl'd frotn tho.sc in a jHCvious invt·~tig;Jii~>n tJc~:-.~:n, l~Ju9), nutt'ernlng 1.1nly 59 and !10 paticnl.s. On the whok, Jargl.'ly dul.' In 1/Jt' Ltd thai tl1i~ lnvc:>tigalton w.1:> il t'tllllintJ~dion of the !'ir:i!, the tcsults conl~· .S!Hllhkd Jluwcv~:r. th..ctc wa~ a tlifft:rt'IIL't' !\!lhcHtgh in tlli:i invc.slig<~lioll we again found !!toll un!y a k\V v.tiiJhk~s allowed u::; lo tl!::.~·IIIHiH;JII.! a:> reg;HUS sut:t:t!Ss of (or afkr}

lrc;,~tlll<.:nl, they Wl.'fl: ilt'VCr!hdcss sligi1lly ddku:ut Tlw first time, I hey were fador!> :-.ut:h a.s t.:lillllllal!l~'. wbdclllt'illlOIIf of the LJ!ht't <JIId age 1.•f lhc patient wlicn fir::>t scnh~nccd. The .second till!\." lht' 'run11ing aw;1y' va!l,tillc:o. v.crc impo!lanl. In bDlh t:u.scs I he number

uf :-il'ntcn.:cs pl<tyl·d il :-;~gnifkant role, In our opini<m, tile cxphm:.tlion for thc:.t.: Jif(crem:cs can probably be soughl in the

f'-lcllhat for the pil:-.1 'J years the hospital hilS lakcJt In a Jifl'cn:nt kind 01 patient. If we compare the 'fir~! 191 male pl.ltit:nh with lhe bsl 147, we find that 50% of the

foflncr 1an away t f1olll institutions} after I hi.! <tgc of I 'I, as compared with 44% of the !at ter. Tltc pcrccut ,JgC$ for ru1u1ing away from home under 18 were 29 aut.J 1 tl, rt.!spcctivc· ty. 51 'X of the funncr ~atcgury went to dlildrcn's homes and 65tif, of tiH' !alter. 5l'i~· of the fo11nn \\ttcgor.y was unt.Jcr JO whet\ first adJHittt.~d to the hospilal as against 6Yi'(f of I

j I f I I ( I I

th~: !.Jilt'! in ~.holt, Joi till! p~1sl Y ye;tfs the J..ind of p;;!iC'Ill ;uimi!ted ha:; not bt.:~~tl the

:-ii\IJL\', !l\lf lh\' J~uhl )CJ\1 on ptoh.Jttun,uy k.~-,(. Wo'.;o;nid~·• lhiJt :;u~,-·h fad'> ilhi:,lLJll.~ !be !d,tll\l' v;dur of tht:; k1nd of :l'~l';lldL No! Pn!y h:t~ the !hi)(•d:d .nlmilkd ii. ddfnl'!lt hind ul palh'Hl in !Ill' u;ut:>t: o/ tile' y,·,u•:, !Jut fur :i0/01! ICit)u!l ul lliht·r lht: knHI of jiiltic.nl sent

ft;r :~<hnt:-.)ion ];;!':> a\:;o been di!fr!~:JIL

Jt i::; par!ktd;u]y WtJrlill!lcntionilll~ t\ut quilc a IHIIHhl'r of t!Jt: pati.:.nt:> admitll.:d {0 I!Jt,>; \lo~;pil.d dullllL~ lh\~ )a:il k\~ years \'/e-ll' 110( lilllllllit!l'd to (;I!Y~rl1Ha'lll L;nc llllCOOdititJtt<ll· li. It i·, di!fj,·utt lo ):1y v.-h.d dkct ihb ILt'! 1!.1d on lilt' hospital'.~ p(,Jwy in t';nnul. At tht~

S<llllt.' !niH:, it i~ hPtHld I•> h;H-'t'- afleckd the policy of gLHHing probati,moJ)" lc:.tv\~ or (Oild!li<,n;d di~ch;nrc and abo of fin:d dt':it:har;;...: flom til.._- husplt.tL This ;;)Hh'.':i once nl<)lc

iliJW illlporLJI\t it b In J.nuw ~~)rm·!hing abuut the inm;~lr:> o( cad1 instituti,un bdorc a !l'it!iorH!Jiy juqifJI.-!d l)pinion ~an bt.: lofllil'd ;~os to tlu: ::;uc<.."c~s or othcrwb~; of the trcatmcnl

it JH OVllk$ , .

But, a:, al11_~ady indi1:<d\!d ahov~, cvl.'li lhc population of rarh S!:parutc institution is ilhdy tu f!udu.!l~ comidt'fithl}l ~- with tlbviou.s n~p.;rcu!\sidns. We thncforc St't! no point

at all in .._·olltinuin;l 10 study the re;;u}[:; a! scp;;rak iu:-.tiluliun:'i. ll is of the utmo:lt impo1 !awe !h<Jt re$c:JJ.:il of !Ids kiiHI Lc unJtrtJken on a nationwide s..:ak, as is being doH~~ ai prn:l!nl wi!h rqtard tn the mental htn1h!:. in The HdhCILHHls. National rc.scardt slwuiJ b.: bas\.~d not 0n iwilitution~;, but on p;dienl:i. The quc!ilions thc11 to a:.k arc: Whilt pati!!nts imd thdr way bad; into the ..::on11nunity after 'official treatment''! Uow ::>oon Jo they n:l.1psc'! Wlwt about the 'type' of tn·;ttl!lent they received prcviou:Jy'! Wlwt is lypkal alHJ\ll their bnd oi climinality·r The object of sud1 rc~e;m.:h canuot 1w to find out whirh of !he in:;titutions fuudion p1opcr\y and which dn lH)t. Thnc are probably IHllnt~r· ou.s institutions with all kind::; uf plJS:>ibihlks, although the possibilities may vary for difkn:nt kind:, ol patkots. The objc;;::t of a nationwide research !i~hclllC shnuiJ be t(J finJ

out lh~: po.'):.Jbilitics of each s\~Jliifatc institution, either on its own or in romblnation with olhcrs, owd wlnll kind of path:nts ~an be tr~atctl there. This may he of little inte,cst to lhc in:;titution'.:i thcnt:;dvcs, but it is all the mote interesting for tht patknls for whom, after all, the institutions are IHlppo:;~:,! to exist.

AUDENDA

I. The qw:~twn of how many p;tth:nts 1cdtlivutcd is not easy to an:;wcr. Although it is !ilalcd !hat 26 01~ of 110 {or !Oo) Welt: recidivbts, if we take into •~~count the period duriug whkh lill'Y WI!H~ at liberty, nol all of lhcln nm an ,:qual ri:ik of n~cidiva:ing. Some of the putil!nb had just returned lo nonnal ~-;ocicty when we tcrminat~,.·d our inquiry, others hud alrt:iiJy been a! liberty fur many years. Tnble H gives a gcJJcr;tl ide;! of the ... alt.: at which they h:cldivatcd,

In the first jllacc, the Table iudica!CS how many patients llild been at liberty for at \t:a~;t 2 3, 4, 5 or 6 year!>, .both in I he lt:st group <1S a whole unU in the ·~ckdcJ' test g1oup. Nt'~f. each ~.:olumn indk;ilt'!. liuw many patients in cad1 of tile 'lest groups' ICt:idivatctl within I, 2, J, 4 and 5 years, H~:.:pe...:tlvdy (in absolute figua·:> ami pca.:cnl· ages). The pcrccnt~1ges arc ~.:wnulatlvt:. hH example, tlu· parlicul<~rs for the 5-ycar group :;how that out uf 77 patients 3 9~;: Jt:citliv<.~lcd in !he l!>l year. 2.6% in the 2nd, 6.5% in tilt..' 3nl, 6.5% in tlw 41h an. I none tu·;(d wtht~ Sth. lienee n:dtlivi~m in tl!i:-; group was 3.'J, 6.5, 13.0, IIJ.S anJ 19<5'}0 Within I, 2, 3. 4 ami 5 yca1s, rc:.pedivcly. lhc lad that the

various column.s in tile !Wo groups cnoe:-pond :-;o dusdy sup pori:> the <l:>lilllllplion lhal the jH.'rccnlagcs 1;lv-cn here iu fad giv~.· a gu1)d picture of the talt: of fl~t:Hlivisrn.

The top figure::. in each of the h·} 1.!<11 ic~l groups ~how the total peh.:cntagc of rccidi· vbts. The \.~liiHU!ativc tahll's arc bu'icd on Jllosc 22 ol !he 26 p<llicuts who reL·iJivatcU within 6 yeats after disch;_ugc fmm ho~pital. Tlu: remaining 4 !cch..livi:;ts have not been

INSTil U I"IONAL TltLA I hll·lrl OF V lOLFN't' OFfEtHWHS

lt,·-cid 1- ·•~\til

(yO

6

4

3

2

'fe-:;1 group (yr)

Numbers of fh\1&\ll:J

1't!L:.lttSl ~~rlwp

--·~---~- ------~--

19.5 15

19.8 19.5 17 15

13.! 14.0 I 3.0 ~~ 12 lO

9.5 H.! H.! 65 11 tl 7 5

4.3 5. 1 4.1 3.9 ,, 5 4 3 --··--·-~-~~ .. ---~---··

2 3 4 5

116 R6

I ~1,? 14

ItL3 13

llL3 1:1

ll.J H

5.6 4

4.2 3

6

• '$..:k,:tc\1' tt:~l f;fllt.JP

-~--~---~-- ____ , ___

2L9 14

21.4 20.3 15 13

21.B 2\.4 20.3 17 15 13

14.4 15.4 14.3 !Z.5 13 ll 10 G

10.4 8.9 9.0 7.1 6.3 !1 8 7 5 4

4.7 5.6 5.1 4.3 4.'/ 5 5 4 3 3

--"·-------------------------- ···-

2 3 4 5 6

!06 Wl 'I (l

indudcd ~~~ lhe ::;izc of I he group con~istiug of discharged patit\nts initially decreases in a

ratht!r ~y~ll"-llliitic way \'.lith the years ~.h11ing which t!n~y could have been in free society, bq.t dt·ctcJ:;(.'~ veJy r;tpidly after th~ 61h yl.!at. For th•H It:ason computing pt:rcculai~Cs wouiJ b~ l~ss mcaltlngful. One patient JcciJivatcd in the 7th yeor, 2 patients in the 8th and I in the lOth Yl~ar.

Sunuuing up, thl! authors t:on!iidcr it " good progno.sb to a.s~umc th;tl thl.! total rcdd~ ivbt pcrt:cql;.lg~ 1:; likely, eventually, to b~ Jbout JO•J.,,

1_ Aftt.:r compktion of this pi!pcr, Mr E. Langcrak, a psychologist at the Van tier lloevcu Cliuil.:, JJ~;"'tv nur utkntwn to an m:.tn.:lH<li..:y in H~.·Hillg the .sicnifi~ancc of the dilfcrcuct:s Ill lho:-.c C<~se.s whcu: sum~:>t:ore:-; wc;·c used. bc~au~e of the urJin<JI t:hara.;tcr of

thc:;c.: sr.:orc~ ;~more powetful tc.'it should have bn·n used, e.g. the Mann-Whitney U-tc:.L in that Cit\l: the diffcrcn..;cs in both Tahk· S <1nJ 6 would have been :->itnifictwl Consequent~ ly, the ;.;ont:lu:;ion giVI.-'ll Dl the fool ofTabk) ... lwuld bt~ that l>y mean.s of the :-;um-:l~tH'.~S it hi poll:iiWtc tu pn;dict tile rc_cidivhm tor patn:nts ()II probation;uy leave from this Cliuic.

REFERENCES

JtS:,(H, J. L. ( 196 '}): Onrvluchtiug of Ongeovrluo{tit' Afwetigheid (Hunning away or Absence without Leave). J.A. Uoom en Zoon, t.k.ppcl. The N~tluuland$

JeMn, J.L. ( i%9); u~hunJcling~resulta!i.!n In Lh: V<ill Ut:J Hocvcn Kliniok (Treatment ICsults at the Vun der llocvcn Clinic}. Ned. r. Crimlllo/., Sept.

'i

D~.:s.:-.~L0Ll __ ?:-.5:1.· Li ve:."pou1, ~MJ

Grr:m<lon .ir~ mc:~rU.oncd _ nlon{~ ·,r:ith Wonnwood. Scx'ubs bc'l.i).J(j a !;u·cctc~-1] tud t.

Secl:.icm ?<r/). Cl'('ndon is srJoken of as having a p:_:ycltiatric uni_tt alonr; vrith ·::·;1·-",-: .. ;·1·J----1:-·_:~-1 .~--:.,·oy"l·l' ·-,tr·,· c l"li -I· hc-l nrr sL>.l'·b;d at \'h,l'lXUOOJ. f:lcrub~) in 193G. Grt:;ndon <-.- '" ~ •• , 1.._1 .._., '· • -'J, •• [, +~~) ---

if: i.>JJol::cn of.· ;~~-; bu.i.ng the .lare;c~::; t ;-::.ud r.HJS l irnpo:t't~-~nt, opcn::.:d in l9G~~.. 11 1-;orw~ ()f

the~..:t! pcvchL~tr.ic units in equipped to Q;.:al \•:ith acute or oove.t·o !l!t·.:nLuJ. illn·:!H~1~ Guch ca~;~n :coqnJ.r(; t:ctln::~f cr to a N;lt. _~_on2.l Health Serv Jco 1 ocal puy-ch.ia L:c.ic l10~~pital or ;:;. ::~r;ccd.<.d hor::pit~-~.l under the power::.: gi ·.rtm to th~~ Horne Seerctr:.ry by nee Lions 72 cmd D of Uw j,!unto.l Health Ac 1: 19'!9 ',

pe~.t~. :?J.1 S. J.I ~---·~E_r:~-~-t~.Et:;_j:~£_~L~l~!E~~0J:.:~.)?.:?~~!!.?_YJt:J):.\_:~: ___ 0.Cf~:!2~!.::~E.~. rh~-! re in a nut·{;;c-u tion in th.ls cectio.n that Grcnd(Jn i~.1 :..ielocti v;_~ j_n chuo~~ir:g tho pn;ychcpathic patient and it is uucu;t~~ted that more <!f,rTn:·~::'\ivn offonde:r:~J a:cc not w:!.l:li.ng or ~:tblo to co~opcra-te in thv t:rca:tment offered. Oyer thl-! ye;,iJ?tl G}'(::l'JJ.on h~;c} de-vel~

opc:d 11 system of haw.U.i.ng· and treating cxlrcmo1y ncr:;rcso:ive n:en ~1!1·~: fnlf:ll~:~ one of i -t~3 pu1·ponc~; as rocei ving cmot i ona 11y· distu:chcd n_ggre ~;Gi vo men fro::1 o'Li1·:~;_·

outhb1i:5hments whoru they have cone into the vicioun cycln of H<?.,'Gl"'GrJsivn b<d1[l.Vi GUr; punichmcnt. c~Jcala ti~G aggr·c:-Jui ve behaviour. vory rc ~;tr.ic ti ve y,-:.mi uhLf~nt w1til an imr:.<:u.:~.w is ret~ched... Crcndc·:n nor-ve:n tho ptn·po;;e of ta..Ling tf·w~.:~~ wen )nto treatmu~it and hopefuLly.· nnd i.n many ce.ncs breaJd.ng tlli.s vielou::> cycle and :c;o o.:J.lo'!.d.ne; tho person to opera..to in a.J.e~Hi de;;b:uctivc mrur:·t(:~r~ (Sec rcc.:;nt figures from the ncsoarch Dnp;:lrtmcnt on Grendon' n lK.~.ndling of thLJ t'(!~O\ll) of men)~ J,~othod;; of hc.t.ndling this group of p::tt.ientr;. as wc11 CtU allowing them to undc-r{·~·o

treatment, depend on u eerie·::; of fGctt!:Cn!

.. L Continu::.ty of Gtat'f. It iD important tlnt a core of at loar.t 4--5 sbff

mombor!{ rC:ma.ln on the wing for at lo.?.ut 1-2 years.

2. '171Cro must bo more: space than l.G J.rnmedlatcly needed in ordr-;:r to allow movJ ...... mcnt: with:ln th0 wing; that io more roome, moro bedn~

3~ Free movGmcnt within thf! wing. fJl.iw most cxploD.i.VG and counterprvducti ve nlf~CiSUre C1,8 8UC'e~sted by ttD IDUDPO\'.'CJ:' tearn V/OUJd be D. mid-day lock-up in

order to cconomic0 on utaff~

4 lilultip:te, varied and frequent opportunity for verhctl e>srreosion of violent and aggreH:.:i '-JB fcol_ing~ in an open but struc·~ured area.., nuc:h ao the daJly group an(l wj.ng mcetingn.

5. Regular sbff mootinr,s in order to assist the staff in abrwrbing the tension a11d rtet!.l'erHJion of the pntionta and at the samo time maintain a relaxod. atmo::;phcrc r;hc:ro trcn. tmcnt c.an occUr.

6. Full honesty bctwocn tho officorG and the patients. Information C'ivcn to the patients an noon as it is possible and taking steps to avoid any long ongoing period of insecurity between the two groups 1 for instance} if there io a soc uri ty invcstication occtu·ring, thiG must be cru:ricd out rapidly and full information ).'oferrcd back to tlw patient group as soon rw possible. 1'hose investi{;(<:tiom should be avoided except on rare: occasions of cxtremG ·dan{3'cr, such as planncd·sorious violence, cg hostaF,C-takine; or thrce.ta of violence.

~'he aim of tho staff in to limi ta Uonu of the nyn tan. staff pa ti cnt relatiom;hiP

encentlm· an atmosphere of mutual truc:t within tho Thic is brought ilhout b,y honesty of staff in.thc

and a dom;.qv1 f'tn~ ,., .... _ ......... ~4 ~

I,; / .\ ..

A cc:;:non n.i::l ;/_;;•_l cc;a1; r-;\~.c~-1 ;)_~\ 0-h'(!,J.t:ncnt:J v:.lth ~;ta.ff (\rHl paticnt:J r•.l'f: t1iJ'(:()tGd

tort:n:d;) tid fJ curd'

~>taff ~~nd j}:lt-L<;;-;L; r;t.b:: .C:cec<ty .:.:nd ;n·c in\'o1v\;tl c:JJ1.:d;::-.rnU,:cJy in the intt~lTt.:1l

Jl;<.nn;_;};:;ment <-lnd tJ'L'a ·bJ:•::nt l·:L'Ocos::::on in th0 w.i.ng~.::.,,

No DlHlch.:n df!Ci:li0~1--m:tlcJng· (;y th.::! :::JtD.ff Ol' the GO!;)p]l_JTI.ity ~:;:!ow carr_:f'uJ (:Xp)o~ca-tion in depth of i::_;::nt·._~;::; m::ch (l,!J the trcul!Jfer of <·'!. pt-J.:Ue:nt or· i.n innov-.:1!:ion to tho l'O[','imC~ rrhir3 :~bouJd be (iOne in :JlO'.'! dclih:=:rato p:I'0(>.~£;~:r:n :i'O(jtt'i.l.'.\fl{S

p2.:.rticipti-tion of e.G m;HW uu:.1xu:s of t}k: cc:mununity .. otai'f ;_,;-:d paticntnl aB po::;niblo r.nU hop(·:'u1Jy aft:er this cu.rofnJ dr:~1ibc.rtJ,tion~ 'll)tcd on and enfot·Gcd by tho com:_nuni Ly.

J1eal deci~don makinc; not G]_)\tri.c.uo dGci s.ion mc1..kin~;, i~J imp<.YclanL He_peti t:Lvo ep(;ciCLcat:ion. of tho rn:c:~:;, fol' e:x.(:rnple a pcrnon Uecou:en anr;1'Y on tho vringt ·he may he~ pu:r.nd.ttt.-!:3. to e:xpro:::: thi;; vorba.l1y cvc:n dire~t it at mcmb:Jl'U of staff but when hn is off the wi:r.,c:~ ho j_s not permit ted to cU ~-;pJ.~lY hi:.; anger towiu·dn o·t;her staff mc:;Jb(:L'B. If )~:~ dceg, tld.H in examined in the tTOt~p.

Flexibility witbL'1 the f.n::J:l0\'.1 0X-1-~ of thu ru1e;;; tho comrnunity nnwt be able to . move fir;;t in one: direction, then in ~1notbe:r dirc;ction; fo.l' example when the

eonununt ty .i.r; -~J.:r:ca. tencd by pvr•h;:.tp;J n.n i ntnJce of 5 vi oJ ont w.-:m i it lll£"J.Y i1 t thi :J timo v:inh tv r~~inforco tlw no-vj.olonco rule and if neccnsary for minor c:xvlosi ve 1;ehaviot:·c. anJ havo ·pw nE~f;d to se::nd ~~om•~ body- a 1ih.ty, At otlK!r timc:J, more exp}oaiVB boh~"tViOUr J}·i~J': \H~Jl be p0rmittcd. 1?his flexibility dc:pending On the f;:xpl orod, cxpr.; os(:cl opinion a of staff and. p:t tii3n tu, op>Jra t ing togothc:c in collnborati ve r~·.:::TUJ:';FJ.

~. No psychotropic druc::~ or nieht sedation are u0ed in tho trc<.ttment pT:occsr:c!J of Grendon. 1.Phcru havn be(!f) cm~ral accow1ts of tlw use of :l ibrium and valJum in C)cplosi.vo JO>;ychop;" thic pcrc;on:tLi ty di,;ordc:rn, par;ticuJ;;rJy in tho field of child inju.ry when it is -~he opinion that the une of the Go d.J~uc;::: co.n l'C!sul t in losn of control of the :;xcti~Cnt c.nd tllCl'Oforu rosul t in more explosive extreme behaviour in violent <!-g'grcsoivc people. It ir:l vml] known iu tiw a.busc:~ Or n-lcoholic liquor and a s.imiJ.ar offect can occur with the usB of hypnoties~

~~ rrho E:~econcl feature \7hy these d:cugs a:co not \WOd in -Lh~lt the patient ic seen to be responsib1e for his behaviour o.nd ho sees hLnoclf rrs being recpon:;i1il e for hi.n bohav.iour and dcve:lopG an undorstandinrr of hie ngc;ro~Jsivo ft?olineTJ and can hanc11c these in hi.m,_;clf and 2.pprcc:latc these in ethers. Whm only partild.ly ;ma:ro of these foe lings and tlw effoc t of tranqu.illioern, ho 1 oscG tho opportunity of dcvclopinl'§ .this control 2.nd unqcrstanding h:'is arGn8 of vulnerability.

) carry out these principles of the handling of agg:eosci vro and treatment of ~eroanivc men, no.:110 modificat.i.on :i.n the classic prison regim(! is noceosary_

Jci;_i'2l:c_.;i.41 'fhc comment on thirJ section is that wh(m tho evidence was submitted ) llutler ubout 1970-71, GrGndon )1<!.d not <'.t this stage developed its now definitive lttnrn of treatment. It had at this :Jtag;:,, although conniderable work had been :me, li ttlo formuLction of th,, ainw and go;;Jr; of tho d.iffercnt v1ings. tmdorstandine :.~t 6 oxcluc;ivo crit.o:cir1 for Grandon: •

Intelligence. Thc intelloct\4'll capacity must be in the ranc;c of the P.vcragc. Although tbn figure is r,ot precise, ono vtrJuld ony at lc;wt al1out an IQ of 95. If ono b in doubt, one repeats tlm intolli(;r:noo tostine; by difforont methods.

6.

,,

uzt.tiefo.ctorily to pr~ycho-.-.

HOHCV0l'

· · · · - · ' - ·t'r·' 1' ~""]·' o·i' " 1JI''1 .; "'t d'FH'''''G Severe ore:-'JllG br~an tLtGO:t'U.(::r~ GllCJl ~UJ occux·n t:~J J(·, • l:,_.....~ .!. u. (..U.J '"';'\ 0-T~

]· 111·t'-r'l( (•1·"1·1·i .-, alonrr \·d'!.li (:'}i]c·r,r>J;•·. if it in rr,·_i.:rdm:_\1 <-:.nd c..J!r;v;:rt nyfillYtom-.. irce; ·, '--.;~ -~"'/ <L;. ·· ·.J_· • I '

could be nccc;:h:d,. bu-t if the per;::on GLUl r:.:Ltx·i:)nte hie dioo:('ih.:I'f;d behr\viour to oorne Ol'CJ.lliG ~JJ-:.:i~m;- he ;·1as little :inr:entive to alter hir; cJnTt.ionnl lifo., his bc~hnviour or mel-hod:; of r·el..:ttinr::;.,

Ho ;;:cti.vc pDJchoo.isQ ('.t1his rc:r:rniron other typ•::!D of trccl.:tmellt- 1 nuch u.n phyeical mz:~·Lhndn? llor::pit Eclicat ion,. rcho.bili tatiun. proccnr;c~r; and therefor~':! i u not suit<.:~1Jlo foi.~ Crcndon)~ rl'rd.s inc1uJl<::J the ri 1;id fixul purauoin.~ the r:c~cr.tlJ.cd parano:Ld p:o:.ycJ:opu:tliic po:rconality diDordcr~

'l'lmo~ It in derdro.blo t}nt Fl .. pc1~Don ~::pendu in the trcatmcmt rcgim.-:1 a poriocl of at loast ono year tv 15 montlu:;~ (li1rorn timo ·Co t:imo Ho H:ill uccept people for [1. BhOl'tC1' period. }Jut 1 e.rd HO f~:CC J.ooking nt ;-;c"l;t:i.ng Up .:1 reei:JlC for short"LitnOI'G in thu a.dult clepo.rtwent

1 to coo if HC ca.n operate at a perhap;~ 6 .... month

period)~ At the p~·cr::c:nt rnorncnt 1 in gcncrnl 1 a pcl'fJOU rcquircn a.. y·car~

He muf.:;t clcsi:ro olf• Hi;;h to enter :i.'nto trDtl.:l:merrt ~ but he muDt be free to rcmai11 or ruwovo ll!~Jn.::;elf fro:n ·t:roal;mont.. If an appeal or parolo itJ pendinc;1 it io not cle8ir::~bl0'J that ho crrto~'B into trcatmo;~t tu1til thoGC rna:L"\:c:ro havo been rloalt 11ith.

Grandon vi.ll then at tho prc<JcJot tiuw nee opt nny other type of patient. Any variation in the: f::cxun.l L:pcct:~um,;0 any degree of .sxploni ve ~~g{;T'Or::::.i vo behaviour 1

tt hiotor,y of d:2u.:,r~ak:!.nt;·~ Pv hi~:;tory of aleoholim:1~ a hj.otory of chronic rccidiviom 1

but by taking th:i.n groUl) of puopJ.c 1 ono rcalino:J that tho potential fo:i: treatment is limited nncl I:l<:·1r;~inal ~ :PhcJ:~o Hill hopGfully be some improvement in mothodu of rolati11g n.nd bch.::wiour.

n. 'l'o inventigato aml to trc<•t offontlcrn nuffcring from disorders Khich cull for a pr:-:ychiu:tr:ic apprOach ..

b. ~c'o invcut:lcato tho mental condition of offondors 1 tho· natm'o· of' Hho8o offences r:uggcrrt I:JCnt al cl:Vnordcr.

c. To explore the problem of tho psychopath anrl to provide treatment or m<lllal;'cuu n t to ;:hich llc m1eht r·oc;pontl. 'l'hono nrc the objectives of Grenrlon nt tho Jll'CCJOlrt ti1.1o.

Objective c. hcCJ bee:1 (lcv.:.lope:d by the :lnnti tution of tho ArJsesr;mcnt Unit but for ftt:l'thcr ])ro~~rcns in th:io a1'ca~ j.t is important tha.'t \·:o cndcuvoux' to vwrk out noma formulD. of )H'O<lict;dxi.lity of respousc to Grcnllon. 7'hi.n ;;ould result in more r:.:elcctivity; ·thz~t io tha oolection of caac;.~ Hho are npprop:riatc for thin fol'm of treatment \'lith a connccruenl iUJll'OV08olrt in the reoultD particularly in measuring the results in term of re--conviction rate.. Ao I hn.vo stated in other c.roas 1 - thore io a movement m:a,y- f·rof:l £clcc-~ivityo I fJUCGCGt that at lcn-trt one Hinc; operateD on n more :rigid fl¢1oction; no.rr:.?.ly in choosing people uho havo a conoidornblo potential for altorn.tion~ Uo~·:c"tOl' this te:ndn to create nn elite r_rtuff and patient gr·oup and poDcs the old quc::;tion of ~troc.ming 1 e.ncl this nroa iD open for con::iiclerable discuO-

. f\ ·""'-(" '

\-;_i-th a ;_yo~·;rdy (~{ !i·,:-~l-~·:-(1 pr;:tf'(lll~dity to dt..·';Ldop :;t:;o_·~ d._cg·ccc 01· potcr~t:i c:.l f<_·;r f'YG'~-;~h f'(;;";l:lt:\ ;·;? J.L h.l.;_; r:u le>!!((::· r.:::.:urtinc to extrc:;te vj_oluYlo/ l,~d;~:v:tour Hi.th ·t-:·:<: l:LxJ.tr-d nira;,, .Ln vic:\L On l\:(· otlir_T );;:;_nd f~C](·l~·:·,:Jnt:: iJ. ry;_c;:on \"lhO d;;;~_;p_-l.tc hiu pl'C~;cnt ~~~no-t:Lone.l

1,t,n.:tn 1:hu.:n dcf:i_-,,·i·~•: ·i_nd:i(·:·;t:icnc of p,_Jt•::nLi.:cl fu::' .:.dtt:T':t'\.:i. . .i:-1 ,:nd. Lhcrefc<·f; total

pe:cGcJnu.J·.l t,y ch<!.L 1~;<: ;~nll r•::::~ nGt :ion in rcconv ict J ~::n p:co hab.Lli ty 4

G:condon fil} ;.; or,. import~·~YI; roJ.o in th(-~ prir:;on :Jcrvicc by prnyifl·i.ng a 0 first v.icll' rcseue cc:nt~'e for ac:utcty di.l::t.u.i'Lt_:d alHl pr;ychotie prir;onc:c;o; \;hv ,--,-t thiu o'te-rre nhm1 littlo pc)tonti;,.<.l for r;'lrlte'Lt<~cr~l pc-.r:.;ona15:ly alt.sr::tion ~-'--ml t]H!reforc 1;hoH predict .... abiJ.:i·l,y in t.;;:r·rn:~-; oi.' Toconvie't:i.on 1 hu-t 1,-;ho cctn l'ccpond to r: .. IJ(>r'iocl in the Gl~cnclon rO('imc 11'r Hhich they nl'C: no 1nni-~er ''wtin,'.; in tl r_;c1f'·~::1eetn.lc·:;:Lvo or der::t--;·uc-~ivc ) J ,_~ •-

IM.tnncr tVd'-a'dfJ the prinon etc~:.rr in thci:: p-2.-l'Oli'~ p:d.eon~ In pr:.~ctico i-t io iwpor-tn:nt to cetabl:i.ch a b~·d.ancc beh-Ic:<::n thiG Lroup of pali.cntn i..:..n(~ the other r;roup::J mentio:notL, 'Jlo --t£;.kc a ]__~1.rcc ;nu:Jbor of th8::Jo 11 Huscue jobrJ'1 Hvu1d reoult ir1 11fl'ho "tail tH-1.g(::ing tho dog11 in tbo thc.:rape:utic com:·;mnity on the tJine.

:l_<:£-~L~~l___l~_:-1~1~ :i.n 1 :in e:m_;cnco~ the principleD of Grendon~ Hm10vor it iB quito out of da:Le on tr10 cowrbJo In the co.rlier p;__1rt 1 uhcn the variety of forma of tr;.:;;ttmcnt nre clcucr-ibl;d 1 thin in l10H incorrect. No clcctro-convn.lsi.on tho:rnpy in in nso~ Ho innulin 'll'catr.wnt ~ no n<.1:ccooi:; 1 no <.\vcrt.don thcr(~py_b

Pcyc}JOtlwrapy~ l)oth individual and r·.Toup thcT.::-:.py nrc provi<led in r.roa:t.(Jl"' o:c lcnrJ dr::£~rUG in the G tllc:cDp;;utic co::1mm1iticfJ £lnd Jl::-:;::;c~:;iJJ'ilDnt Uu.i.t -t-.ho.:t nH.tl<:eu up tho Grcindon pnychiatric unit- tfhe trc£ttmcrit in intense pcye;hothe:capy in a ·Lhe:rapcutic comr:Ju!'lity ncttir.g~ ""'l1lH) cor:--;:.nwit:i_cJu .var'y in the nwthodn ulthou[)t o.ro cimilar in thoir aimD i.!.nd go.::tlr:~ Sor:F.: ·t.:d::ing tho more: i;.wl-'xted men Hho require the clooe relr .. tionr::hip of --lndivilluD.l therapy and more pr-tcrnalistic officer councolling to tho open full com::mnity ttppro::tch. rr~ho b~::r,::ic crr.Ue officer iG tho main t:r·catment agorrL · One \-d.ng cor:-::-nunity Op(:'2etteo on trannnct ionu 1 unn.lyai s ( cncot.llYt or Hork~ role plc..yinc{ 1 ~~oc:Lal skilln training vlith tho uno of audio and visual equipment play i:~n irnportn.Lt part in tho \rcatmont process)*

The nec.ond f?CCtion -~hn;t iu. H0\1 qucntionablo is the ln.nt Btmtcnco of Section 5~46. J\lthour:h· violent .bchaviou1~ nnd unco~---opcrrrtivc pa-tients arc trt .. i1t;forrcd .from Grcnd(Hl1 '·the: Hc,rd "quickly" could no\1 bo cliuinatc<L Doforo n. pntiont is trmwforrecl thcro in careful ovv.llw:tion by hirnself and the __ stuff <?~nd hi a pco:cr:1§ · H2.rcly --. iu the rwccl.for· a rapill tr~umfcr althotigh it in impor"tn.nt that thcoc fnciliticn arc available aucl because they arc ava:i.lablo 7 the need fo:c their usc is lcsu likely., 1~Phc rapid trannfor only occurs once or tuico a year,.

Section. '5.-17. 'fhio noction iG true for Grcndon nt the pro:Jont moment but the p)7~n;f·7vahin.t:i.on of the Hork GrOnclon in tloing hun been -~laboro:tod over the lc.nt 3 yncrn and there ic nO\-I a. functiono.l AoGecsmcnt Unit \·:hich in there to cvn.luate chanc;o in tho patients uith em attempt to evaluate tho effion.cy of the rogimc. in tcrmd of ito aims and goulD and the officucy of tho di_fforont rcgimco in Grenclon, to find tho DUitctlll(, patient for tho regime thn.t mon·t sui tn his treatment noods4_

Butler reports on tl;c fact that n.lthough Home Off'ico Research Unit hun looked into a number of acpectn of tho Gronclon regime 1 i't in still too early to n.oseso ito rcoulto.. 'rho feu early rcoults in relationship to reconviction rate aro conunented on. Butler then Bt::ttcn "Jleconviction 1•ates aro not tho only 1 or oven noccusa.cily tho 1nost valuable yn.rdotick for cv.:~lun.ting tho ouccoos of an inuti tution such as Grcnclon" 1 and other rcscol'chos concluded tlmt tho therapeutic community model io particularly suoco::wf'ul in the management of' disturbed priooncrs, by lossoj,ling their gencrn.l opposition to' r,uthol'i"ty, brce\:dnc lloun tho trn.di tional prison aub--culturo and improving inma'tc 1 s oHn solf-cstccm.,

C:omr.J<-nrl. ---~ ..... --.. \/ork .i.;; r!OiJ bC;iilL~ done in the ;\ssonsmont Unit Grendon to e:v;.tluatc the

cl8r':l"Q0 of cht:n.:~--,! tht"t occurs iu .:t p:.ti(:n·· --'l t-. ~ ·. --,. ' ·1-{;

~ ~:.~...;:t.i (;';"; 1) ';[L 1]1;_\]k:: (,f Ll:-·; J.':.:::it:~-t_i_(.l!;:- of lhe nr·t'J1don l't.'rine ul:.d:c;!_; L/.C•U()l l>)l,lj)OGf_;J

pre -;:·;, n~~J•'Llj c;;." ;:h .. "il td.·~:l r;er:t•)ll~-~lity cli!;orJc:r:.; ) ;-; ~\ t·J.it)dy r;c!]_,·:~_:-LE:tl i>Oup (1 very . -t··t- (_.,_ ---··iu• i.):.l~ lr·-r·•·t lto~,.;.·lv --olc-"t.--.,11) 11_y J\di'ilti:·:;·; Lltz.: objc..:-:Li.•n:u <;f Gl'L:ndon 1

;~;;'-·r:t<.~~(;:_i''j:l~··:>.~i) ;:, ---~t·~ :i:-:,:~::.:~~-l-~i-~;-:~-;.n ~n:i"~·to.tr~:;:~ ofl'cn(:c:;·r; [Plff\--l'in{: fr<X.'l (_::LD\iJ·::crd

\-Jhicl; ctdl f..:;r ,-~ 1J:·.ych:i.;.~"t.yi c ;~P!}1 ·u:::.ch, b. to i;t-,,cnt:Lc~·.t(; t-h(; r;h·.-nt~.d (::.~r:ll.d:1m1 of off~.~~~df:J·;.>~ tho n:.c'L'...trG of ,.;!w:;t:: off..:nce;.:; nu[~t:·>·::::-L J;i('iYI.<.i.l ti.:i rw;.·dt:·c <:.ncl c. to c:xp1ol'c the proh.l<:,::l of the p:'ly:..:hCJpc:th cuH-~ to provitlf: tJ·c,:.:~tJ;if·nt 01· trhW;<~c:cmu;t to \:!ric.h ho mieh-t rcnpond,

Grc:nt.lCJ;Ii in fact J rc:coivcn 2. cr-;;np of pntic:ntn uho j))'lodoJ~rin;-!..rrt'ly fit into the chn:r(~cter of pu:: ;;i()H<-llity dino:rllur~-J 1 the: r,FLjorj_ty o:C 1\·hom Hutd.<i .fit into the ~.ti<::~[~noein of 11 ut:ere::~td.vc J;~;ychop.xth 01~ inJ.de:quate pG._Yl:hop~tthn ~ Cl'CJH1on fulfiJfJ nn ir:;portt:11t 1'01L' j;-l b:cir:[';in::_;· p:~tienL; hho (t:f'C u:mwr;:\t;cablc: jli other f'l'iGOrt t.iuttintJ-'1 t-li1ll there-. fore rc: li (NCB tll\.J !"CquJ.rcr;-:nnt ~; of liOi\vy t--;'l ~~ffi11;f r;l ;d }\envy ucr.L:-. t ion nJJd houp:l t: .-.J i c ;:~ ..... ·tion fl'Ofll th·:~ ry::f.<":"' r~r:~.\.:.on~;, rfili~; n,lco G01'VC:n the -purpo:H! tn interr·upt thu viciour; cycle of t'.r;r_:·c:~':::_·~ :':-·: ··· !Jl.ul:L;.:i·i;:.",_~nt - c::::c~~.latJ.0~1 1 ~::; lle;-;cri1Jc;rl carlicJ~* 11'L(n~cfore by fJ'f'OVitl:i·;·;.~- <~ p<<'~;,_l:"t :'1.H th't.r.~ ,;;;;J;t:iOJ;a). r-rtnt.c id.ith Vll environment iil Hhich h~~ Cl.:-.,1 opur~;;~ .~: ~!]_-~;-:-::."L l J'i:>Hl..t~;u 't -:; (<~ l:::·:::1.1:,:: 1 ~L~·~·cc~>:.::i vc _, p<;c;: i :-::tent, vio .lent hch<:'~·,fionr 1

;;.ir~:~ L\ Li::~LL}.::.,>·· hii>: t.v :t·c;c!•.:-:'{~G ~~c:;·r: 1H'0r...:(:n:-J o::~ {::I'o•.-rth., Crcmlon ir; col(;ctivu but by l'1~) 1: ·:..:c.-::~ !dt;-r.Jy ,_,(}lee r·.;_-':·;L

~i~;=:.ti(.~!-) __ ~':•_·_:X:!: 'f'h:.· Fc:1 th-1}_·~.:;, '(1;1c::..::~ v.lll l/! t;,!t up to trent puoplc dii\~~10G\·:rl a:-~ h:.~·/:L:·:;·~ ·£,~_-;_~:· .Jt·:-:~.L:;:-cy--·l:f;~~;:;_:;_-:-~:-~·8 \Jho c;:1nr:ot fit intrJ Lhe Gre!)don p~:.ttc:rnQ But1cr'n tnli: :ti' t.h·:; Gl'::L:lon az;r,ro~t.:·!: to··H~3'd~.: rc:~c;-:L•.li:_:,::~lion i.n b:.u->cd in cmu3:i.dc~J'(.'.ble p::-...rt in pr·:,J;:G·Linc; :i.;-t;::~i)rt thr~;rq_:: 1.l :.::.~.·:lf·-<.:·.-F.tJ~n~-L~ ~\rHl :>(:1-l'-------<JUf!:~tioning on -lhu p<:o!'t of ths offe:n"L~· .in tho• l:.Jp(~ of c·n~:blinn; hi~:l to cm:;e to t,.:n:.:J· Hith tho pro1Jll'!Tt;,; tdlJ.ch lio be:ll:i.u! L.~ ~_; 1•.:'-; 'L-r•:;,:!~i)<(;·. 1H:i£J 7 by no ::1t~;mn 1 'rul Jy (~escrj hnt_; t.he Grcnch·,n 'Lr-(~L~tuGnt JilGthod. G:ccnd.c~n l'C:;').r:l'--' L·; ~ lci.:.r;:int; ui l.-u£~t :i (Jri; it in the coPrcction ()r i';-J.tlty pHtt<.~l'lt~·J Jf bl:l:::'::l·;ur? :·;~)cial cmd c"'motlc,n.:.t1 th:•:t nrc normally t~cqu.lrc:tl dur:ir:rr ch:i.ltlhouJ t;~·1cl ~~.,·i.:;]c::~cc;ncc- but h;:~ve !'..C\-'1_'1' been CL',t:i.::;f.:-:ctorily lcurn(:d by the pE;rchope.th 111lw Grd·;.:l_;)n l'(::(!,:!.r;:c: :i.~-• nufficierrtl,Y &t.ru.:~tu:r~~::d •:i.!·l o:r·~lcr for- thuce bche.vionr pntturrw to be e:::-:<:;.r;rir:c~c.L hrH1 rootli.f:ie(t,

It ue--:::;1s that tLD nc:\J unit;;; \·Jill find g-reat difficulty in operating <:~s 11 DOH uni ts 11

and .:.~:ro not jnrJt. v. :ccr;ro(~uction of the rn~iDon ltD bcfor\J. 'JrJ-lcy Hill 1 by dcfinitiont re:qu:Lr.:; to op(;r<.tto- in Bor:w :;ort of Grc!-ndon type regime~ \·Jhatovor the type of unit inBtitutod it \'Jill rcrruiro 1 .::fJ rdth Grcm1on, u .. heavy ntuff/irannte ratio~ CbG.pter 6 of the ~Ju'l.lcr l'(:port trtlk;; of provision i'o1~ inndoqu2..tco. At lca3t 20j·~ of the 0-.:.·cr.don populatirm could b(~ de.cJcribo:l aD socially in~d.cqu.::.te and it rany Hell be Lhis group 1 and tho c:.:>.x·ing fo:t• ·~his c;.coup 1 tho.t hold~~ back thiJ procc!:lc of chnnrs(~ in othcro~

Scctio" IL 11. 'flio l'alf-·:~<"r l!r•\we. llcre it tdkcl of tho Gr~ndon Club and the FeYU;z;;l .. Ciltb. nnt"CtT;z--T:-:J;J:~-.f',.{i~;y-zlopmcnt of a h;:.\lf~·,·it.;.y houoc for Gremlvn.. It -"tc.1ko of thd noeU of n. pofrt-rvJ.o.:::sc hoctcl th0.t could bo ~:taffed by Gl~enUon officc!'D in ordc·r· to contin,,le the pcr~~onnl ro1n:tionLillipD formed during tho pnrio'l of tren.tmont~ It r;cc::J::; nt tl:dfJ timo that thi:-3 e.:cca could he ro~~·Lhoucht ~uvl invcntir,a-tccl? at lcunt kccpillg tho book OJlUJl.

In :=-;u~;:!;::!'..X. The Imt l cr report 1 in ccrt a in nrcc.o ~ i o tot ally incorrect on t roatmont methods at CrutU.on l'.G the-y c:.:::ir:.t t>:t tho present time~ It iu al:-;o incorrect in i'ts cli:-~·-cur~::;ion of the high eelcct:i.vity e..t Grcndon c.:t the prcocnt til(~e. Uhcn it tE~lks of Crctdon'f: i!';'.;tht~l3r r;nch n;J tho g~ining of L1Gicht l.Jy rpychothc~rupy 1 it totD.lly ornitn the i'o:ecu;:: G.f' the ·t:hor<:tpcutic eo:rJliUnity peer r;roup UJtd. tho cocial learninrr n.nd rolc.-:trning- thr:.-t is the ft:.lcrut~l of the C:rcnd(Ju trcv.tl,:cnt re:cimo. ·

n J lic.,rrci. l f;cnior ~~Gd:ic2.l Officer

(

CRJ1'Y<1{U\ Jh~H rl'H 'I' f: 1f_l (;!l'"f2f.OC1U ,._ -~~,- .. --.-. ~«···· ·-·· ·'--"->•·,~·-->· -_,,_,~' '_,_., -·------~,-d--·~-··--.d>

boJ:~rtrd and YJl Uings - ag-1) ran go iG 16 to 2'1 ~ Adult llingD - ;,~gcl l"'ttngc bot~·tee:n 2'1 rmd .")5 yo;_tru.

Si11oo HO aro a:tmll1t'S ut maturD."tion tul.:in{-?,' )JJ.nee~ tho :.roul1F;er ue GOt thn pntirmts tho l.~cttor. Pl'om timu to t:i.mo~ ;lf o-~b,;r factors t:t:ce indicn;tbJc' HG uil:t ncou}-/11 }_)D(,ple 3~ and over up -to tho e:·lr1y t'ortit::HJ. liO\·JOVOJ.' 1 this gToup doc--:s not fit into tho intcnu:Lvo t:coatmcnt rc·2:imcv :i:~ crm bec;or;JD tuo trt:ronr:.fu.l fo:t' -thanl and also ·t,hcy do not ren:voml -~o psychotherapy ..

ll(Y.l'E: lie hrwe f<,unil thni; poc.ple Nho have r]ilfficultieB uHh re(;'crd to rJeXl\ill offonce:J a.gttlnt.rG cld.1d:ccn -in the lato t-r.-1cnticu aml or.trly thirties onv1U.:l"cla hav<;. littlQ (~upacity for change and perlu~po do bottex~ 1·omn.ining in iriti.vitltull _pt;ycl;othorapy fl'om "tht3 viuiting- ps;rchothor-apirrt in their pt-'<rent priuon ~ llm~evcr np to ·tht~ rtge of ~25 thJ.u (~roup rcopond Hell to Crundvn rer).mo n.ml treatments~ '1\tcnty ...... f:ive to 30 - lor;a \'lOllQ but still nro nccoptnl.Jloy other thine,-s beint~ c(rua16

2. 'f:lmc. Ow· uings domM<l a time stay of at leas·t ono yoar in treatment. The optin1W~i· fcing r;tnt0d. an 15 montlH:34 J.t is desirable that time Bhould be twn.ilable in order tlnt :fpllcM.i.ng Grandon troa-l.men·t thoro !.f.! "'' opportunity for a period of cofi:l>lernt~n-ta:ey ongoing troatrneut on parole~ However 1 people nhoulcl ha.vo t.t.t

lontJt one y·o<(c i'rom tho time of coming to Grendon to tholr r::DH.

3· Y".J}V.':L_''":;'LS:~o·'-'.":':.'!11'. iH roqnil'ed both at tho initiation of treatment and during the contintt~~ti.on of t:~.~eatmnnt~ People Hho do not Hiuh to continue ·trcatrnnnt a:ce o.blo -to x·c:Gurn to -their pa~nt I>riHon D.nd. tcrmino.te their -t:reatroont ..

4• .Ji<:L~',~l~C-~!':?,iil':::;;;:l:L~'!.!· 'L'reatment should not cornmonco at Grcmdon until any legal wr.tte:rs !Javo be.E:n clealt \'lith such G.H appoalo~ fcyther ch.:n~g-(m or li a peroon hao appl:lcd and been rccolmncnded :for parole, until a decision has been made.

,?• for

6.

Proucnco of Jletivo Pnvchonin :requirin& hospi"tal::.sation~ tX-;l)£l·t~;lGn1~LG;~:;nct;h~"'~-.'fB-iE;:;-X:equire psychiatric hospital

Theoo arc unrJUi table treatmen·c.

Pc·'·ients muDt be prepa;-·ed to adm:i:t their rooponsibiHty for the offences ·for 1·1hich they are serving priuon sentences.

7 • !D.:L<!-l.!lf££1!<:..£• Patients munt bo of' averago intelligence or above average intelligence. Jro figure is fixed as cxclusi.vo, but people belo1r 90 IQ do not fit into the tro!ltmout regime. 'fho m.ajority of Grendon men have IQs over 105. However on admis,;ion 110 do a llnvon'o Progrosuivo /.Iatri.ces and if there iu fJJ:l;f doubt wo do a Ylcchlrwr·.

B J Banet t !W Ch B DPN Clinical D.i.rootor 15 Maroh 1979

•

Gl{f111 !~t~TA li'CH '"PHF!': ;-;;,:;~·r IN .AVJf.H' \VT:;(l;) :V.r Gnt:tn):)H ~-•• , .. ,_ ~----~-"'·-~-'""-«~~--- --~ -"~~·---.-.~--~~~,~~-~-~-- ,~ .. ·--- •-'•_......,.,. ____ ._._~__,__.,,_,~-~-·-~

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'Nh.: r:~'i' -~cnl .:d Hf c rr.nge bu·i nL bc·t\Mt-n ?l und _)').. In g~,:ncrD.l -~he yonnscr tll,~ be 1 tcr 1 n.l thcugh tho ~~re.;).'LHl.L:nt 1 ~,quir-..:c> uc::a·! dcgTc of i:ifli.'.U.nJtion nnd nor .e ; 'l}lle l!l\1.,} b;-; tn'Ji\~ ut;ito.ble in Ltw Jt idJ1e t\·!e:-lticL.. Xn tlw rvxe CfJ.f,_:

of H f "JJt 1 :c f.>€: con. offender u c 1lic~ age of 5t1 or )6 treatm('ilt 1nuy tH;

r··it.:.~.b: (~, b:t in u:. ::r-~ over )6 iL ·:he clasDic pr,JChf~' 1,hic: pt::·Donnlity tnc Etf't: rn.nge t:hou1(, be cloGe to tl11. middlo tvJentL:s; L~.t 1 of couruo~ excopt.· onn Yi lh oLhcr thingw btd..ng :l.'O:~cnt could t-c wol1 coL::iiJ.c:n:·,-i.

2. :tnuti ion:\~! ·i · tio'~ · . =----__,_· ___ ....;:;;._~--~:~<-~"-~·,:}·.'

Long r ·potii:iv,! pcricdc of inutitutioru ... iGation f~·om the e::u~J.iest yeurG 1

np to , he mid<t~.; th'er.tie:~/middJ(; V -! r·tiot 1 in a cv1t1·a -~ndication for e~;.ti~;fnctory, ti'cntw~.:nL Hovc-vor, i thcxc hnve \)(',.?ll pn::---iod.'5 out of in·;tit1·tione, or :tf tho pex·son iu i1\ the youn:·-Jr gJ'Ol..l.pirtg auJ show21 oo:no d.:grcc of per non~ in:.. tia t:l ve . (LiD~ on i ;:s O\in 1 d- •_:$ nut C)~cl ;.1dc 1

buttLlOlt(~ \·Jif:h the othet g·r-uul- i.:ngn [!JS dOrY;ribc•J tJ~_ i.a is 't very bud contra. :i r:1lication to nntisfnctory treatmc:nt l.lG pc1ctisc ·l in Grcmc:Jn adv1 t ;.riu&B~

36 E E,.,~0E. _}~~l}.Ad':.T!:~C_l.!E!_c!._gE;)!::2, fx2:._·.;::;.£~f:!.~c_;:;

TheHo ~'catu;·eG w:i.Jl UfttaJ ly be found in number 2" but \'/).th r.v:;.sociated Lmti-+t< -thority., iu1ti···aulhority on its or.·n c-)uld -be conDl_dcrr:d as ·rcn.oon.- .blJ' -;ood pJ:ognou t:_~_c fco.bl.rv 1

1mt v .. ';eoci a ted with gro..:>o dope; · cnc~t in rut . nnti tuti Jn&J.it:cd }Y-rson CLUl auw.tr badly for trer~tment ...

4. h:.G.£'!l.E~E.:..'!-.C:.l"!.f!.!"£-:..5.tnd ~1 t i :E:U t !2.~J .. t'L: These, on their o\m, I pcrcOive ns v. reaemta~lly good uit9J for involvcmunt in tro£mwnt l but \1J,ll require u good c,ommuni ty to hand-.1 0 them ..

5.. ~!lpes C:~-9 ... ~f.o~~c..£.: There is no reason to cxclnde peopl.:' wi tL D..·:y type of or:·encc, such as paedophilia, arr;on etc. dru1 ~ abuse, uieoholian, but if too n:ay ge:- on to one wing, such :ts a ~;roup of drue offendcro, they will. fo:·m a firm clique and act ns counter to the therapeutic conmmr.i ty reci~>.c.

For complctnesB I add the three features to bo avoided, but these arc generally acccptod in our referrals. a. 'Phe I.Q. mur;t be close to average as potmiblc 1 ns Grandon men in general arc above average 1 tmd the person vtill lag behind and become a pet, act out as a reaction to hi.s inability to verbalisc in this extremely verbal setting.

b. _!'_!!Ych_?sin. l'my person whoso connection with reality is so tenuous that they CM not .enter into ordinary verbal and emational interchange, and can not accept the fact that they are reGponsiblo for thoi:· behaviour, are unsuitable for treatment in this regin:e 1 and in Jact require the treatment of' another therapeutic setting, SllCh aG a depressive is better treated in a prison hoapitD..l with anU-depresnants, El'C otc. However,. tnany of cur candidates ut hmes, under the stress of' the thcrapoutic community setting n:ay move into the areas of' P~>'Ychosis Hnd pre-psychosis 1

tUld thcGe actually can be carried, but if a person is frankly psychot.ic on arrival, or· roforred with u fra11kly psychotic emotional and

. '

f ;;_

I l

bchnv.i ... uro.J Jn0Chtl.lli.~;m 1 hr: ie Ul::-.;uitD.hl~.· :''or troatmontn

c .. Tl·:( thi:•.d C"1.teGoJ~y ifl p·'ople wh• ;uff· ':' from e:~tcnr·~v.:! 01~ oven moderato brain d::.u:wr;c t l·:hc;·.:: tlw., r bcht~..viou; can JiOt be ec:.wnt:c· ·• p.::; their own rc;_;pon::t.'.;.bi ·.ity, ,:·}Jileptict; fit int. thic cat .. gory bee<., 1r:; cpile:.JtiCsqin th: con·! cc; of tLeir cor~ ~itit)n l'fi: l :rcqu:i.r1: .. eu.vy Jrut J.GngG ~ Under hunvy dntt~ ur:a.f~c the cp:> loptict<i.r; f'CfxJ.:rat.C!d :.'rom lliu fcc.linj B, n:·d aa this trcatm0n .~ ·cg:i ··;e J'(''ltlir ;G a \)O:'"BOn ... o be ".n c loGe touch \·ri L t hie. feolin6G and be 'fi mr ·.t l'U.lt.!fJ out th.i:J po.rl:.icul r (!;roup

1.

'f.hc younrser nr0 .:roup in gone.r:.n) ar•• moro <;1menablc to tr· .J.tment, anJ ;l

pe)~ fJon t t·.i l!:J:..t th .. :: ll ho, with all ULngo being c onci do1~0d, a high enough -positive .-'CH60·. fo. ~ntroducin.g the t:cc-ntmcnt l'C[!iflle ..

Bon'ie prc~vi' •UG ~·en. tmo:; ;~, oomc in.sighi. or CK .nc un(. Z!l'stn.nd.inc, evc_!n thoug h it hD · not bc0 ,, put :i.nto practice, c<ril 'J,c of VWk3 as a posi ti vc ,,cur;r;cstion for tl aatnwnt ..

3. ..

Some drive, ov-.. m ae/9-"(~Htrivo. This con l·e secnt as a positiv,J attribute, ua olJ dec true t..ivo v.ggre. sion is ct·; <,;placod, t.:nie can l• t tines be directed into creative and conntructivc bchuviouro This would depew! on 1 he iHdividud wing ru"! the individud situation from time to ti.me.

A pcrBon with some dogroo of fnmily stability or socinl stability in genora.l, has more chanco on entering and aucceeding in tho troatmcnt situation, but with the usc of family c;:roups a good fam:tly, on the surface, mey turn out to bo nn·intornnlly dentructive psycho-dynamic situation. l!owover' 1 in eon oral the drifter ia lesa ·liable to enter into a satisfactory rehabilitation than a person from a more stable socinl netting.

§!Elc DBfirce of A..£!::.ievoment

Thlo io a very irnporto.nt poaitive qunJ.ity. Tho degree of schlevement may bo very amll in gonenu ste.ndardLS, for instru1co ~ a period in early lifo when ono '0' levol in eainod, a period M a prefect for a short tirne 1 a corporalllhip in the Army for even n short time, un election to a ahop steward for a few months at work. On the converso if there is no ovidonco of any achiovemont whateoever,tha prognosis by its vecy ooture, associated of course Hi th the other factors., is· V(Jry poor - 'the evontual :prognosis. ( e:x:capt:l.ng under protecti vo regime) and the prognosis · in tJUrVj_ vnl and bano fiting from tr.oo. tment. · · .,' .•·:;

•.:.·· ;\ f:·· .) ~' .,

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vuo .:crtn-t-1 1r~ .TJnr-~.n dr;)q_ tFf p<):·;n <.Yt o:n_n prno;; 1 d.no.x:; 111 ,._,y "''f'[''l ·r·J· _,,-,.- -~-1 ~.l'''''···j~-.·'>?f ·1r1 ,·•, . .,, "J"Y[)Ot .;.,_ n·· ~ 1 q 1 [i ,_, :··t+ ,..._, 1\.U·) \../_ i'>., ,_-.... ·~-·•-v<.'( ,__._t ~,_,_.,,} _'-·,·. -U ,~.-ll--.1;) ~II

<Yt{:} JO lJ01.:i:;-~) rpou ;:)~)1~.)~-; ~__;;-_; P~J-.1()\.JJ·r: ~)q ·;cq Pt:ncrq:; :~J -~·:j_ "!J1JTJJTP u·r-:.}l_.:_ ·rr-1 ~~~,;~ '_J_nq_ ::: THJl ;_;q :1 }u fU'!-Or' OJ .. :co·~.:rd

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\-lhen you allovecl me tO .attend a di.!JCUiJSicJn meeting of the ecmmt:n:U.:y t\;JO or three woatho ago, Hr Dunc.nn Hacivm: posed the qut~Htion: HoH

.~':?.J~.~~-2~.r: ~:.l ::::.; __ t:!~.~-~-"-.~~~~~~~-g_;~~9X _ _:~~ e -~.?.~_(_~ "~~-~ .. J!:~L~.L .. ~-!.f.~~l:S:.~-~!2~2 .. !.:_:_'1_r:.=L!: i :!..J~~~-'_i;_(; __ ~~~~EL~:}~.;__,b..:.·l~~-0 __ :r:.~~--~::.~J.!_1.Y..!E.S::~~L~.~-:.: :J:_. rs~.5?.~L::: '? T [ i i ~j tj l:ii r t \: d WD

thinkiug. I am convin.ced that u Gtudy of hV\>l the UnLt: \·H.n·k:l, what happens in it, nnd \-Jh<lt TCIH.tlto it: p·coducen,. muut Le vnluabJ.e. Sol have tr::f.ed to uod{ out a numbex of central to rd. en. or lf>BlWB~ · liy l-u:nurucnt iu t:hllt: nny inquiry l to be r~;~·;f(Y frl~iLiUf;-nhl'ti-t-·;,iRte und try to an:.nmr central iusuct-J o£ this kind.

r have oct out ten possible central ise.ues on tho attached uh.ccta thus:

A. Aims of the Unit B. Sources C. Types of inquiry D. Specific research questions E. llho benefl.tn? F. Hhat must be revealed? C. lvhat public? H. Confidentiality I. Constraints J, Conroy was h~re

For the first three of thcr.c (A to C) I have addcd a few of the possible nnswern or aub-headin1~o (for exmnple, under A, some of the aims or results \;hic.h the Unit might be seeking to achl.cve), I have made no attempt to do this fot• issues D to J.

You gentlemen will., I am auare, he far ahead of nw in your thinking about these qu,ntions, and you have learnt thingo that I do not yet suspect. Vc-.:y likely you could state central ionueo that I hnvc not thought of, and certainly you c:ould write down nwny other anuwcrs or relevant connidcrations. I have no illunions about that. And it io not fot· me to say t~hat, sort of Inquiry' should be done - that should emerge by diflcusaion within the community. Still I am sure that we can all of us bct\cfJ.t if we start our argument from central issues of the fi)OY.t I have liotcd, am] build up L1 atructur" from there,

I should be grateful if I may attend a discussion meeting of the Unit one ~leek soon, and I hope that we could discuss th(lBC notes and try to move fonmrd from them. I have mentioned this idea to Nr Tom Melville of tho Department, who neea no objection to this procedure if it is acceptable to the counnunity.

D Vlebster Dept~rtment of Sociology University of Salford Salford M5 4W1'

18 June, 1974.

•.

In judging huv; f;J:r the sr!(!Ci.al Unit i!l g 1 BltC:(:Ulf.~f > tAW.t

ni::w do \:C ttave in wind'! \-Jh~:t po:J!_iible i":f.!L'nlU.: o1·· eo~.~

tJitlei·u.t:lui.d; n:r0 rel<~vnnt'( How much ~:c:i.eht Ghc.·uld \::J(!

pL1ce ou e.:lch? lhn-t do \!i.~ me~i:JUl'c the:n'l h'h.Ht if they cclifl.lct? (That in; you cal! ~lchicv·e one but only nt the coct of loni••t onotb~r.)

(1) Buhr,,viour/charnctcr/intel:aal li fc/p1·obablo fnt:m·o behaviour of indtvidualtJ has chan_£~ccL 'So-and~sa :{r; coming to terms t-lith the \vorld) i.:> accepting rc~Jponcibility rtnd doing thlngs for himself, :lo noting rntionally.'

(2) Persona in the Unit beliove/mointsln that the Unit io C\lCCC::l-8 f ul.

(3) l-evel of trouble/tcn~:don/numbet· 'of Lwnaultn :l.n the Scottish Prison Synt~t:m as a uholc falls~ ass.nultn b;:.ttv'l;cn prlsoner.s._ b8Ch'ecn pef.uorifli:'"U nnd prlnon officers, feuds nod vendett~w. 'Trw level of tension in Pcterheud han fallen.' ..

(1,) Publlc/ncwsp"per cotnrnent on the aims, working, nctivity of lJrtson Department and Pri~;on Service.

(5) Effect on 'the criminal conununity' outside, especially in GlHngot.:.

(6) KnoHledgc is gained Hhl.ch helps therapeutic communities c~ lsc.~uht""!LC.

(7) Tcchnl.ques and knowledge nrc g11incd which produce n more succen s fu l/ :H:cepto blrdhuw.ane./ pos i t~ve prison ny !J "tcm in Scotland: usu o-f hmne pHrolct co1~reupondence, visits, trust, etco

Hlwt sources of information or material nrc available to nn, or con be or in in prlnci ple could be nvailob le to ua? >lhlch of them can be got easily, which with difficulty, which can not be got at all? And why?

•. (1) l1inutes of weekly meetings of the community.

(2) Pri~on Service Journal: report of vinitntion by three members ofr;:·inon Of fl.COl.'O I Anaod a tion.

(3) l\i.l..nual Report a ef: Privon Depattlflc:nt. ·

(4) Pr-inon Dcp.:n·uncnt. internal l?eports und t:m~king documents on the ~h:g.rt· 1~at:l.on Unit in Invet'J1(WO und tho poaoiLility of aGtting 11p a Sllccj_nl Unit.

(5) D:l.uduo lwpt 11ithin the Unit.

(6} Letters ecnt out ond in.

(7) Internal ,utuff t·epm:tn, memos, rlocumcnt''.

(9) Collated tmpublinhcd matcrinl on Special Unit in the lwnds of the l'rivon lkpnrtment.

(lo) Opinions of Governors in Scottish Prison Service.

(J.l) Opl.nions of the Inspectors of Prinonu.

(12) Opini.on'a of individual prison offl.cero nnd o£ POA.

(13) Opinions of main Barlinnie flt~:tff.

(11,) Opinl.ons of Prison Wel fnrc Officers.

05) Opinions of ..

other persons eliJewherc in Scottish l1rlson Service.

(16) Hnterial l.n possession of Ian Stevena (nature noc known).

(17) Newspaper discussion.

(18) Stt·uctm:ed interviews with members of community.

( 19) Qucs tionnaireo.

(20) Opinions of visitors to Special Unit.

(2l) Opinions of relatives of members of conununity.

C. 'rY.P.es of l!Jquir)!

!<hat type of inquiry is possible? Which type iu needed?

(1) 11 psychiatric or psychological report on 00p<'rnte individuals.

(2) A study of a omall or primary group as "n acting nnd decision-. making group or organization - like a team, or <l family. •.

(3) A therapeutic conununi,ty in action.

(4) A numbGr of people who hnve temporarily come together in one place. All of them have some aims and tnsks in cowmon or shared (e.g. those created by the cor.nnunity) and some aims and tasko not shared (e.g, rcludons with family and relntiveo).

,.

All of thcna lw·v-0: come here ft"ol~l dJ.fforent: places clnd hnclq_::.roun<l <_md int•.:r·c::;tn ;-nHI morLvcn; .;,t~t; h::ru l'r,mpm::~L·ily

tog<!tltcr; and will Hcparntc ~~g0i11 nnJ nll gu tl1eir own wayo. S(•l.:.iC GYe h~-. .'n::e for nhort p(!riod.;:; :ccpe<:t:cdly, :;c,me occn.si.onnlly, uome for <1ltn(11lt all of tho tim2~ At no t:i.i.ll!..: Js cvc·cyone p-resent to{;ether 1 .::md the population vnr:·ica nll the t:Lmc:. So an Lmu.sunl Lroup or e:ollcct:f.on of p.::•)plc 1 <:iJ.-t.d 't-~hnt other. gt--(Jnpn or orgarlizationn docs it mout reschlbl.e?

(5) A statemc:lt not in terms .·f thn conr.mnJty at: nll but in tennn of the re:;t of th.:~ prison Gystem, or pedwpH thH :~.-·est of the pcnnl nystct:l.

(6) A hiotory, a otroight recltnl of events.

(7) An nnalysJ.s, in ternw of 'If you want to achl.cvc X, you should do Y'.

(H) Comparison of dlffercnt prison x-cgitnes - size of entablishmcnt, staff ratios, cost, intake, reDult (how mccwurcd?)

;,; D. ~pe~~ific r~nC~J:'Ch O!:J~~lUl

The sources in ll are sources only, What questions v10uld we -vmnt to tlirec t: to them, 'tvhn t ltnoHledgc to elicit from them, ;:hat conclusions to <.lraw from tlwm'l What relative Height should be placed on"f these nourccs und the infot-nm tion f1~om them, ,,nd »hy? What if they diuagrce or conflict? (These questions hark back to A. A auks \Yhat: possible aims are relevant? D sayn: "Vlhnt questiona do \10 aak nbout these aims, ho\>1 do \>le I'JNlsure tYlu~ther we are nchi.eving them'( E. g., what if So-n.1d-So is much healthier and lwppJ.er in the Unit 1 but a homo pcn·olc never works well? )

E. Who benefits?

What forms of hcnefit might follow from the existence of the Special. Unit, from the work done at and the experience gained in the Special Unit? Who can be argued to benefit? Hcmbers of the Unit itself, persons strictly ~1ithin the Prison Department only, or within the prisons and prison service generally, or what wider range of peroonD?

F. Hlwt must be t·eve,..led?

l!ou serious are He in any systcmatl.c study being done, how serious are dH ferent people and interests? Thcr e is bound •. to be prying and uncomfortable hcnrt-ocarching, releane of some facts or information that persona would prefer to remain hidden, and perhaps untvelcomc or painful or simply undiplowatic thi.ngs revealed, perhapo conflicts or interest or policy stated which as a rule are toctfully left unsaid, Do people really mean to go th:cough 1~ith this or not:?

.. .s.._ __ Ph:\1: publi.~?

Is any eonclunion or report for the.c;yes of the Special Unit conanunity only? The Special Unit: plun interested people in the Deportment'/ The GovernorH' Conference? The POA? The rJedical cor:ununity'/ Can anything ever be pubHshed openly, no that othet·s can benefit'/ lf not, is tharc any point in a study of the Unit nt all?

Can anything b::; published outside the Prinon & forstal Service (the Official Secrets Act circle) 1-1itbout nnrnce being n.:>mcd? Hho may be h<trmcd?

I. Con:trai.nts.

1-ihat constraints nrc there on our aetion (coot ~ profcssionnl opinion nnd tradition - pressure groups - competing demands for other needs - p(lysical plant - training - gen<!t"lll public opinion- und so on) and bow bc3t do we' tnckle these?

J. Con!:.SY w~ s h~rc.

And Hhat do we lcnm from Bernard Conroy?

DH, Junc/74.

•.

I I

\

'J'HE FlH-lG11T ON Uli' 1PHL Uf\rrrp_. ..------·------~"~ -~-~~---~~~-~~~--

11'he .Uecretary or f3t:tte pr·opoeeu r:.o cho.ncr; in the concept of

the Unit; and the intc(';ral part played in it of discussion and

con£5Ultation -- involvirlg Department i Gover.~nor·, Gt:::d'f annoci~ttions,

and stn..ff' and inmates, both sepn.rn.tely and a~-; a community ...

In particular, the community Hill continue to d:tBCU:o;; and,

arraH[';e>ment g within the Unit. At the same time it iB de3irable

that the ultimate respondbility for mntterB relatinQ: to the

Unit and i;ts OJleration shoulrly defined.

DEPI\R! .. ltEN'r. ~--..._~.~-

1. Overall responsibility for the operation of the Unit .. will lie with the Department:.

2. All matterG of Gecurity, includin('; recommendations for

chanp;es in the security categories of inmates, .vill bo referred

to the Department.

3. ~Vhe approval of the Deparrrunent will be required for rmy

change in operation .vhich (1) affe,ets the concept of the Unit,

or security, or (2) requires an v.mendment of these instructions.

'rhe Department will consider proposals for any such changes

which may be made by the Governor, by staff associationr3

concerned or by members of staff (to be submitted through

the Governor), and its decision will be final.

GOVERNOH. •.

4. 'l'he roann~;ement of the Unit is the responsibility of the

Governor who .v:ill administer the establiEhment in accordance

.vith the l0rison Hules and Standing Orders, and as instructed

by the Department.

• The Governor will determine alJ mat-t""'" n rr.,,-.H,,. tch<>

:inL;v:t'll::~_} operation oJ' the Unit ..

6. lc 11 IH:mbcr;; of staff will· e:nTy out Uw.Lr dJJ.t:i.c;; in

t-u.~cordance v:ith the P:eison Hnl(:G r_._ncl f:.~tanding Orde:ct:J and

as inr-it:cucted by tl1e Gu·ternor.

wLil b; held at ~meh interval~; a.s the GovcJ'JiOl' :~nd stnff consider

8. Any irref",DJ.<n·it:ies which are brour~ht to the attc;ntion of

a mccmter of staff Hill be reported immec!Lttcly to the senior

ofi'icur on duty und confirmed in 1rri tine; to the Governor.

C01'1l"11JNI'l'Y. ~----~~

9,. A coJr.munity meetixit~ will be held once each vwok and may

be attended by the Governor·, mer!1bcrs of Htaff-; inmates and

p:cofec;nional vi::dtors to the Unit.

10. 1\t lea,:t 21l hoors notice vi:i.Jl ·be e:ivcn of any clw.ngc in

the normal arrangements for the regulnr weekly rueetin[', of the

community.

lL Dome8tic arranrcements within the Unit will continue to

be discussed and conBidercd by the community under the overall

authority of the Governor.

12. All community recommendations will be considered by the

Governor and his decision wi 11 be final.

13. Becurity, stHffing and.conficlential matter8 will not be

discuBsed at community meetings.

14. The community may discuss the progress of individual

inmates provided they do not object and are present at the

meeting. •.

15. Representatives of the Department will not noi'IUally attend

community meetings.

I f

,. \1

1?.

• .l: I., ; '" ~ '. j .·' .; :-:;·!<"' ----

approval of thn Governor.

:Lnte:r·va1 :J ..

22~ Visit:~; ·by other persong {JTld groups to the Uu:i.t v1ill be

perw1ttad subject to.Lho discretion of the Governor.

2). 'l'he Governor v:ill be respc,rwible for the Gppointment of

official Prison Vi~;itors and he will prepare appro1wiate guidelines

for the:i.r information.

2LJ.. Persons vtho are involved in a professional capacity with

the Press, Radio or Television will not be permitted to visit

the Unit without the authority of the Department.

2c: )• Escorted vii;i ts wi 11 not be permitted without the authority

of the Department and they will be carefully controlled by the

Governor.

26. The assessment team which interviews all prisoners ·.

recommended for transfer to the Special Unit will comprise the

consultant p~;ychiatrist, two members of staff, and the Governor

of the Unit who will be an ex-officio member of the team.

te:_tln fdtc.'t.t}\l

prior to tl1c p1·ir~onc-!:C t·einr; .int(:)_·.,rit:\·Jcd by thn a;;~GCi.JC:ment teamfi>

letters, visits etc. will be majntained.

contirnw, but will be moniton:d as eorw:Ldered n<'ce~JE:nry by the

31. Parcels received for innm te:> Hill continue to be opened in

the presenqe of an officer.

32. Inmates may continue to rece.ive for their personal use small

amountr3 of' mone;)' and tobacco from visitors. All such items received

will be declared and .. recorded in their personal records.

The present arranr;emfmt which allows inmates to augment the

basic prison rations by purchasinl~ ndditional items will continue.

3li·. 'l'he use of the telephone by inmates Hill be subject to

normal prison regula.tions and may be author) sed only in exceptional

circumstances by the Governor.

35. 'rhe procedure i'or dealing with :inmate:o reported for breaches

of' d:i.scipline Hill be reviewed and determined by the Governor.

•.

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; ;·Ef:::"'· · .::\·<' !;Jc •_L:::l ft~·nci...:c·l! v( L(tL2:.::g .:.:.:lu~:s 1-:n ::..::r::::.r::l: ::.nd :::.Ctc-~ i(· "::';" ·: .. ~~-,-:; ;_J.:-..:::: ,;,~::'~n-. .>:-~~- Til~r,; .::n ~wv ty~d ;_;C ?~iS:):1 ·1!..··::::! :.i.:ld

·····,_ :~~t::r~-~~::..'.. P;::n::.i:·.;;:.;;:.::::'..e :l.;:~d S~;,c:.i,u, :l.r'~ :;·::gh;!::l

::-:i:;•.::;:: ·.;.·!·~:.::!1 ~' .tJt :.i::c.:::pt 2drr:iS.':,;ons Ci::-=,:::t fr0r:< ccu.rt. Or:~)' p:-:s:~ners -, --~:~-.·:· .,;;he b~;,_...:- C,;~n S(:;c,;tcd JS st:it<.:Sl~ ::::::; (:;:; tr::.nsf-::rreJ

Y~:::.::;;_:: --:-:-,-:~;; :,::.:::-s :.--::>::1tt.:.~;c;;:;. wo::rs br:.J:.:p)1: !r-,tr..:- i11 J:..:::J<::y, 1S65 .--· ~- :: ::...... ;.Jr,d:·.-::- 1l is scntcr:.-.:::C to 3. p¢rk:d ~_;f ~;:;?r:s,._-,::r;g!!\t.

-:?.:><r.:d. ~~·: u :·:~:: (,:.f\ te s-e:-:t:.-::;c("d to a sk::ibr _?c:-!c·d sf dc::~nt:o:: i:< J

... ' ~ ·-~-·1· -~ l'' , .. 1~--,.., ., ~,.- ... .,.~,~,..., • ., -,.~.re ·~· .. o:--... ~o. '.Jri:l.~e to their ,-~·~:.g ,).:..::·,_~7:, ~~'-''l.JH~-• ,..;.,c, .... · ... y.v:::, • ..:..:.:..·- ~'-'•· --~ .-

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:.: ::.:.·, ·:-.· :.' ~~-=i:. ,;. p...:~ ;.j ;.-tr--tt't:d is J:.:tcr::::i!:ed by in:;:.n;::s' i-:-spo:.:::e to

::-~:--:·J ~-.:-)<s :::.> :.;...-:::·.:..~,;; sEg)·~:ly l-:::,3 th1r:. or.,; ye:1r.

A! c>.·; ~5.:::::;:~:.-;;;, ;;~;:!:-:! (:J.t G1:;.-:c..;;;!-lH, n.:::ilt" All-~):!) ~n.te:-r;:2. :s f-::r a f~xeG ;~~c:~-.~--:0;:~:-: I.:ss c;.c-::h::.-J. :.-~ry:issi,::.;, tvr gvcd b·::h.::.·.-io~;.

The :.·..-ers.ge dz.Uy number of persons detained in penal esta.blisbnents, which stood at 4,238 i.n 1967, peaked in 1971 at 5.338.

The ave:-age dally population for ezch of the years froi:l 1972 to 1979 w~s. 5,2.20. 4,8 I 0, 4,689, 4,951, 4,884~ 4,$7"1, 5,062 and 4,579 respcctivefy.

TI1e ;:umber of prison officers at JI December, 1977 was 2,034; totJl staff at ~n:.tl est::.:)EsP.:r.~~nts 3t the same time was 2,566.

\Vhen the ilrst Secr;;tary for S..:vtland w:.s appointed in 1885 i.he dd Prison Com:Y~ssion w:1s o::e of sever::d beards :2nd co:nr:1issior.:s J..lre::dy est:::blished in ECinburgh which h-elped to m:2ke cp his portfolio. A feamre of th.is system of :.i.dmini~t:ation. was th:Jt th::: b0ards an. d. their staffs were :10t s-:-rvo:;.ts of t11e Secre~:>:ry for Scotland, a!'!d though he a-r.swered for them in PJrliament h-: m.ig!1t :1~d himself dis2.g::-eei:1g 'J..:i:h their 2.~tior,s.

in 19"2.8, two ye::trs Jftu the offke ofS<:cretJry for Sccthnd was elevated ro that of a fl;inc lpal Secretary of S'!:1te, rhe S..::ottish Pdson CoiT'_rnissiuners were :lboii:-:hed. Their piJce 'N<!S t:1kcn by a Prisons Dep.::!rt:·nent for Scotland t.vl:kh. tho:.1gh under the control and dircctbn of the Secretary of State, existed :tS a st.:.:. tutory bo.dy indep-::nd~rH cfhim. It was 1eft to the Re-org:1nisatlon of Offices (Scotland) Act of 1939 to abolish the dep:utr:1ent (::nd other similJr departments) :.Hl.d vest its functions in the Secretary of St::.te who wJ.S free to m::!.ke such Jr;angernents as he thoug.:1.t fit for d~s~ charg!ng the buslncss of his office.

Ufe ... Inside"'

For in.tnJtes, prison is a life cf routine. Th.e whole day is timed and scheduled. Unl<::ss JC1L!::!.Hy experien.;eJ, it !s .:Efticr.;.!t to 3.pp:-cciate how st:cng. ·.::;111 be the- effect on an 1nJir..:i::u.:.ti of losi,.,,g'tb.e fre,;d,:.m tv do as he \':i.shcs whenever h~ r.;...ish~s .. -'\!thcug..l-: -:he:e·h::..ve bce::1 contiaui.'1g reforms and devclop-me:H of the- s:yst~m. p:uti>..·ularly over the Lust thirty or forty yc:::1rs ·it u~ed to be pos::;ib[e, for ex:mple, for a priso:-1er serving o.1ong sente:1ce to be able to ?redkt cx2ctiy what he would be eating for years ahc:.-d ·the:! d:sci.p1~nc of routine is still a m::1jor fJctor of prison rife.

The pr:soncr's first l!n!-.:.s w!:h the J.d.min~tr::tiori of the- prison S\!<Vice arc the prise;; ofD.ce:s. ?:is on officers are no longer sirr:ply ,;ustodbns or turnkt:ys. Tbcy t::.:kc :m increasing ;:xut in d:q·to-d;ay mJ.:·,o.gement, and the intentio!1 is to C.ev!!loo this trend. Officers h::1v.e- to set :1n ex:.;,:rr,p:\! of

·co :::.nco:JrJ.gc ?rrson~rs to ;,;;fnrrn. Aithoug!,~ routir..es vary from tu odson :.t.:"'l.d arc·different for ir~dividu::J c::ttegodes of prh:cncrs,

the 1vp1c:-l ·:;·,~ckJ::lv of ~\:1 Ir.matc serving a se:1tence of more· tha1 six ;;10:Jth::. n1Jt :::;.:1:]t>:t to ~ny sped::l secJr;ty CJ:: trc-atn~<:nt restrictions may be ::~~ tl::J>

7.30 ~ 7.50 :.:):;::·.

7.55 zm

2 2.45 ~ ! .45 pm

!.50 pm

5.30 · 6.30 pm

6.30 · 3.45 pm

1 T:,c;c:.~ :..:.:::! ~pc:::I::.t1 :.Ci:-::·~.:. ::.:;.:;:..:~:y !·..1

s:op out; wash; r:~zke bed 3:1d de2.n c-tll. Du~r:g this ?Criod a prisoner mJy notify staff if!:.,.; .,,,ish(·S to :.;e;;: doc~or. sod.:U <.Yorker or

Br-;:,::<..~:-,st- t~:t, O:e:.::.d 2:1d marz.;J.rine, porDG6e~ cooked Cacon or saus:3.ge or egg~ etc.

P:1raGe for wcrk.

Vlork. Th~r-::- :s 3 :::1iC·mQcr:i:~g r.e2 bre::k: (te:J: miL1J.t,;::s) 1.1 :nos~ ~s.~.::blishm;;r;ts whkh ;:.r:sc<:ers n:2y s~,ok~-

D-~.:ri:lg this ·.;;ork r-e:icd, ~prisoner v,;~o has ::1s:-zed ~o do so ~s ~e~n by th:! scd;::.l worker. He rr:o.y ~lso be ci!~d to the Gov<:;;1or's o~derly room :c b,; .:·.cd~1ti.i cf an::·);crs to pe~iti,.)r:s, 1

:r/o:m~'..i cf P2.rot'; B<Y~rd d~cfs~orts or to hJ.ve =::isco:~C:t;ct ·2e::Jt wit:?~.

;.!!dd~y :-:::c:.i.l--soup and roll, m:::ir:. course and s~.•.::..:ct. Us'..lzlly a choice of m22:1 course is 3V3.ii

:J.ble. This de:::..:nt of chorcc h::s resulted in

i.es:s w:;..s:e.

P;:.;rsdc for work. N;.1rr:.bcrs checked by staff.

R.,:-c;-::::::c:: p~riud~. f·b~d.:;.;n.ft cbsscs :?.n.d t:CL!..:::~i:.:::: .. ,;;.l f:.:Eitics av:E:t:k. So:T',~ cst1.b1is:h-rr.tr!.:s ;;r:;.::::·:;;~ ·,-:Sits f;-(:r:: pr:s0::ers' frk::ds 2.f:d : .:l:r~:v~~s d:Jd:\g th¢~0 ?t:"h>·:is. o~:-..(;rS.

•

8.45- 9.00 pm

9pm

10.00-10.15 pm

Typical Cell or Room

Supper- tea and bun or filled rolL

Locking up commences.

I.ig..~ts out.

.-Dimensions of a tradition:U ceti or room for prison~rs are some ten feet by seven and a half feeL The floor is covered by li~1o!eum or vinyl tiles. A .. .'1

:lpertllre in the door permits st.:1ff to keep inmates under observation. There are s.:Ct!rity b:us in the ceil window. a.-:d furniture is a bed with mo.ttrcs:s, four army-style bl::!rL...::ets, two sheets, and a wJ.rd.robc. On the wall is a smJI! mirror, a smail metal bJs:..11, and a picture/notice board; ar:.d there is a mof light. In est:tbll3hments completed i.'1 recent years rooms are designed and fu.rnishe

4

d to modem star.dzrds.

Educ::;t!on

The:e has alw::1ys been. a place for educ3tion in custodial treatment and training. \Vork is proceedbg to exp3nd educatiom..l activities in penal est.::.bUshments and to make programmes more relevant to the needs of lnClviduals-~ At Ed~nburgh Perth a.n.d B,uHnnie prisons, Gienochil Young O!f~nders InstinJ.tion :and Detention Centre, Dumfries You:::g Offenders L'1.Stitution, PoL-r:ont Borstal:and Cowton Vale Irtstitution a::d Lo:lgriggcnd Remand Institution there .are full-tim-!- e<iucation officers, assisted. by full~ tim~ or pa.rt-time teachers. Mo~i: of the remaining establishments h2.v€ the professional services of fuH or part~time teachers or evening cbss teachers. Levels of intelligence of im;;.O.tes vary Vlidely, but thoug.,l,_ -ed•J.i.:ational histories of many prisoners show little motlv.nion for eduC3.tion before they come i.\'1tO prison lt appears tD.J.t in the prison situ3.tion::. good nu:nber are prep:u<.;d ·to give educJ.tion a try. A revised system for progressively assessing borstal i.nrr.z.tes h.J.s been introduced to try to ensure that e3ch hd is :::.Uo.ca~-cd. to an in::.'titution w1th tr::.'L-:ing and other fac~llties best suited to tis needs. T.'1.e assessment programr..1e coy:trs six:. weeks, during which the ii1rT.:a.te is giv-en edt!cationa1, intelligence, personality, psychological a:1d rr.echan.ical aptitude tests as well as pract!cal vocation::.! tests. L"1 deciding his allocation. the viev.-s of the i.nmatc are taken into account a!ong with all other rele:v:J.r;,t inforrr2tio:1.

Response to edt.:C3.tion.a1 facH!ties differs g:eatiy. At one e:t.d oft he scale some i.n!Y'..ates lcJ.rn to re:J.d and write. while for others acquisition of educational skills m.3...l::e vocatiof'..al tni.f"l.ing a realistic goaL Much effort ro.s· •

fc,r ycung;~: :r:rr:2t.::s ',vho have not reach;;;d s.chocllc::;vf!"!g age, and for some e:'t':::.::~s \~:hD lr;:,;r:J to return to schoc! or wh.:> art: continulrg hig:h~r .edu.::ati\-;.:;:, ,;v::1y ,;:·r:.,;t:.ur:·,g:::rr::::u t:-: g~ve~ to Ct)t:ti0U·\': st:1dies th;o:.r.g}: :iny a.rtd/or

~l.:.:;.3.~s. st~dy 2.r . .J. ·::cr~cS?V!'!J~n·:C ,;ou:-ses.

·.:.'· .. >.::::·.::; '·'?<:':Jte .:i':. :1 ;t;._::nbe:: of -.;~;.z.b:lsh;·.:~.c;~ts 2.~:.d CO'~'l~r a v:liCe rillgi! of :;k.i'.~:;. :\::3:s:.:::·:c~.e in:?:~ ::h.~c~r~Licd C('i:it.:t:t of s,;:-.r:::...: co1..;rs.~s is given by ~,:·c::.:: 2-~s :·r,~~' \ . .);,::-:;] t-c-.:::-u~:..:·:! cc''"'·:.c:s. ?:-:.::.~tic:.:1 or-:o:octs h:1'l' 1.Jt~i1 r.:::tde :.1n

I 9;9:

t::: .. ~lc ,c:;:;ir:.:::.::ri:lg :~: .... ~tor v~~~i.:>:.: r:;.ech.:.mi..:s du::·;est:~ J.?~·liln.:e ser-.,·ici:::.g r..;1l:~·;; :::·rd. te:.;v~lo:i servid:-:g

c:;.\q:·e:~~ry 22:d }:;i..:-:~:-y :o::r'd t.k:cor:J.tit:g

<.vi:h t.h~ d::velop~

37 iS 20 35 50

1:59 22 !2

122

T::-.: ,::.'~;'.,~::.:~~:; '2:.~;:.:--,t i:o. -i:ly d.::.ss-:.s ::-ai1;S~ fro::-: r~:-T:tCi3.l .ec.~~c::.{ior: to pre-

~~~~:~~;~;·;~~~~:~ ~~~::rs t~:;; ~~~~:l ;~: ~.;~~l~·:i~~ ~:~~~,i~~~~~<~ ~~~~c~~~~\::·:~~ty

.s _;-,·.·::·.~:; ci·:.::·;,.:;::e a ~r·. of1> .. ~ t·:·::.i;-,~r,g pr~:J;;:a:':"l.:-r.e to :;;-~,l ::-.ecr·:::J.::cn. Th:::rc ;::.r.; e:b~-::.)us d:f:!c:.:ltics of s::·.:.:.:ri:y

:: ...... ~ £:-<>~.::. ~;:.:~ ::-:.:;..:.::::.-·; :~:::.v'~rti:.~~.:ss :::re :t~c to ta:-~e p:.>rt ir: :J.Ct:>·i:ies s;.;_c;'l <:os b:Liil::::t\..'!1, 'bc:xir:g.

..:::: ... ,:~:.:~, anC. :;~c>:.ox As?:.:.:: of::-::~ prcg::;::-::::e of i1e!yir..g :..-,:·::::::.~.::::::.. t:·:cn:.:i:::lY::-s physk.:::..!.£J ::.~ 2.::.d r:-.c::u:3l:y ~te:-:, s-=vec::~ est:.bEsh· ;.~.:;:--~cs ho~d s;;x:·rt d:.ty·s. Fot)tb::.ll.h"! ... l~1 .. 2-e.r:~:-1.l the mvst populs.r ~;vrt, a:1.d

1 Sc:..:h :~.::tiy;_!i~s. ::t::x ::o: c¢~·-.:::.on. to :ill es:..?.b:.ls:t:·:;.~:'!rs

there are pbyi.ng facilities at most establishments. The must popular indoor activities are snooker, billiards, t~ble~tenrjs, dn.rts and dorr.1:o~s. Several borstal inm.at~s have won swirr1 .. TTling certificates and bronze medals for life~''i-"g :csts and ir:.mates have taken put successfully \Vith peopie from the su:rounding Community in :activities wch as footb3.H, L::lble-·tenni.s, chess, atf>Jetics, weighdiftfng, the Duke of Edinburgh Aw::s.rd Scheme J.nd the Thistle Av;a::-d &heme.

Co mm·uz~jty Senice

fnm.atcs :rt most e$L~bUshm.::nts ur..Gert:1.1(e projects of vch.:;:tary help to the co:nrmn:lty. Hc!p is giYen to ti:e aged ::nd infl;m·in reCecor3ti.ng t:~t:rr horr.es and te:1cii:1g gardens. Food is prepared for the meals On wheels

' service. Other activ~ties undert;;.ken r.:.ne included tidyiJ1g holiday beaches, restoring canal b3r.ks and p;3.ths, help in Icc.al dilld;en 's hon~es a:1d community centres, assistL1"Jg at fetes run by voluntary crgar:is:J.tior.s, o..r:d helping to bt.ii.ld a klsure cer:~re for :1 mr::nt.::lly har.Jicapyed wci:::ty. Svme e:;tabIish.rr;ents are lmolved In ;l pr·-=:ject wasf-.J.r:.g coins coHecred in public hou.K;s for the Roy::.! N;;tional !rrs[itute for the Blind; a pioneer project is bei.:tg u...-ldertaken to transcribe Open University texts i.i1.to Brail!~ for bli.nd students.

S.;lecteJ· bors:al trz.inees t2ke part b camps at ve~ue:S throu:;hout Sect land, &ch ca.:np, JS "~·ell as having a recreJ.tional co::: tent ai::;v includes a project such as assisting with mentally or physicaUy h.JndiC'-1pped cb.ildren ·Or adults who are at the camp or undertaking a work project in the vici..rllty.

PRlSON INDUSTRIES in the olG days, pri.s:·2-::1ers w·orked in their cells, nuin.ly on rr.::k\ng a.nd

rep2iring m.3ilb:~;;s .2nd sirr:.Uar simple occup:ltion8.~ t.::.sks. SlP.ce the hte 1930s, ~h~re r:.as been a trend tow:uds more productive work, and in rece:n~ years there !">.:is been a positive attempt to provide workshop con .. ditions co:-n():J.rabl.e to those of ;r~nufJcturing employment in t-he o~tside cor:lrnu;-,.it)' .. Up-ta..J.1te equiprr::c;:t is r:ow supplied w1-:erever \VOrkshops ue· cor:.struc:,~t! or mDJe:n.ised. A prisoner \'/Orks a week which, at n: current nuximu::s. of 35 hours, is ne:1r the basic working week of :1:1. outsfde factory. The Hes.dquarters o:-_g3.nis.ation responsible for prison industries provides pbnnir.g and co-crd!.r:ation of production, and centralised rr . .::lfk;:ti.tlg. Work is seen as p3.rt of the Ltr:ute treatment :ar:d trainir,g proce:::s. the oCjec~.!Y::s of r~h.:J..8illta<kn a;e kept i..r1 focus, .and though i..r:dustrial efficiency is so~.,;,ght as part ofth~ workshop environment, the provision of useful. s.cti-wity takes priot~t~

~·2: :.::: 2.,:.;. ed:.:c2tion for the pdsoner, expc$ir:.g hlm to the h2blt of <·.<'H~-:, :if":. d. tn tl;_,; d>2:r.nnds for ::.pp1k3ti.:.!n, disd;.-::Iin~ ;;.nd co-<Jper3.ticn

.,_.,-~,.:.:{; ~~:e fo;;r1d In ti·.e :·n1m.1f:J.c~urtr:g ur:it outside.

::::.::.:~ :-:::.;d C-.! ~-~: :-:::c:.::;. L;I.:.:t Lli.; !~hc:1r :s ch.:::p: t;::; :.:b.t .,,·:-:s~ ccsts ;-;~;Jst be ::_,j :~e:~ 2 ::;:>d 2 io-.v.-:r ;-,;';:,;:;,.-,en ovi:::he::.J.:;. ::r:J cz:.p\t.Jl err:ployed :::::.>.::.J.,~:::::: ._;:· U:.; ;';C~ci ~-;y; t::J.;niEg ~.i1d tL-:. s"hu:t:-:r !~C\rrs wo::-:.ed. Prices for

:.:-• ?~- '"'.; i:; rJ.:-~-;-;:; <:.::'d g::lfd-;;;,s; 2:.d 2.: j;; m1~s:de Ci;"'.i7·10J!""tJ:-:~t.

('\ ;~.-::- i.:::;·J:~-.s ::::re c::·c:0Ioyd. (Jr; ,J.::,n,~stic t2.s!-:s \;...:.:hL'1 -::--;e es:.::.Cl;s:-..:·n:::-.t.::;,

~rc:·;:.c· >1:~ ~:: .. i;-;;·n:res --- L254 cr 25 p-::r c.::·:~ I- is ;;-.>t c-!f..:c~~·:;,~ly e;t:?~C/CC.L

~ ::-::s,: :~i:: >:.:-:·:::::::.::: ::c:-:d ;_.>.:<.Jir~:; tr::d 2r.d t>:.(.,S.; :10t .:-~:_:;:Jir·.:d to \vt·-rk for

:;:r .. <::~:'- ?~:-:c.:-, i;,d-.L~i:ri.::s, 2.nd ;:.bmlt 3C({1 c:fp::-ociuc~ic;-, is ur:den.-:;k.:!n :.o :-::.:·::: ::._-::e.:s ,;; ;:L!~::i Go'-·'::.':T;;::--.e;-,; Cc~J.;tr::.t:r;ts. tt-;e t:::::w:-t of :Wr:1e

, ·· ·.--; ::-..! '.~: . .:-:~ ~'? :~:~ ;:-ri·<':::t: st::cto: :::::k::t. Thl;; ;-:-:t:~::s of -.:oc::·5·~ t:~J:t

:-~. ;·:,·._:::,::s cr,,_-,: b.:! i:l t-::r:~".S vf ?dee ::.1·,d . Thi.! ~.vork~ ;•_, :~:.:s :-:~~- :·.;,.~::~l:·::.;;;:~:rc: cr 2. ·.viJ~ [~:r;gi.' o:· ;::rc•·h:c:s. T:·:ese

:·:;;::~;--::r ·:·;· r-':.'-~:~·;:(;; ;;; li~ht ;.;.n.d :-:~o.··<Y :o;~;;,:s. i=: p::n-e! :.ni ;· ·'~-·' "t;_:r:::, tcyS ::,_;: .. i WO•.)C,\V-.)7\. 'v\"\)Od\l."l~;k_ ?:CJl:CtS

... :--.'--

L.:·:;:·:~.

;. s;::.;,·'} :l.~-;:: :.-.t<...;s f:.;:- ;:~r·.:.:::. ~.:SC!, :.l:'\d UJy;; f1): tl":::: .::..-:--.:l:-::c.::.::<..: -..vc;:k i:1 c:;-::.-:;-tt:: :s

::·.~·.:.:. :\t .-''.b{.'":--~cc,-;. ..:.::3. ?'-•:,,;~h~::.(: .,,,o~:-:. ir: W?ts <:::>J. :·.·.!ts ts :·.~,: rr.~~::-,·: \'--';,:-.;·\. T;;,; Yo·.~::g Ot":-;;r:-.::.::--s cst::b!i3h~li.':ra ::.~

:,;:;;_· ~-::-:;~;~} :·~J~i:.::>.:i.c::n ',;,·,::_-:f.:Sh(..1.['$ 3.~ P:.:;:.-::c-nt. c:er,0ch:l =:::J. A::.:.:~--~~'::·.:: of e:st..:.bli<-:::"'l.tn:s, b p::r:ic-d::.r ::.\t P:2G::::-::;h1:r:e

and Norans!de, horticultural and agricultural operations provide produc.Hve employment for imn::ltes.

The value of goods :uld services from Scottish prison i:!dustri:es ar;;ounte:J to £2)900,GOO in l97Si79. Thirty-five per cent of this out nut w~nt for dor:1cstlc use, inc:uJing su..:-h items as prisoners' clotrlfng, cd! fi.ur;iture and officers' lJ.niforr.:s; 30 per cent represented SJ.lcs tv other Guv:::mr:1ent d~partn~er.ts, 2-nd th.o: rer:t::ind::r (35 p..:r cent) s:.1Ies to the private s.ecto:. S=des :o the private sector have incrr.:!ascd sine~! 1972 and it is pl2i1ned to expar,d this penetration even further :lS new production resou:ces C0171C on Stieam.

Spiritll:ll Weifare

Ch1_;b\ns J.r:.d visiting cl::::rgym:::n pb.y an important ro1e in all establishrr:.e;1tS. They z.re concerned wilh the sp{ritu:J ·.velfs.re of the inmG.tes, 3<ld give support both by vi.siti:1g :1nd g;\ing d3y-to-day help in religious and persor.3.l m::.tters by holding services. t\.H religious beliefs are co.tered fo:. Attend:1nce :::t services by inr.utes .is voluntary.

Hes.!th _.C:!.re

All prisoners are medlcaily examined on ~J.mission and receive medical attention as :-equin;:d durir:g their sentence.

BarEnnle P.iison is the only cst~bEshment '.l.ith full·t!me medical st:1ff. At other estJ.biish.:;1ents gene-rc.f medk:=.l se!\·kes are provided by visiting gener2.l pr::1ctitkmers ·who, with their part::ers~ provide fuE·time cover. Psychi::ttrlc :::r.nd psycho!cgic~ sen ices arc provided by vis-iting consultant psychi:a.trists and psychologists who holdjcint appointments wit...'1 the

·Prison Serrfce :md th:e National Health Service. Dcnt~l ;:re;;.tment fac~litie-s. are provided.

Prison nurse officers are trair;ed to EnroJ!ed Nurse StJ.ndards at NHS schools of nursing.

Letters

Pri:>on~rs ::;_re at present :1l!owed to '\Vrite one letter ~ach week to rel:.!.tives al!d f.:-:c:-tds, \Vith postag·: p:lid f:cm pub He funds. Post::.ge for :1-..!ditional ltt:ers is met from the pdsonc-r"s e:1m£ngs but before befng o.liDwed to write extr:l !erters he has to sub:-rit for the Governor~s approval a list of people \vith whom he intez:.ds ro correspond. Prisoners• inco-ming and outgoing let:e:rs J.re inspected. Prisoners at P~nntng.~::une oper: prison and on tr:lifling for fr.;:edvm sc:h-::mc:s 2.re in gene:2.l aUow·:ed uncensored correspcndence.

P,:;;:;':.:~: lc.<~ ::=;::y Je g;;I!Okd fer prisor:ers to ~,:;r\tc to th~ir .2:~·~l~~.:r.:n l '~;·:r on p2;>.;:; ',,/hL-::1 dc<s not ind.!-::a;:~ pl::..:c of origin.

::-. .. ~:;;: ex~:-n;;1:ny ::.nd ~:c:n.: cor.Jitivns r::ust be

·.::: ~.:.: ., .... c': 'S2 ot e; :::~~·!i::;)::n:::r:~S f(;~ ~;r.dc:- 21:;. (lr ti":c ::-u:'1cdn.g of

-r:.~·:·: i"~-::r:-:1 :;7".;:-~.Ht:x t

::.:~d. ti"'.:;::·: :::::C~ ::~,; ~:·,c:: :;) :: ,::,;-u;._:;;~J.b;-:-

by::

escort~d loc::l short !e:.lveS, each lasting about four hours. Th.es,~ take pi~c~

every three months and escorts are provided by prison vis: tors or priscn staff who have volunteered. Mutu:.1l tmst is involved in th~ scheme. which "·.:orks wen :md is l:r.~eful for improving rcb.tionships :u:d helping prisoners m:lirltain contJ.ct \'1/'!.th the outside corr:mur.i~y. The ~upport ar:.d fricndshi? of pr~sun visitors :s gre2.tly 2ppreci:1ted by both prisoners ::1r.d prison st;::.ff.

Parole

The p3.ro1e sy-stem .1l10\VS pd.soners. to be released, t:nder specified conditions, to Stf\o'C: po.rt of their sente;:ce und·:!r wpervision in the community. A person i:1 pris:on or dt:t::.:ned in a y2~ .. ll:g offenders institution r~ay be re!:::ascd on p;::roie n.ft-2r COir:pleti:-~g at least a third cf f'js sent::r:ce- o: one yeJ.f, which~ver is the longer period. Sir-.ce v.rii.h normJJ rem.Lssim; a prisoner is releJsed 3.nc-r t\vc.-th.irds of his sentence, p2.:ole is limited i:: p:-a..::t:ce to those se;ri.ng more t!1:1n 18 months. Cert:.!.ln young ,?COpie se::::::r:ced on indictrr:ent :md placed outside prison service c:st3.blishments (eg fn a List D school) :m~.:;y ::lso be eligible for p:.i.role .. The decision to re!..:::1se on tJ3rDie ts taken by the S<!crttuy of ?tate or: the rl!co;;:r.,end:J.tion cf the P:.:.:-ol;; Bo:.ud.for Sc:otl:wd. Once or~. ;J3.rD!e, a lic~nce re~1;1:res the p:1ro:~e to

comply w:~h certain conditions~ and to secure .::o:r:pUan:::.c he is supervis~d by· a local :mthorit)' social worker from the area in wf-Jch he \ViB stay. During the period of the lic~nce he is subject to rec.1II to custody for bre::.::h of :1:-:y of ~ts cor:ditions.

{}nless tt-,e iamate has opted not to be considered for early release on parole, a t!rst review of his ~ase is put in hand in advance of the date on which he wouiJ be :::Hgible .. A dossier of Lnforrr:.ation is laid before a loc:1J review co~rr-.itt<:e (appol:~tcd by the Secrc.!tary of St::J.te a:-td co:':1pr1sirtg the

inr.ute'S Gov;;rnor. ~!1 ofi1c.c-r or 2 !o,:zl authority so.:i:l i.VO:-k d2p2:tme::.t J.r:d at least or,e indc:p.:nden.t member) :and this is folfmved by sc:xtiny cf th~ C3.Se by· the s~cretary of St:lte, ::;.ctir;g through his oftkia:s. CJS~$ b which the SecretJ.ry· of State is Fep~rcd to c~nHt:mpl:lte rdo;!;:;.se are form21ly ref-~r:ed to the Pn:-ole Uoa:-d for Scotbnd~ if t!:e board m3kes a r.;:cor:·:r:;,t~JJt:on for p:lrote th~n (exceptional circ"JmS<:J.nces J.F:::rt) the &cret:.:-y of St:H~ wi~l :.l.Utb.odse rde::;,se. C;:.s::s in -.;;hich t:-:e- S,:c~e-t.::ry of Sr::tc ts r:ot prepJ:ed to authorise rele:!S~ go to the bo:::.rd for infc!:Tiatton o::fy. tho:...:gh if the bo::J.rd feels th~t :my su.,;:h peo?lc might be ;deas~d their :.::;:..:;e \v-ill b:; r~cvnsidtred by the Secretary of St:J:t~.

0;" the 379 c:::.s:::s r~ferr:::d to [he P:.trolt."! Boord for S:.:mh:r.d i~~ i978, '26.:2 were rc-:ot:l.Dt:n.dcd for parole, 70 -..v.:-r<:: not recomr:1end·-:d. for p:.1rol-::- LH of this tot:1llS were recommended for 'e:lriy rev:ew'. Tr:;; (;h::ir:n::t!'l. of ~he

P:2rcte s,.:-.:rd for S.·:othnd is!·,·!:: D A P Barrf~ an Edinburgh company di:.- ..:::tor. C::e or th"= bo;1rd's pdme considerations in recommending early re~-~:::-:~ m~t be the s.afety and prot·3ction of the p-:..:bHc. A very se.rio'\lS view i-5 ::;l. . .;c~~l cf b:·;;:;;_,:!;._(:s of p:l.!o!e Uc~:1cc. ar:d t:,c board does r:ot hesltate to :··:c~,· ;:-::::e~~·~ .-~:.::<1:1 of:: p:.:rGlce wh-::n s:.;..:.:h a ·.::u;.;rsc see;r:~ a_?t.

:.::r::::·:;:c-n-:·c::ts :?:;;:)iy tc the re!css~: on lice:;ce of pers.cns .s~ntenced t(o !iCc i:::pris:)~.;;:c:tt or to d.;;;:.::ntiot: duri:1g H-:r !.:I::j.,;-sty's p!e;;.sure. The ~ec;::::on t;) ; . .::~:.:se i~\ t::ke:1 by :~e Scc:-et:J.cy of State nft..,;r consuit:.:.tion v.·::t~ L:;:: :::.nd c•:: tf.e s.dvice of tte P::.rol~ Bvard.

T:-:,; f.: .. r F :·:;edom ::d:.::::-:e :J.ir..s to c2.se selected p:-=I.Svn,;;rs senring s,:-:;:.;:c.~es ::~r,::;:- Y'~ars or IT\>Xt:' inro::: situ~tion '.Vh~::e they caa work ·,vith :::: c.~...::·:;;,_~:;: the pr:sc.n. P::-iso;;.ers t:J.king part in tL~ sch~rr.e ·a total 1,: ., ·:,c· :t 30- ::.:c;;ive :sc:Y":e i::.:c:-:C~d to i!lcreO:.s-:: the~r s..:r:.se of

c~'ir:d::lo::.s in s.n 3.E~osp1-:ere 'Nhich ~cs.;,:crtSC. They l~Ye in i'-.ostc.!.s 3.dj:::c;:::::t to AberdeC'n,

~~:-,..: i·\::::h Fris(-.;.s, ::.::d tb.rs b_"J.ve no cont2.ct \v!th \.he ;r,.:lln prison

~c-:..:- ;s,~ :~:~:-: L'1 --;,;n>:: ;:::ses h::.s r~cor:nn:~i::l.<~ed tb~t a period of training L>-:- ::-c;;c:~=:'' .,,;.:·...:;.:, :J.:: bc::,.:·::,::.::.l ~e:co~ :-c::.:::.s~ ,,):-; Ec:::nce.Prcy:::% by

is c3~e:'.1l;y sturli::d ::.:.;1d a;;clysed. hbourc:, joint!r, ciectrici:.:~ . .n and

:!:..;~s::d i::s::itu:kns a~S/) h3.\'::0 l s-:f:;:::n~ where St.:lect<1d i.:-,:r:ates work

c:·::J.:<. 0:~y ::r~ ::o~ <~qtlir,::d t~) wr::-~·c bdt. !""Tl.::!Y do so lf tb.~y ,,_..i.sh ond r:::...:.·::>;--.· ;: . .:;y;,~:;C'I t. ():~ p:.:y:·r:::::·n, :..c:.t:-:ed ~ds.:.:;r;:;o::s '2::..'1 h:Jse roor:1s or c~!1s

·-,,,.,, t·::·:;$;;- s::?;:-::-:C. h·r orC.i:-,J>'i ·:~:;::;::-:C: :.::::.:·1 h.2.·;e :H r~e\r C'-:m cos~ :he c;.::~ .:_:f :"•..r:r:~tu~e ::;,;1d. ut~:-~sUs ::·??<Cvc.:d by :h.: Gcv<!m•.:>r. Ca5h m2y :::::: s::.:::: :;: fJr :..:.;::~i~d. ?ris,:·:~:::s to :::r::J:c t::-er;: to p~;:ch.:l$e focC and otf,-::r ::.:::\~:; :: · ·rn c!l;: ~:t.:·J:<:.:~n c.:r k.:t.:}:.::r.. S'J.th prison~rs m3.y :Uso h::.ve food

•

SP£CL4.L UNIT, BARUNNIE The ·crnit was set up in .March 1973 on nn experimental b:zsis following the reconunend:1tions of a departmental working fXlrty on the treatment of certain n1.'2le ior:g·term J:nd potentially violent prison..:!rs. Housed withi:J:, but s.egrcg:Jted fro.:n. E.::r!inrJe Prison. it has its 0\vn govcrnvr '3.nd s~.1ff cowprising both discipline and nursingbf.ficers and supported by a consul~~mt psy·.:P..iatri~t and clinicJ.l psychologist.

P. •. r1 essential fc.:::.ture of the Unit has been tl'-:.at the staff/inmate rel:::rior:.:;hip should be a dose one in an atte::npt to bre3.k down tradition.al:lr,tagonisr.;.S.

The "'co::mnunity"' of st3ff and prisoners within the Unit is reg:trdeJ as b.3..vi.'1g pLlyed a positive part in est::.blishing meaningful rd3.tionsh.it-JS.

Inve-rness L'nit

A tm.lt exists :::.t Inverness Prison to accommodate certJ.ln priS(.'!ners. The typ ofprisonu likeiy to qu.alify is one who has a bad influence on other inm.::tc: perststentiy refuses to CO..O;Jentc or exerts generally a subversive ir:fluence in the prison to which he has been allocated and who l-12s not responded to appropriate measures i.>i his prison of classification. Prisoners are not kept in ti"Js un1t, with its strict but nonetheless hun12ne regime, for longer th.1n titre mo\1ths save in exceptional circumstances. A w.lnimum of privilegtS is gra.:ned. aU Jining is i..t cells, and ther~ is no recreation in assocbtion with other lnrr.ltes, ahhoug.h then: are norrna! exe-rcise periods. Teic•,ri.sion view in is not perrr.itted and accu::nuia:~ed visits, where due, 2.re deferred untii the prisoner is returned to his origii1al prison from the lli"tit. A board meets each month 'Nhen the 1J.ntt is occupied to consider all cases in custody*

Bt..H.LD1NG PROGRAZ.'iM.E

Prisor.:s znd. oth~r inst~tutions, rn.2ny buUt i.n the bte 19th ct!ntury and at the b{!g.i.r:.ni..'lg of tfris ce;J.tury, have often been overcrowded. The aver::ge

daily number in custody in 1978 was 5062,521 hig..~er tt-w.n ten years eJrlier Programrr:es of r.ew construction and improvement b.av-e, like: 1T'2ny o:her arez.s of public ex?enditu.rc, been subject to fl:-.J.ncial restrtctions over the ye::t:s, althoug.:t: work t'-..3s been carrkd out as £'";..1.ance becomes anilible.

The new fe!r2ie institution at Cern ton Vale, the mediu:n security prison at Dur!g3.vel. the new young offenders L'1stitution at Glencchil 3.nd the first phase of the new Shotts ;n:son have all been completcC. since 1975 and sper.di:1g on building work in 1978/79 W:lS <ilmo:it £.1 mill.lon.

-r;·;~ c{,''·'::.::;;.,;:1,::"\t ~.;u:o:;:1:::.::d :~1::-t year 2. .£L r._illion prognrnrr.e of r~deve1op* ,u:::t :::n.d :~~fur'oi:'c;:n~:":~ 2t P'Z:.tcrh~ad, to commence~;:. 19SO anJ appr_ova! h;::s c-.::;;::: <,:;·;~n fc·r pbnr:.il:g to b.::gL"l on t.hd SC:.:u:":d p!-.:ase of Shotts pnso:1, .. ~·~:-:;1 '/·i;·~n COi:''?~c-te:J. willln,::;reas,e th~ r:'..:!rnbcr of pbces there from 60 to

?:: ;,::J :~3 ,·~.'.Y::c:..::::r:.: ·,~G ':i~ u;;~r:.~~J prfs<·<~e:·s. f....()(.'J:\ p;i.sor:t:-:; wi:h ~;;:·~t:.':t:.CCS 0~ 18 :·:,: .. ~:'.:.h:. 0 ·,- lt:..·:. <'.:· . .J ·::en::.i;:-, oid,:r or,,J;.;'.c:.ry ;n:son~rs with se~:~nces or over :S !t::;;r~:·..:;. /':."•'~r::~t U:i1y ;::.!rn>·:cr of ?riscr:trs- 159 me:1, 3 women.

~:.~-,;: ~:;~ ~~',:.~,,'0'~~~ ~~i:~~::',~~;i;~ 'c~~;~~:~n=e :~;:~o,~e 0~~~;~ ~:~~;c~r~i

. ll!. ;,;..;n:ba c.f ]-,ere v;ill be g:JC.~..:aUy bL::li up to

I..:.:;,.:.1:, ;~:-;,c::ed y~i::.n:·:~;~; J;;.,;al p:isvncrs witf'. s::::::~;!;:c;;s of 18 :::::::; c:.;sc o!'f::::!.~-~!5 '.'iit:·: s,;r:;:cn.:-.s of 0'i(:f 18 :nomhs ... \v<:;::_:;.::

S.:;;(:,::~o!,i p:wn:::r:; ·,,;.;;th s.-;:1te:::.-:es. ::-:.2::-::ly vf six : . ..:;~;,;)G! of ir.:1-.:.:.!:~s- 2'22 n:t:n.

Pcnning;'tame Open Fr..son (near Newton St~wart): Pr1'S.oners selected. as sui~able for open condttions. Average daily number of prisoners~ 47 men.

Perth: LcC3.lur.trieJ prisoners; !ocal prisoners with sente:-:ces of 18 month or less, cert<.!.in orJln2ry prisoners with sentenc-::s of o·.:er 18 n;.Jn ths. Average daily number of pris,)r:·:rs ~.5:15.men.

P~:t{;;-rhead: C.:!rtG.in younger ordi.:1ary prisoners ·.• .... ith s~nte:1ccs of over 18 montl',.s. Average daily number of pri.soners ~ 274 xr.en.

Shotts: For selected prisoners .. J:n?j.nly of'B' cat-tgory, serving a wide r2.r.g( of scnten~es, and transfMred in from other prisons {No untried prisoners).

.. AverJ.;;e d:;.ily number vf prisoners- 51 men.

Young Offenders Institutions

Comton Vale: All female young offenders. Average daily nurr:ber ofbt17'.J.t - 19. .

DurrJries: Youths with sente:1ces of over two years. Aversge dally number of in:r..ates - 1 ! 6.

Edinburgh: Local youths with sentences of six months or J,;;;ss . .Average dally number of iru-;1ates- 40. (Closed in February 1979 ar:d inmates trans· ferred to G!enochil).

Friarton (Perth): Yomh.s with sentences of six months or !ess. Average daily number of i.nrT"2.tes- 63.

Glenochil: A new institution wPjch can accommodate 500 iz'lrn.ates. Aver::g dally number at present- 379.

Borst:::! In::."titutior.s

Castle HuM!y (r.e:u Dundee): Open instttmicn for youths !ik.ety to respon( in rural conditions to more indivi:.iu.;;J n::ethoGs oftrJ.ining including engineerir;g skills iJ.nd who may beCor.1e suit1ble for outs~Je employment. A·1e:a.s~ daily nun:b~r of i.ru:'.:ltes. 87 youths.

Com ton Val:::: For gi!Is; although this is a closed instiution, inm:::tes ITl:lY

qU2.li.fy for outside em?loyment. Average daily liumber of iar..ates- 4!.

Nor2nside (ne:1r FortJ.r): Open institution-for youths judged suitable for a fairly strent.:m.:s open-air Iifc: and likely, Lrt the laner part vf trJ.lnir:.g, to be able to work without con~tam su?'l!rvision. Aver;lge d.:1ily number of L>1rr.::.t . 67.

P<::lr~'::..':>.t f..":dkirk): Tl-:.e main borst3l ir;-stitutbn in Sc·:;~iand 2t \Vhich a~c ~!."e :·.::::-~\·eel i;iU.:Jl:y: s~;:-:10 sn~ subsequently :Eoc:::ted af.,er ::.::s.:~.,::;:-:~1'.t ~v e;;:-.e oft~::.:: c::ht!z lr:sti~u:ion:;. Avcr;;ge dJ.i!y m:ii.:be;:- of

G\·J::c;:;l:~ The (ln}y ll~~·~::-.t:on .::sn:r~ ir: Scv:>::.nd - for :l')utlls ::. ... ~-::..: :~ :.c::.;.;·: 16 ::::d u.rcJe:- 21 - v;;-;:cr: pro·v"iC.ss wh::lt is often r~f:;r:;:ed

t f:·.::-~:r /':..iC.:ie~: Fo; yot.:~l:s reT:"::ar:Ced to &.rlir:n~:; hi:::>vn for ex2 ........ " ~- ... "" ri~ily ;:n:r:-:.l:·e{ -of i..:.::-:.:.tes ~ '250 youths.

:,;: 1979.

(l97S)

16,753 12,32 7

5)4::,') :,-:;n l ,305

710 919

S05

8~· _, 657 336 ' "'., 1.1...:..

Av-=r::.ge daUy popu~ti~.)n

661

3,766 2,537

227 663

55 ~ .. .., ~v•

99

(1979) Fert.:de

30

!22 62 9

i9 2

41

•

Further R;;a"Hng

More d;;t3il;'!d ir:formaticn on specifi~subjects may be found in the followiJ'!g:

Prisons in Sco!land- Report fur 1978 (also published for prev-ious ye:J.rs) Comncmd 77 49 E~!SO £3.c5 .. Crirzina! S:arisrics- Scot!an.d- 1978 (also published for previous ye2.rs) Comrnand 7676 H!v!SO £3.75.

Parole Bo11rd for Scot/.J.nd- Report for 1978 (.1lso published for previous years) HC Paper 95 HMSO 85p.

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His nim iH to b..::;co:::e n·,:,t;n·o cf ld;:; belL~.viorn' :_m,.1~ ho\i this .j.() X'Cf_C .. tl~Jted. by hiD cmotionn/ f.:::J.in;;::: ~ Eon tho;:,e ~~'.1') ·-:\ff(;ct hiB rel~:t:i.cnrdtips.

J3oh[l vi on r

Io'cclings

'110 develop nnd ·co:r:rr:ct. s0ci:.:tl skills by involv~)!(i.::nt in the com::lUni ty-.

1\ pornon :i.s in tr0-':1t;;1..:;nb in tho co:·rrrnunJ.ty. He is not n:i.c:1: 1 boing tronted by u Uoctur nnll nurs0s. Ifo is G person ~llo\·d.n,::~ h:i.::~scJ.f to t3h~'1r~: in the $Upport, u.:{f"d:tinution, confl~Ott'i::-ltion of hiB peL::cf3 in his '.':hola lifo situ:.~t:ion.

·Viz 1 Hir3 e:~:Jctionnl ncc..J.B Hi o physic:::.l nE,.:::.t1s Eio c~iaordarod bchnviot~r His t.lLsordur;.;j fe;(3li.ngs H:~s disordered: :rclDtionships H:Ln r0ncu:~ces, 2::~vt~~-On0.l .~.-:nLl physic:1l

'l1o dovolc-p :1n-l unhnnoc th.x~o poai ti vv q1Y~li tiL1G he ;:ny possess and ao produce::: so1:1e f vcling of Yt.)rth.

1.. I11:;. llil:i.ty or· :~is1.bili ty in fe,1rrt1ing .:.n1 su.stdinin~-; sntizfnctory eJTJ;) t.iou1l r·vl:~_ti'Jlu.:bipn _.

,., ~· Inn1J:i.lity "to rcrc,:dvc on;j 1S orm nt.~cds in relntion::;hip to th~ needs

of otlwrs.

3. l,r.:~otice v.r :.:xtroue bch~:vicur. Violent Att.::cks on others or p.ro:1~.n·ty or ~;;0lf.

4· PGrsis_t·Jnt· rCpct·:i ti ve lr!ck o{ judgr:I.._Jnt.

d.ost:eucti vu or delinqu.::n t 11ct3 'ilhich i;ho'>'l u •

5. Di~rpJ.~ct::i:Jcnt or Jcvin ~ion of 8~lk!tionf\l :lri V-JD, cs violence! 1 sex., J;!U;Ibl:i.n;r, J::-in!-~, drug usage; 1 doli:nqu.:·n t b'-'·1:.:: vi our.

B. Volu.r.ttnry nenf-;ent :i.a roqu:rud both -'1t -Lhu initi~;tirJn an1 during the cc·ntinn:.t::.on o£ tr(.~Jti~~~~rrl;.

COl J'd L:.:i8t 3 yo~~r >1cntcnc0a rJi~th ::ilxit.JiX"J st.:--:y of ~? ytY~rfJ, Uj;itir:~w~;i Btr~y of 15 !.tl)ntlw (+or ... ·z) ·;n<l. Minit:J~H~l r,f l~" wrri~.h~l-

,,

t!. -:\r.~.:~. It is hj.;,_:hly {~O;~i::':1lJJ.c~ tlut l;:_:;(:rL.: iP. this wv:l.'l{: nru b..::Jm·; thu ·'-~GO of JO 1 1)ut <k.-p.::ndin£; on thu r~o;:d.n, <.tl' i,c. ~:he ~:c; .. :: ·:>f 33-,_jQ'

1. So~;.o Ll:..)i_"l'C(; of :in:::1c::1t, no :::· .. t.tc:I' ho·a Dl:L::~ht 1 t!lc:t ho io in sor;;CJ Vl[~y .~~o.inrr ~·lhvut his l:Lf0 in c.r1 u:u::atisfn.ct,)ry rr_.~nnor.

2. ~3omo degrLc of c:ch:love:E.Knt, .;:g ono 10' I1c!vel n l:Jne~..1-ct):rporal in the l1r.m,y n univn 1\::prcRcnt:::d:;ivo c,t work n :oul-:e n:l E;linbux·gh 1 s [:w:·trd soDa ouccvus in to·:;m work or ~\ thlotics 1 no rrL'!t.t.:n~ nt vhcrt lt::val ..

j

Sottn dueroe of drive, bch':\ v iol . .ti'.

some croot:ivity, .even if ns:3ocir.~tod with acgrt:~sive '

4. Sm~10 decree of !Joo:Lnl st:---lbil:i.ty ·& r1 pcriol of ~;v:~rr::i.tlGO or cGhn.hj_t':ltion nc 1x1 t b.::::.· h<:.~v: short 11. vod .. a pcr{u.~~ in h:i.s ?'H"cnt:1l or fo3tered. hcmw ;:;f 3 __ or ~1 yr.y~ rH

1. J)octs-I' r:ill tr::nsfCr in 0vont of !:i0-::.:ie·:~l roasons: '

(,~) surgic:Il etc

(b) tho cJ;:orGence of ·c. psychonis

He r:ill confer v:ith t}H) r:ing 'YWl utaff, Gnd ~:wk0 the dociaion.

2. Disci pUna ry WI\ t tors, e~; D fi,.;h t

Tho s tn ff h:wo the pOI'Ior. tu ucci<io · nftcr c:::rof'ul explor:' tion of tho !'thole ~:d.tu[ttion.

~h0 Doctor delogc.t0s this dccisicn r.t:~king ::nd is nn activo collaborator in the exploration emil cvC<lucd;ion nnd ilcoJsion, but in the ct::;ff grcup it is one mc,n one voto.

•

). In ;-~c:;::rt (_:':;(-;c;;-; l.:h·_l :::;~·-:ff, ~~rtv::· :i:JCt.~u::.:i_cn 1 ::r:y hnnJ d1l; dnci~ri.on-

J!l"~.k:ln~: -·~:n t,; tl':c col;·nunity ::.n:l :',f't,:~:r_· fnrt!-iL'~-· ;:;:z:~_d_or:·,tion , ::~nd_ c:-·t~.:llt:tionJ t;h(,! c:c.;:;t:_n.::.ni"ty H::_1l {;(-.•.:,;; tc <1 dc;•.J:~rd.on ort Lr::1nsf\:r by l'il1l:: ;;;,:.Ut JH{; 'J{.: tG •

In con;;i(1.i:rr,ti<.:n C'f" tr:-:n:.~f..:..~:t· \'<hen :: p<: :c::>:-:.·rr :is ;:>00n by Lhe··c6r:1r:iu,nity not to bo :ro:-.>p~~r.Uing r;r.b<olnr; un. blo t;:-; t---:lc: ~:-T1~t in ~he tre-:-~tw. __ mt rc;;:i.nt.:J 1 the H8~!CtH.>!.h:§at .~~ron:::, :·:i'tc.r- ~1>:Jibc;l·n·ticn, r::'11 t:-:kc: :.1 ve:to 1 tht) ;:tssc~Hlf<i.:.:nt group b~_.;in,z r:t~:.\0 Uj) ,Jf .t,·;.J r:l0i~lbl.:~.·u of :ho cor:r;:nni t;y r:n-.1 <~t l::~.:~st four i:•btff rr.oraboru. The ~us~.ssG0nt c~~!:~ittoe 1 s JeciDiGtl j_s fln:tl"

i,ll tht,·.st:: J.ociwiou ... ;~rr:k:ing ~H·ocB~hn'OS c:~·:n etl:TlY only to J;ntt;crs t}1;~t o_ecur on tho V/JJJ(;i· If t: pc-r:;cn cc·n~:;::~ts n d:L~;ci_p.Li.nnry brc:~c.h ontsi lo t;h,3 ·.;Ji.ng or in :cel~·.tionsh:ip t,:-1 s::~;:,sbody ---u"tsiJ-o the v:L-4,;, he is nu-bjc;oLe\l to a report <:1nd edjud.icn lion -'Jy ttlr: !.ler:~icc,l ~iur .. :rinten.lent ~

Jd.l vd.ng 'luc:.:.:;J.Cl18 c~L'O) by thG:Lr nr.rtu:r·v, :rc:col:~rilunt1~ tiona to tho ll"iodicnl Supcrintcn1unt ~

l. Phyaicnl viol,0nCo which can't be tolfmJted by tho cori1':lunity.

2. Opt:Lng but of t.r011trnent·. rc,rsiutent in:>lJility or rcfus<<l to conform to tho rules of tlw community, s:-1y, 4 ti:!les in 1 rr.onth.

L:i.st cf RuleE3~- .. \ll Prison Rules .1ppl;y, plus:

1. Nc conf:i,dcncen.~ On .:.\r:riv~11 ~ p~.:-:rsc.)n agrc·.._:s to or:.ter into the si tu:rtton Y1hero no confidences .:;r6 peTj:li tt..::d bet\'JCcn himself and nny o~;he;;r pcr'sf:n on the winG~

3~ If c. person w:i,Bhes to lo:'ivc he !:rnst dincu::w in ~t small groUJ) hiH wish0s nn'.l after e:nruful •lnliber~>.ticn hi:: thDn Jit::\y t:~kv his nish to tho Y:ing :-:-~c.-::ting. H,:~ ~:nkcs :~n c:~cn st~~ t:~;x;n-~ on th0 wing mcoting -~'nd his decision_ ic f:i.n:~l nnd irr-Jvcc.~tbl2 p

(a) (b) (c)

(d) (e)

(f)

(g)

psyclv.1ni:1 (-t:h0rn~ists ~·!.Jcision final) physicr-:1 tre::tr:-~ont

other trvnt;1onts, io the noc:l fo:::- condi tionJ.ng or individual treatme-rt tho emerr;..:.-;nc.:J 1)f the pati-:1n t -1-B a profossi~;n:"Il crimin:11x· tho fJ0ct:;n} offenc0 c.f ~~ s0rious nn turc, ic s::n.l(;cline in drugs or brewin[; up grcn3S Oi:.K:tion:-_•,1 rlep&!!(lQhCY t 3B80Cinto,_l With in8ti tutionnlis:.::ttion. (~Ph0 person cmst h--!vc somu cn1~ac:i.ty for t£lkinc (lCtion in nltoring his o·~·m !~ctho:ls of beh2.v:lni?>· iia n:ust .:-11 Ho cxpvrimcnt nn-.:i h:1vo suffi.cicnt (lri ve nne~ noti vrtti·: .. n to in val vo hi:.1self. If th!.s is net pro sent nn;:.~. hu is "tctnlly J.epcn:_"'..llnt, ho (is unsui tnble for this for.:~ ( ,. t·~:.,r., .. t) ' l_ ... .;;;._,vl •• ~..-:n

throats ascoc:i.otvJ. with h.:mcsexu~1li-ty ..

ii· Ho hao coma to GrG.ni.lon to sOJ:'V(? his sentc:nno in n loss ri-::-;0rous onvi:ronrn0nt; h~n no ::1o'liiv.::tion f.,:r ch~u1c;e.

Ho chc:·:::.thc:l·~:;;,:r i:; u:oo.t:; n,·, ~'f::ych-_;t·::.·:r·t.c -~ru;·-:::; .. -<.--. :i'L;)tt s:>'t ~::.i ·-n.. (.,f:!_:d.:r~:.n \'l: u.1·:_!_ ;:<< .c:i.v._-"'1 ··-.,·:· ·!·i:;;;::~i:-r_·~·::-u:;_·· L;ut t;-l~.n · . .';')ll,J. b,-: ·;y;;cn to :_;:r>.ur "-~:i:·:cw::;~c;:ton)

P-~-n:Lei.11in,

~1n:~. th:: c:::-::::::nnJty h !V·..: :r"_;~:;c'..:·,:-cc;s -~-:-- c,~:nt1~--:l tht:-1 lv:··h::.vic111.r ·a:i.~hotrt ~h0 vc:~t;..;;.-ct.:i.:_.ll (_-£' ;;;u-.l'i(;-;';-t:!cn~

2~ l:n th·; ·.i.rrLcn::L!:v,:: trt-;·1-t::L'~lt lJo :·n .. <.~rl: b,_-.; nrnrc !';f hiu f'o~:1:iJ1?';;H

in :r>~~L-: Vi.:::.>:1f_:hi.p to h:i.fo h·.Jt::.:·vinur :nh! .h7,:; thi~J ::;f.f:'~:ctc; his ::.ntt::::.··!_'; .. rs~·-:rnl :::c-L:ltj .·m;;hi::m. ~-iiu l;;.:;rcr;pt:i.·)n it> .Jullcd ~11'

.-..~1-t(;:C(;:l b:J L:~::li_:"~:lti,:•n.

Opti~mn. Ln.wt bt.: rrnvi-:1(1:.: for f~L .. )c:pl(!f}:') niGh-ts} n~~Lt:.:1y us.-_;[J of ;}.)r;a.i.t~Yti0:J,

opp;rctnnitie~l tc :r0~1-l 1 .1o CI'-:~i't it,n·lt, lL:,;td1 to l':t,!j_n.

}i'ull i~volvul:h:nt in rrhui'nj_)UUtic Cor:;munity Rc·~';ir:-.c~ If [\ iJ\;I'~.l()fl J.S un'.l(o.e stress h0 :n;Jy be pc:rmi ttcd tz) :Jtny (;n ning.

COf.':l~.lJ.U-J.-ty I:KJetint;fl s;:~:tll :;roux: :n0otingr1 ~ no r:1over;-•ont 1x:t\i0({l1 g:roupt3 :intoracti-Jn crcupH :ro 1.;;-J?l~l:J-'ing groupD work J.;'Y'CUJ.1s

·:1:.Hclnrg-:: .<-;::oups fur:rily g2:'oU_ps cor:Jrd tt co m.::etlr.~~El roeoyti~n1 crcu_;_-:a - th,3 r\~ce:::ti()!l r.;r0up in h0l<: tho ~1-~:y :lftc;r -~1 norr

.. pnt:Ldl~ 1::1 ::;rriv~1l z:n-.~. is to o:xnnino his --..:;xpecta~ t:l.ons ·J.rl Ghu .::'il.:lo 1 or clLnr;c :;n-:l is l:kt-h~ up of ch:.;irJ:l'.'lrl, :3i)Cl'e:;r:l'Yj ~~Gsc;.:--~~::r.;nt rep, r::ccup rep m~'} st .. '1ff.

?.s:;.:;;ssr:'.e:nt 1?;:tcups-fl0l,~ •:!t the: 0::1-.l cf t~1~ first :Jonth'G tro::~tmc~nt c.n-1 urv C·~urle;:!:.:.n~;c:.:::-;y t,-:: th<J rL";ceptinn gr.Jups. 1fh0 D.SDZ:SfJLlGUt ;,.';1'i...'UP is IJ.Q-~C t:.p of th0 ':aSUU8HC~t ,,,~,_,0(''!'"'•\nt -"--·l'J')·'-''·''"'lt:'-1-J'"c"J ('') .")"' ~ .,t )·"~l~t A o.tnf'f •''-'"-''-"')'--'''"'' -'•'-"-·'-~'""'--•• -<I •. Y • ~- ••••• •• ·'--''--•) 't ~ ·

one of ·;,·hocl is ti·u: t-;rouJ."· ·oi'fiecr invclv;.:J or 1 in his ~!b~;cnc0, ::-.:11 ' .. '.Jl(Jcat(·:-::1~ (~~cup f.k;;t~bor.

'l1he ar;sun:Ju._::n~ group JtlJ.f ~~cwi_.::.lc-:

~12 ) for tr:msf~'r - this is bin:linr< on the

) ::m asscsG;~(mt i:\'t ~~ pJriod lcsG th:u1 3 3)- for n nc-r:!;:::l further 3 :·aonths rc:vi.cH

cor.lmunity months

.. \rcas of (looL:don llJ:-J.}cintJ, r.nnagcr.1ant nn-l control c-roups using therapeutic · ccrnraun_ity principles s~ch ns Democrnt:ls~\tion

:Boun·13l'i0tl [',n0~ limit drEmine PcrmissiVf:noGs l\olc mobility Communic:1tion

• 1'ho coJ~Juunity' or ';J:ing mooting ts tho ccntml point of the trc:1tmont, Thero t~rc- 2.Lt2,ll g:::-.:;ups Ylho opc:!.~nte in_ n cloo-:~ int:i.!~lTt-o n'1nnGr.. illl Ylf;lfnro nnd othvr l1(:o~..lu aro :lo~;lt i,•ith by the sr:l~llJ. t:rrcup \'lith -thv cons0nt of the COJ!::7!Uni ty.

'.P.h0 Ylolf~ro c lficor ::;ots :·.n r~ cc:noull;~ni-; in -.:olf·.tra r:ntters

,. cn.\L;:; . ~--~ ~-·~--

rJ1,_; :3·!_cj_l_l~; ~-f (:.;_:;-r:)Unic::Lit:n :·:n.-1 ;_·_'>:;;.{-_':"'··· ··:n·· ]_'}(;· £\>r' C·:rJ<;~:·lrsmt \/~:.;_,h

f(l,.lj',,"i; ·.~n-~i ~J-.: fur~-\ p.::r:;;;:; to ie<!_~r·r_:vt:· h:i::,. ~-d:-:iLLt;y r,r) :!:·c,l:~t~) o,_;~~th c·L}wra in n p:t'tJ,_~_\_tct~_'/.~' \'_"-:Y :1::1\.1. c;..-:J::~··,;<:t I;h,;Li·i,· . .-;!3 of :f',:-;1:~t.i.lt;.: ·.-:l,i_di ,-;.1.~.:; dc.::-.rL:·uct:ivc to hi;::::;e}f t;ltd_ n tl:.~·:c:,;.

By t~1~-:: :~(;VV}(Jp:~"l-~Jn~ cf (~c_,r.:;:\LC~icctti<:--n ::.n=.1 :;;·ci::I ~;LllJ.~j ·jt :i::.; i:o;_10rl n 1h;ttcn:-r~let l1('tl () _c c :);~!!:J.!Yi i C(~ i; :i. n!_:. y,~~ ~.:, :..i 1 t G > :.:--· r-~ :1 r_;u) :i_ n -.:: ;);~; ;·- \.lTJ t ion.·~ l .t<:: l··_,_ L :i. 011::;hi ps ~;n:l b(;Ut-:Uhd {J_t' tJl·j_;J i;:::_,l'(;VL:::lCrlt :i.n t!·l-J 1'•-:--:j_·;.; ·:n n,._:-, r.; • .-::.-~Ui;:t; to U::;(;- OX !;r~;·f;h_:

(~::l:ir~~·,u.Dnt 1J 1~·h:::vi,_:,lLC i.':\tt~)!T1fi 1 e,::; th . .ft-l ·~;'U< c:;)UY.C:G C~h:.:~ J·L_; J'--~Vulo~_.fd r;:)r;:n ins.i.;~·ht :int.-, h:~; ~::L:'"·.)v:t,:::1::1 needs ::-:tL~ ,-_;,Yvt".·L,-~I"~s ::-:(:r::.} Jt::~;1h;;:-_:s of hi::; C:•iln \:orlh

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tL::Jt:H~ ·t>'d. ·r ·i_n:;H~.c:r-: :. .. :::· .. ~ Yl!--' <J v;etJ..'\<Jn o.L' Eh:~rr1 ~:n:·;tru::tc::Yt: ~ ... :i.n tbc: }")(5:C'J_O·..l r-;j_n:~t' •-.}-;c.:·\' 1 ' r~~:ve -~,t:f:·n ~;<: Vi..:n ::-:11Gh :~ cc.: -j ii cntr;.. J:·r·.l ;::c:n ~~~.t:J_ff '.ic::rt.:~ p:·~rt:i.ctl~~ :-1.~ l;y cnr-.~·-_-JJ'ii\~(; nlHYUl: '.;-:LoJJ.:n'L pl'.i.::-.cJ!!_~:;·::. ~:cJ.:•-v-j_n;-; .Lc:"JJ.;·: deLc·rmin;j_-cc ~3unl:enc0:s and ;_;:.i.l±C'--: the ;ll--o ti.on c.1f tbt: derd::h pcn::t.1ty.) ~:b·.ut tj:c rro~·~p(:~ct of vc:-r·y vioJ.cr,L ·i':~;"·~,;~cT!•-~:r::3 ::;e:r·vinc; J.:ifn ~>::·:,t(·J"tC(::.;., v-::1c Ll.i;;Jd; tH1-~£-..! the vic•,., th:..tt ·[,"!.J(l--.r 11, 1·1 n.'Jt-\,.:_nr·-· •··) -L~--~'"' 1----.·· -,,..;,.,1-,)·;'· ···Jl-~' J-·,-:.(•·~l,-,.;., .. ,.,f)J1-t- 1-·c·l'·"-\'l·C·1J<' ·~r·,rl ~"l1'0·Ll·r , 'J J _ •.••• v•~---•+;_, \,,_ . <.}.j~· uj V.•-~_1__,.__>:, ''-' (--_ "-'· ~-~'--'·'·-•-''--'-1---' \J "----'1'-~ Jl.. .•• '"~ J. C -· ·'-"

the o_:-·fc·ct th~Lt th_t~:Hu nrif_>_;nc1>:. Hi-~_ t h:-:vc on oLher::.;.

11 1 ht-~ m;: ... -;n (~01H~11.~r·ir.-,n 0.1 U1e \·.'c-d·:i:~;·; r:-l,~:~r · ~\:; :.h:- t, F!. ~;!l''cia~. un:i.L ~7hcuJd be p:;·c· 'i.:i ~:_1_<1 \·d. Ch:!.1! the ;::~C.\) \:t-1. 1'-c·_,y--,:}~l- ::.~y~;tcm -r 01: tltc lrc:Jtn:ent of 1-'.ntJI.·:n vio1e:nt in;r,r~tc~:;<; thc1~-;e con~·;irlr:rc\l p<.~t;e:~1ti::-~1Jy violr:Lt f.'.Jld r_;c}(;eted lorlg term inw·.tc:::.. It \-,<~n cnvj __ :'.n th~tt tLc: ~·c,gir:Je in the 1Jn.i t v;ould tc~ pr:~yr:hi·.;.~·J·_-j_ca.L:Ly (Yt.,j_e:n.tntc:rl. anJ_ th<l.t i'or· t:lLi.~_-; ptu·po~;e ·t.h~::.:r·e ~~~ho1.11(: -\:e

pf:JJ'Chiri trj 1_' :2u:~~'~OL<~, tr-:~d.~ ::.:taf f ~~J--~.~Ju]/: be a mixture of d_i:.~c·i:pJ.i.ne c-::nd l'\.!'1''''•:·1;'· r,-i•r.:_.--.r,,·., ... . -_,--.-, )."'rl··--<--· 1-\--,., I···-··Jr~-; I--- l'l'''l (' f'('·l'"''l'/-'l'(J"'•'•••'t' ·:· .•.. ;,J.,·;--:,--.r\<'lll'n 1 ..• .;._,_L •. -. '-'·'·"--'--~''-·''; ·J .. _._, L.<"l"'- "tn .. - I.A· . .;,,_,,_L. ---~·- ~)"···---'--"-··!· ;,_"~--c --'·--'····'-'··-~~' . 1 •,-~\(':l .. J .• ·.l.-l._ ~'-{' J.''("·(·l-J' ·1'·1· erl -f!' "']')J·,,,-1>··r··,h!-\·i-·r· Y:;()r•n r'-jl)"(''r··.r ·[·o· "'l +-:.\_._-..y···Jr-·i ..--.-;-jrq·f·ic-~,·d--. ~ .>. ,., '-~-~---•, ,,_,~ '--" • .. 1.·~-•--•'-... v\ .• -'''"-·' '-' V- •> •.-J ~ C. v~~'-·o--.(., .!-.<>V _!_"'"• + -'-V

ba[;ir-; \-:h_'~Jc T":.·>-., .. ;l',.;j'i)' D_ J:'.i..ern {;Ut r~ 3~:i.e di:-.:ciT.)line s:vstcn,. 'J'he U:Jit \·JOUld h~,ve :it;; (l'Jn ... (~~~;~;_::~~·t;l~~~ :·:.n~.l \-:ould be rL~n r-H::pai-·r.:ttcly fx-om nn:-; othc~r entnL11.:.-:hmc:n t ..

It provml :i::rpr·ac:t.;e:d)lt:' to set up a nevi purpo:cc-buill unit cUld it Ha" deeidcd. to n.d~nyt, t.hr: .for·::1(~r.· '.-.romeu 1 s E:·et-Lon in Barli.urd.c T)r:i __ ~-:~on J'O'!' usc 01 e ~~ :.'·"'L.'"·l· .nl U~-l-1- -;-() c,r··c·:rl~"'·T"1 ''~~~1"--l·f' 'l.[l '·o 'tU' '!)·r··~ ~:()Yl'-~-"r'-' 1111-J"• \Yl. c:·}·tnc~t 'l'J'TIO<.-·ro u.. .. j (. , _ __.,_ \ ••• ...-. j._)._...,.., ,, ,_, ~ ~ ~-·--~-...-- t.~Lo" ~ (, • ..~... ...... ~-< _.;., J "' ·- j, ·-·~ ... ';.' ---·

acco.:r:;l0d::-.ttr:d at tlEJ one .t.l:-:1c h:-l~ b{::en ~~even (?)., ~l'he Unit v1i1.~1 opened i'a 1!1ebruur;y 1 C.Yl~· n.nd the !:'ir~:.t pri8oneJ:'::;; \t/ore 2.drai tted. sho.rtl y aftr<L'~·;~n:dr.:.: ..

' A ba~d.e concept of the Unit :L; to involve' the, prisoner not only in his own trr:ntment hu.t n.J.so that; of hi::; fc] lovi irun:Jtcs~ llul·:Ln.(~; the first lB months th:~t the Unit h::1d been in_ operr1.tion) the involvement of boLh staff anc:. inm0tc~:. hi.1cl dev(·:lO~)ed to the po.i_nt tl'Hlt thf~Y rcr~grdncl thern;:;elvc a~J a sin?~lc coi~lPn.nLi.ty \-:l':Prein t?ach hau cq1.Jr.!l votinc~ po\VQr nnd equa.l r·cspon:1iJ:):i.li. ty.. i1 11 rrwl~tbcrE or the cora:mun:Lty <J.l'e accounta1J.Le to the weekly coimun~ty moetinr nnd in tho words of one of the prisoners·ir someone (-:oe f_; someth inc; clctriment~-.~.1 to the eor:ununi ty he ha~J to Dllfn·Jer to the eO.'l::nun.:i. t:y nn:.i it i :-; no ~'3ccrc t tlYJ.t the 'l;ot seat' c::1.n be,. and i~3j a hari'O\·.fiL"il' (;xoc:J'it:~Hec und i!.': muel1 Jrtore effective than anlv rGovernor' s puni~_;hx:Jc~:Clt."'- II

Impri.sonm(mt; doc:c not only deprive a r:1r>n of hin liberty, but, b_eeause he. must eon:form to the routine of r;n inc<titution, it also deprivel> hit:. of the ceed Lo t<').ke w;.ny of the cbeir;i.onl'; which ::re on every day port of life cnt:.•:.ide. On the other .side o.C the r:oin, r;taff :n·e necuc;tot•ocl to rna1ctn;.~· ·the deci:3i.onn und hn.vinr~ the iiJUl-'l.tcs erJ.rry them out o f.l1h;:!rcfore) b oth c-t···ff ern··• iT0 '\Lnn h"VC to.,.,.;,.+ t!Jrmc·(•l\'''' ·to cl r·'lt'l'<tJ'on ••rtp·('(' .,]· ~'"-'·-~ (.1,\•.-J.l.'!~ '-··~: ';'·: ~L\;·--'l" , .:·.J~,-J_ t:,::> • t • .). \-< .J "'~ -•. -~ C\ ·~

are }.tP!OJ.VC(!_ l!l LiH~ c.ecl:::;J.on m:Jkl.rJt'; p:coccr;s.. ~.1 hl.s h:-1,:-:.i led to the que:.~tionine: of m::.;.n;y lone accepted prison p.r·;:-;_cticcr>.,

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t};c Lee :c: u::; ;,-' fr i (:h

-l- J:: LC rn·,n: ·j Li.~ t,~y ;Uj{J I i'Lt":;> o·,- 1.'::''0!;\ :_::: __ :! ut -Lhc.- '''i':;t (:t·) c·-nn ;·_'\l.C- ·, ,.: -·LL c;L-,~,---;-·,·::_:-:e }-;_ \Tt; ;_:(: j .:·~.:- J-.~ ~:3~ ~'lc Lc~t .-v·;:'; : . .:. mo;_'e ~J ':-~:·c,,-,,_._;_:- tt: l_:_inct n_:_. ;_;-rJ:ctr~-~lJi 1 .!\_:~;r;t--~<:::_1-L:lit:::r ~:_:nd_ fL't.:cdc:n 1 tl.:;:_n 1 \~o::--:·t-ro.l :-;nd }-''-<t·t:::i. ~;::; vc:nc~_:r; 1 l_.,_-:e-nu;_::e the: c:cr:(:l~pt ~) ::trotH\(~ ~,hc~:n ::·::.t b·Jo vo.r:~-::.~_;

· ,_, -·- .... ,-.,· ·- ,.,, 1·1· -:- ·--l,·l·v 1'01' ·1' 1~,-,,-,·l· ·-.. · ~.,,~. -~-~.-..-!·" _,.,,,. ,_~;-.,-:';-' •-~·"-· i'o· ·'··· '.-~·,~:.11'.1'.' (_lJ'C '-~!' •_L(;)_;t_L <_\,~___.- U;., U ~- J L .... L • ...-~,,f. . .-, 7 l.t. ,__, U.<.J-,) ...:__ ·' ,_,..,.,·_.L.t.) ,,,J.l, ,

n.nd j r\;::;·-~ tJ·;; tJ)!"(-:thc:J· ..

1J:lJ,::· clovcJ(Jr::·::-~;nL c;.!.' J.-.:·:l:,ticn~;hi:-_,;,; h:1:-; ri.!\·;t<y·,-.: 1-:ncn t;h,;: l·.u:;: t :.u1d pr·i~·oe

ot,Jc'C.CJVI' in the l__.n:i.L) hn_;::c:d on the lo:·:\.c: t}t·:c -Lt 1:~; onl~y 1;_y a J'l'Of.t'r Ln~~dt·:_r'r.~tnn.:-_ht~,~: bct\<Jt:c:n people thnt real p_;-·oc::t'(-:L:· e;1n. be: uch·i.eved ..

'11h(: mctho-:-1::; u:.:;cd to rcn.ch thir~ undc;::!=';t~tnd i np: \-Jc~re brtsed on- the c.rcn.tio-.r1 of ::n :::.tmor~phe:.ru Hh::.~l'e pri~·;oner;-; and r:ci~:~on ofJ'.i.cc-r'r; could r:~~·c tocethcr to debate:, ~_;_-.:·p~tH_:: nnd confront ench oth~_~r.. ·J'b_erc: ,,,rt:u::-; a !!~~-1r-l~c(_~_ levi;l of suf:~·oieion and ant)relv~n~;ion ::;hv.·:n l;y cvc_:··-y··onc: in t:.he in:i.t:i.~d TiC:r'i.od., '1')-,-,_,· ·ir·l·f·t-•','1<=-J· i~-<:r (J[~~ tll·l'c; ]-,·l' 1:•·h 1 v c·I1'-;I''''Pc 1 ,--.-l·t-llDtJ'crrl ,.,,,v 1-.,·"'t''-~c[i,:-,1 -;.,.,, '-'· 11,PV'~-qf'' •'- -'-• ~·· !_.. ... , ~, __ o,.,) • - --•- _,, ·'·J _ ''·-:--.~-~ h>.C 1- '·- __ ;,_,_,, u.)._.,.,_, •• < ''•! ''-·'• ·'''-~ _.:

for .Lr.•cu (~:i ::.eu~;nion.. 'J.;':rom th.i.<; cme·r';?T'd n variani-~C in rcl:· t.ic~n;-;lli11:::-; n.monc;c;t stn.f'f nnd ~~t:·~-:~·-r '; p1·isc!'nuJ~ nnf~ :r;1:·i~:oner, :-tnd :_;t.:lff :-.~h.i ~;rj ;~oner~ rl'he ret,J eJ'fe(:t of thu~~e reJ::~t:l.t;n~;bip;_:; f~ mcrtnt ·Lh:_:t: e\/(~J·/c;-nc i~_; n.JJ.o:.;,re( to (rp~:.-rn.te :i nd:L v:i.dui:t1ly, car.rt;i.-ng aside tJ:ad:it;J.onal role~~ arH~- loyal tie~iu

\:/hen the Un:L t opcn.z:d in J 9?3~ t:hc TH':Jct.i.cc VJas to hr">..ve rz-:e:u.:L:r staff and inm,,to ;_l_n(~ ;_·ta:f'f mc-ct_·i_n_t-·;:::- .. Du::-·:: rw: ther;e c<-Jrly d~:;_:y·s there \·,·;::·-:. 011c !3to.fr n10.-i.::t;:-Lur~ ,-~rKl t-·.-.·o ~:~tt_t;.'f/i::-r::Jr'.Lc rnc:eting~; v:cck1y v;ith the fu.rthcr ::.C.:.dit'i.o:n j--;,,._J.. !(_')··_ .. ,)·.-,·: ,,,.,(''L·J·f!\>'Cl ,.(.l'1'cj 't'-::-. ('·-.l-''1;-,,l ,-,-!- ···v•·'r ·t--il''•--• -,__ .. y ").]"' )!1(']""1-~-~-.--· r)f' +·'"(' -'-••··· V d )\,C ·'~-·- Hlt_ , .. ~,_:_.•-' '~! .--.. __ ''~ 'c'·-'---'-·','-'- ,_._\, ,l~-'-,J ·'· ·•'--· » <• d " ilo.\ __ _,_ \ -"- vll ~

p:roup.. !:.:.:. rt-~1:-~tion.:·~h:ip::.) u.n<! t:r:·u~~t; clevcJor;cc.,~ 7 the noed f()r th~~t Dl'L!l'CI'

of i'OI'nJr!.l Hlc~ct:ine>~ decren~::c:d .:-1.n,: it tut~:; evolved to the pJ:e:-~;ent pcs:Lt5.on Hhcrc \-!(~ h~·;vu one fc.~··m:1l., sta:tl.ltd:o::; con:_t~lunity JHcetinr:: no:r:UJd_;_ J~y hc:ld on n 1.Puc:::;day nnd ;-tn info:l·mal eorcmuni ty mPctinc; held on li'ri(~D.Y ~ '.l'lH~ fD .. ciJ.:i ty fo ·n ''l·lv l'lt'"ll •''r of '·',·L·" (''.J'OU <';, t·o C ·•11 ', ..... ••CJ. "l ffil'l·''·1· n·". '' l '1< '''I'O''~'rc-~ c-'·J· ,,,., ·'- ,, ·v , ~·· _.t.. .. l<A • .._) ,. J •1 c, .._:o!J. __ ~ ·'--'- , . ~t· .l- f_·,•-"' ' r t..J ~-·}:' ~,,c;u ~.1..1.(.:>~

anc: ;c,t.aff mcct:Lnc;s :i.f; ava:LL;b1c.

Meet:Lrws a:C'e conducted in tlw fol1ovlin:-- .farc;hion:

'j!hc 'l'uc-!Ed ny J.'o r·mn l me ::-t-:i ne~ is rt}e:arded [{f::i com_pul~:;ory vli.th everyone exT,,,,C '·r··r' ·(·.~ '1 4 'h.•nc' 'i'l- E' COD'i'lC''' 0 '' th·l· '' l'lf'"·t .L· Df" :t' ,. ll'' "<·'fi O''l tlJe !lOl'ffi" 'l , ... ,,v ..... ,..._, .... v ................. ~1, -~'- .v _., '·-·· L'""' _ ..:.) _ •. <-"-•--·-, .1.« . -'-·

rulc'3 o.f cL;Lat(!: (;J_) A Chai:.cn;.t.<.n iEJ elt:cted from cur..ongst the ffl('!nbnrs ·p·t't'"'l'f'l'• (·•·) "···eco•·<'1 Of -f·'lP 'J.'l''OCt"C·;j],"''''0 'L." mirllt·tpr1 .llt>Y•~·l·'('' t)'f' COU!"'C ·-- ··-· ....... 1 \ ), .. ~ .l J' .... •. vl ~ ·-· <'' -r~t:,~-' - ..___, ...... _,__.._., --<---.1-- .1. r) ~. ••

of. the mc..:::-~irJt:; the) Ch::_d :cm~:.:.n t:.sk~3 eaeh i~ld~ vi~lual tw~~mbcr ~f the:c is r\nyth:JJ.;f~ he 1.'/l~:J1e!.J to rn:t!3e. If Po., then thls l~:l open to cl:tncuss:ton nnd def.::~\tP.. ~.l'hi::.; nil':etinr~ i::-; rf:garded a~; the instrument for di r:cur>sing o·enc•J''·- ·1 :t' .-:· ,_.,., -·· ,--, '-1-,.-.,.-l p ''0·,-,..,c ''J. nr~·- ·i l1l" ·\r:t' iU' l "'0 ''l~'. rn••,n a ·: n 1' .j.h OD '"Ol, ., ci'--t-::; . _,. ,_.____,_ • """''-"'-'-~·~· ~ ~~ ..... ~- 1~ !.,J .. t-:~ ••. ( --~- c (.i .•. P~- t·; .J.~ ..... ;,.~ .) d .... c v e .lc, x ... () developmc:nt of the Lnh:. General dcciGionrc> are reached ty conr3ensus, 1mt ·tl1C''•'C' <>Y'C' ocr·~o' 0'"' 1•'1-lr'n '·' vot~ J. ,, rr" •'l'I "C'd lJ'l·<·r'v:t· rl"'l.l 0 .,,,,· J'•CJ'1' '-'- .~ •.->-- ~ ___.- ~C\iJ.;., ,~._,,.) ,._ '· CA ,, .o,_) - •';~\..,,_,_: 4 \~... -"--'-'-, >.1 (\.J_ ~' , \.1 - •

dise't.ltJ~<:;(:d. \·,~hun not prt:,;_;c-::nt., ·exeept vJht.-:n c:J_rcum~3tanl~es demnnd the rtll.evlot ion of n cris~i ::-3 ..

' The ideas tl~d proposi·tions emanating from tl1is meetj_ng nre processed for deeifd.on throuc:h the Govun10r and can be referred to the Dep:n:tment. Hinor domu:rtic dcci~_;iolls.>i+o>h:--~ndicraftt.:; etc.)are r-e~~oJ.ved loca~l.Jy<l>

f1ntt::rr> CJ.f.r.'ectinrr, the staffine; and t>ecuX'i ty of the Unit nre not nornw.lly diceu:;,r_~ed fJ_t thir; H'~eetinc; except YJhcre tbcr:;e .f~:-J.ctors have j_mplic~~-cion::> fo:c tlH~ eor.tL'i..inity- n.~.J a v,rhole.. DeciE;ion~; on such l~w.tt(:l'::J tiT'O ncrt; tni:.en b;y the ec~nmU11ity-0

\ r . ' ; >'

~-·~--~·-·~-~- --~~-.

-,.-, thf--' c c;:; ::ttn.L n i'o r·mn.J J ~;" ''_L'hc

·i;td"'thVjJ.ll";.' \)Otb t;:i.ec ')

concern o.r· tc;(UJicn :~nd c:·~n ·1-:,_-. cD11c·.i -t--.:1 :::_ny CJI_·:·:i·l_-c}:' of Li::l' f':'.i'01XJJ :-:tt n:n~y ·t-irnc.. 1'1-~.ln.rtc;-~ ,~_:r·c t·-;.1-:c·::l of t._:hc~:.e H;ec·v:,rJ?";_-:, :c\nd c~:i_;::.;:·n ~J-L tl:H: Tlt-~:;.·.t

~I.'hi:-:: \'/'CU C:)f:l-;"Jl"J.:_:c::.: of h J.)C'()j)tr__: wrtr:c up o_:_· :_·1::-t.ff :1.c{.l _i_tln::·;:~cs .. !J.'h(~~;e \-.rc:r,::~ _·,'Jl:·-:~ L-:::i:, fu.r· t-J-,--:, 1y···(,,-,{·-; t· c>~"" )'-c_-,., -,r .. ,r,;-\,--,-.-.,, ·-ri r·ld-11 i--l-t· -·-o··--.'"d]n--i !---,_, ··nrl _. ____ , . ___ - ~~-- L~L·-·····:·'-'- . .J.J. .-'_;_o __ :.,c·_.,,~-·--•-•·'-~-·-'.,_···~. J I.·-·.:-· -,\,.,,,c:,_,__,_,J ~~-~~ ___,__

aJ·e :.:tJ·"tJet:t~J.'(~d to in.fo:r:n the .1nc!:l_v-:.t..:'u~:.J. nbt;u_t 1~ne: un:Lt prn . .Lu;;opny.. J.n(~~l r1re a:!~:(_) ·Ll;·_:;.:.:_~ ty in(\i'l.r:L(luu1._; \":;·l_O 1:.1ns l1r:vc• z-lj__f'_~.'.icult ir1 CO!)int·; 1:itll the la.r·r::(-_}-e :~r~~)u;; ..

~::/l1i\FH -,!:I ·-~-.~-~ _, __ . .,~~.·~-~-;:!, ...

~Phe c~l_-.r_<ly pructicc cj_f hr.l_v:ln~j· :rec;ul'JT' !.:>tuff meetings whic·.h 1.-:cre dt:;3itJH·::d to dj_.uc·u~.;~_; i.ndJ:v:i_(l.U;-il :i.nJ:~att;~;~ in tltci.r ab-~3enc(~, becn.r1e llDllec:c::.s:;_r;] bee::1ur:;e ~:: Lat'f felt r:,ore v.'bJ.c to r·c·.r~olv(-' Lhc~:,c ir3~;uen at n eommun:it:t

•

Oppo:r:t'L;:n:i.t Lt;~·-; :r·cmain J:o1~ si:rtff mectillC~~~ to be held to di~_;c.u~-;~:; staffinc; and D(:.eur"L Ly r::attf·r;; !J .. A Tf<IL-) ..

(Pri~,<Jn ~:;eotlD.nd. Fules 19~)?: !'lumber :J: 'fJ:he pln:por;e of t·caininr-; i'.1J!.d treatment of convicted nrisonors shall be to establish in them the will to l<)<Hl a 1~oocl and u;;efttl life on di,,;cll::r[;c and fit them to do r;o).

Vle bcli;:,vc the pJ·actice evolved s:Lnee the ~.>pecinl Unit opf!ncd is the bec:t for nehievin['; the ob;ject:LvoG of the rule alJOve.

rl1hc i.ndividurd.1s choice of proc;ran1_ru; i~; to Dome e::..:tent determined by the stap;e in sentence)·Lu.t de::;pite the rerd.i..~.nu of a lon~ tUne ~--;t:i.Jl to s(~rve, in [;orne e~~~~ef>, our· l·e) :Lef i:::_; thnt He: ;·n·e prep~tri.ng eve1·yonc fo.~· livi.nc; olr~::;i(_lc" '.~:he on~.~y <"U.f fercnce l;ei ni:~ t:i me scale~ 'l'he process b;y \d1ich thiS 18 ~Ch1eVed lB:

(a)

(b)

(c)

(d)

Prisonr:rs are nominated by Governors in their parent prison.

This rocornrncndntion is discussed at the Community mcetin~ where 2 :-;taJ'f an: r:l:'cted to accompany the Governor and the CorlEUltant Pnychir,trj_st to interview the nominee m1d others cWE>ociated with h.i.mo

' En(;h nominated inmctte h: r:iven a descr:i.]ltion of the Unit's activities. ~l~hc irrtervi6\·J tenm b.:u::>c their recommendations on their views of the pri:>onor£;' ubi lity and willinr•;ner>:~ to participate in and deri V<e l;cne1'i t from the lfni t.

'l'he interviev1 team,aJ'ter intervicvdnr_; the nomineo,have further diE;cu::;oionr:; vii th the Community and a recow1Jr:ndnti.on is made to the Department.

11.1 tht· {'"\''. n1. (;! :• J'."IO:C :L; .~\'\: l'f'C'Y:.:~.cnci·.t·ic-n ti;z: ~; '"·:·cr:t·.-r_· J.;3 C!_;cv:.--:t:d to th~-~ Un:it ··~-,'/ -dlf· :··pr·ci:_-!l__ l;:rit -·-.-.;··.:- r\1'(:ft. the ~;-~---~.t'r ,_;t•J i.-:L;t"!I'\?".iJ;•c"-

{ljl -j_ ;_; th:) t; .:.t H~C: ;r1;_: ('\.'t ·:··y~;nc c.an JY!. tc the \:,':!.y .l n ;,-;h:} ch Ll'H· .inJ;-,;, :.e ir: :i.nt.t·od··t:~c~(~ to t!-;c- Urd t;., ·_;·he e::-:·~~e::·:i c:ncc c; ; _ _.(;; L)::c-:~-'i.:-,1 Ur:.·i t h.·:::.·; ~dlC'.-·.·n L}t::·Jt Jl(-:·:-J ::driJ:i.;_:;_;,_;_c-n:·; do h::~v-(: diff~tc.u}tieF; :i;: c:_t:·n1in;·,~ ~--:i.Lll the f):r:·ol)lc:!fl oi-·

l . . . . . .

ma \:::tn;-'; r-~:unpJ(: {JCCJ_uJ_ons

;:~J<'l_iii1 J.Tl;(:; IN I<·:;_~TCD ~ ~«~--..--. ~~-------~~---·-···.

\-1e rcco~':ninc th::t thr~ neVI inu:· te; i:n comin~·: f_~'CTt thf: t ticnrd. in~rtitution~il. :_--;ottinc..Jn~:f:d;::; ti.:cw to :leGoJ·•t Lh:--~ cor .. chtJ1_~ or 1 frcec~_or,l 1.-Li.th I'C·~·:,por:t:~:,ih:L\_:U~y' ... i.t: j;:; 1 -y;-·fJ:\1 ·p:;~·net.i_ec; fox: th~·: c.o<"~;.rnur<~_Ly to rno:n:i.tc tlH-: :i.rr~roduc_to::··y ~H:.r·.i (;d n~:> r: :Ja.r.'t::; 1:tl;' __ ;'ci to t.hc: 1:c\:J n\l'l~rn.nt r_t_n~! to ~;h?. eomtlunJ_ty.. ·_Ph::.~~ tnkt:n Lhl': .torn o1 ;-;t1.'Uctu:ce('i (Ut:tJy l;. r·;:_,~olli)~-;; conr;:~_r:·c:Lnt:~

of :? e:zDcric~-:ced momb· r~_; an.d the no.·~t rcc{·;nt 1nc1!.!Ya:l' oY the: con::Tn.Li.ty~

'J..'ll';' T111 ,-,-,··,o·~ ,, o·i' i-'1·\-; ,:• ~---c'' n<'' ·•-o ) ,:,..,--,() l)·i '" c_>)j·r·y)"'T''~-; ~)·i vre> h·i lft ·j nf'n--;>r;<•· i--1 ... )fl on <.c J:·' ,.i r, ~.·t~ L / ,L.;.l !_, <.i ~-.. 'f \,.-- ,,..._._t.._-" , ••. h! ~~>,...:J, -.._!_. ~-' ~ . .'-""" •• -•-'-·•· •• "--·' •·l •0 >.I. "'-

the TJl·.jlo··olJt--.v "f·~t-;l•·inf 1 1-t,~~· Un·i·t- _,-c.-1 +o l·c' rl·h-1 t·· -r~o af::;r;f:i!.) b·i<~ 1,,,-,tu-r··!,ty :in e.c~ e:i)~; ·t t;;:;,, r(.; ~~:(Jons it<i~~-l i t:J~: .... ,_rh;-~ r.:~~ :i. ~; :-~i~:;o, ·t: he :info :r·rc;.l ~~~f:,;oi~~~ ; ~;n ta~ t \·d.th other 1nowber!-::; of tlle comwnn:ity ~

On o pl1ysiettl lUV(-:1 hir'. viEits al'O cJ.osel:y sup.;;rv:i.!1C~d ·l::;r ;J. men~tcr of the conl.:~iU~\j_t-y.. 1l1his ha~3 the ~tcideC_ actv~-:.ntar':e of introciue-'Lnf~ 1ncmte.r·;-:J of th(:: communit.Y t;o t}HJ inr:ta l:er; 1 rel{\1~ivcr; and f:ciond;:~, therc.f.'o:r.·c c:i v~:<_ne; them a deeper urv:ier;;tn::-.td..i.ne; of the: aim~-_; of the U.n:i.t so that they in turn can SUJr~~ort him aryl. ·t-f--COl'rH~ i.nvo1.vt~d in h(_:J.pinr; l:::.m nhrtpe hir:: futvre.

c'

Another· :prec.auti.on:1.:cy meD.sure -~akcn ,by the co::nrnunl.t:J i~-~ the er:n~:,orinp: of mail.. Normally thi::J is carried out b;y a. meml•(:r seloctcd -by the cornmun:i.t

'l1he close monitoring and supervision of tho new inrr:ate h~''" no .fixed timo ncale., It i~~ 011r expf~;::-\cnce thnt this do<~;; vnry frc-1:1 ir:dividu~~J. to indivicl_U:\~LJ tr.n~l't::for·c flc::-',ibi1ity i.~:, esse~nti.al.. AnJ deei::.ion to rc:move t~1e clo~~e monitorinr_r; must be don(-? nt a e:om:nuni t;y meet inc; ufter .full dlBCU~_;~:;JoTI ..

\'lo believe t:hr•t it is important for any noH nddition to the comnunity to havt:~ a full understanc.~i.nc; of the way-· in \·thich the Unit ha~3 evol\rede li.t this point it v:ould 110 <mJlrOpriate to 1·emind the re:1der thn t the i:.,pec.i.(ll Unit :i.s experimental and thnt the standnrd :it ma:i.ntai·w3 i!J by le:<rnini~ throup;h oxperinnco aG opJlOe>ed to any ruleD imposed. .from the outc;ido. 1'hi::; c;:rn h:st be illuf;trilt<•d in doalinc; with the problem o:t' violence.

\,lhen trw Unit fi r'Et opened ,the majority of in;n::tcs admitted hac: lonr. histo:cier-> of violenct~ within. tho penal settin?o) Thus, the emphar:;is was on ho•d to rco,olve this. ln alloHinf; inrnateD the frcoedom to express verbal r:.p;u;t·c:3f;ion \o.rithout .fear of l;einc~ punished, one VH-JS preventing the tm.LJ.d-up of tensions VIhich could lnve re:Jultcd in Tlhy~;ical violence. In tl1ose dnys 7 lots of nnf~Cr was express:'d and staff found this difficult to COJ>8 w.L th, but throuc;h cndurinr; such confrontations a more meaninr;ful undcr,;bndinr~ bec;&n to form which eventually developed into meani.np;ful relationsllips. . As n result of the J'elntionshipE,thc confidence in the [!;rour, e:rcw to allov: phyBical chcmr;e:J such as the use of metal cutlery inste::.d of plnstic cutlery, of proper crockery instead of met~l trays , and the fr-eedom to usc too1,s without EUpervic>ion.

As a CO'"Jl\Unity we extenEi voly discm;Eed the problem of violence r,nd coneluded that \'10 would .find the use of physienl violence intolerable. 'I'o dnto no memrc:r o.f [;ta.fi' hns been physically ac;snultcd. '.l'hcre ha£; been one occac;ion o.f violence by one inm:1te on another inmate.

rLL,.iJ,:t: ''!~ > :L:'il' ,C·Y-:11"'~' T:lc:_;yt:)_J

ty fCil()_;~: <1-\ f_f':i r;~t-1 ~;y :i :n C~-

> ' '; '•'

' ' '· " _j th

Lh_i_;-- tJ. u~, ·-· .. rJJ e.i ;·:tLhc r:i.(';:(~:.-, c·--·lrJ'\ h :: :~-~~ov a (~_c''-h1orrr:c,nt

cd_- ::·1-· .. i .'! :·- :tnd ;-:-;.:_;-:L.rt ;:~e: Lo uc:_d~ ',-:~; ~·11 t:ld ~--; cur:~;tr~;_(~t;j V(:]:--J" ..

·,.JlL:J·i t~r..:: eo<.r;nnLi.tJ fccJ th~_lt ;Jxl ind_: -~ridutJ.l i:.: ae(:npi; ft•c-cri(JL:1 ':.'.:. h J'ef..:JiCln:_~:U:.;:i.}itJ;ho f:i.n.-:1:~ ui tu:) L_i en ..

c:~pablc~ of be:inc; u.b1c to ::u~clf in a lv~;n ~~upc:r:vi~_::ed

r.l~bi;:_; :.ncJ.nde;; -uncc:n:::orcc: m:.:il, :Lncomir:t~ ,ttnd cr~Jtf<('inc;~ thouc;h it i~_; mac.e cl(~DI' tc l:he i.rn~L-~ Lc th:d; ~-~:,_:y eo.J·JT:--:p.::)n;-_l_cn(:c~ -Lh a f'!t:tnf";;:; r· of Pat·J:i.Dment; murit l"'.i_:';_:;t r:o th}'OUf)l the; n.o~'ma1 clv'.nnL~~u~~ Hr:: .Lr; rlJ:Lo\·H'tl ld.r.; vi_;_-;:i_t;3 in hi:; Ct~1:i v:·; th a _;:J:;Jlbr:J· (J.!.' ;_:.caF 1-: l~c.i nr': :La th(.-: .:l·;:en; thnu;'·h it c;hcru.ld be cmr>h~;::: -j_ ~-;etl th:{ t; _in ~i ti11:llv !DO~.>t :Lr1m:\t~:L> f:i.nd i·:_. di.fficnlt to conv cr!:;e '· . . . . - v

arul :cr;'L'.tL i~o Lh(-:ir vi~;;:i_to:cr;, theJ·efOJ.'C mc,m1-,e:r:-_) of the: comrm1nity ta}:c par ,·lrl (~),- ·-~·r· ···+·1· [''"' ]'JJ .. ~t r-~~·,·c'l.l''·',.l t·h-; e i: ,-.·.-~-; ·r, t·,'·\,·· rc-.:tr-lc--,-. (·hou1 t; l-·e .--.,)mi 1''f1C'd .• '"' .':"'~;.;_"--'-('> --~<- V!_, .• _ , ... J~J" •·-'-·'·'~·~ --~'- .- ·•-··-<~-'· ,_)_ -- -' V· _,.,___,,._._t~,.

th:~t t-ht.,·r·c i~-' a p;re,::_;_t-; dE~<-1.1 of !uovcnt('nt: r~nd inte:r~~ction bct\·.:ecn the: C(JEwn~ ·ity 'n·' y: "i t'Cl''' '-p t11·' llr·'t l'' .;,. 'YJt ''J''·c,,,.,,C•'l f'or tlh; f"miJv \'·j,,-:.>-c :~. '". ,,;~~-~.'::; r, .:~:-:-- .',' ~::~"'~: ~ -:" ~;-- .. , ~--~:;· ~~ j ', .. ,, -~·:·~.~ :_,·_~ .. : ... ,~:-:"-:~;''".'~",·rJ. ·'·, .. <.: .,·.:.,: .. ·n:.: •·r! ·~:~~~ .. L-~-·c~ f._,nd ( LJ.!..,r;~_,.:) t.J t:.__J"'ume .dJ.\-(,.J-..vcc J.tl L •. \. _, L-L_:_t. .• -:t.t LOlldl i(J.CJ .. Ltl-L .... _... Jf,~:. .... c -.LL·

no s~ruetuTcd da5_1-J :r.·out·:.ne which t~iver; the int-:td:c the .fruedom to pl~tn. h 0 11/ll d n i :J-s rout in,::;.. rl1 h:i~; G nn l;e ~-J. diff:i eul t; experience for fHl iJ.u:u __ ~ te \·Jho hn~; ·been u;::(;d Lo hi~-; da:y Leiru:; ~;t.c·uc t~ur:c-;d for him.. 1l'he only co1lcctivt~ dcmnnd. mrdie on him in Le:crnr:-: of H(n·lt,.: is that he mu;:::;t r;hc~re in the dor:1C:f.>tic cho:cc:~·;; and fo·c this he 1:::; paid in canh* rllhc normal ~I';J_~ti~~ in th·:tt inm:_d:_cs u::-;naJ Jy pool thoir v-:eckly trJr-.tf~0s to SU!'Plcmcnt the:Lr Ulet ancl to 1_1u~·ehnEc other cxt.ru:_:;.., \~-Je r·ecogTtist; that n11 of theE arc-•nr> could be"' o-p~:·Hed. to abu~,:e.. On the few oecn.sion:::J th_.:t th:i.;~ br:..d O('CUJ·rl"..-1 tl-lf' '!Il~,,-._·.~-c· •---c-•'-,'JlClYlc~·r·t)·!r' l· .... _,l,,,_,,.l,-.... to ~c~·our,·t fcYy-' )-11·(-.. -::c-~-·•c)>Jc! to

J _ '~ '·· ') ~ .- • _ ., - ' ' ' • .>. • ..._ • ..J ~· , . _ •.• •-H-. \..c - • (-.. ~ "'--' • - .i. • • ,__, C" \.1 .1_ ~ ~J -'

tll('• ('0'""'1'(r·"lt·v '"')r' •>c Cjl\0 1-·'cl J·n the> "~co'+J' c•h OJ''J"r'<'" Fr·cc-c l''li1CICJ1lt ' 0 '74; ' J "''·•-. •-· 'v '-~'- -' {~>.J • • vl;-..~ -· ' •....- ~ LV " __ } . • ~v ,._)>) _., _ - .J.. ,/

'·if SC)Jil£~crte d.ocs no1ncthin~ detrJ_men1;nJ. to ·the comnrnnj_ty llc hHs to anGV!E'J.' to the: ecx:-u::unity an•,' it :L~-; no ~-;c~cret th;_tt the 11 hot sent 11 cu.n be, :Jnd i:~j. a h:.Jl'l'OVI.ine· E::xpex;,;i.ence and i~;; much more effect :Lv(: than ;;~_ny Governo1·' :_; punid1ment'. In concluc:ion it i,; :•orthy of note thnt nev. mem·bc:J·f; o:L stafE hnve to underr;o tlle same introductory mnchinu:y bt order to fc:•in eonfidenc:e in expre~3si.ne: his vie;·w. He) o.lso has parallel pl'oblc:m:_: of st:r.'tlctu:.~:-ine~ hi;:; ov:n ctaily routine.

ONGOING l'HCG''id':l"lL~). ----~~--------

There i.r:; no !:;tereo ... t;ype traininp; pl'Of'~rrunme laid dovrn for inmr~tes, :rather after the initial period the inmG te devclopr3; in clirJCUrJsion wi -~h the community>a programme 1-1hich is appropriate to his needs.

Tho;:;e needH can chnnge from time to tiine and in discussion with thr, commurd.ty, pror:ram11•e G evolve Hhich are Geen to bn of benefit at any riven point :i.n time.

'l'he :d.m of the prop:ranr:lG is to o.llov. for the acreed development of the im:t•·tr) 1

1_1 total pcrsonali ty and will include oqoortun:Lty for emotional deve1opucnt, the opnortunity to try and porwibly reject a vari<;ty of educ:cticnnl :md cultu;'al activitier1 :mdldepcnd:ing on sentence stnce, an appropr•it:lte pre~-relca~Je proe:ramme $

One of the difficulticro in clevelopinc; a proc;nEr.me is the uneerta:i.nty of how J'clear.e iE) :i:r·ranved .. It :Lr3 our t·elicf thDt- some inmates.would choose nncl benefit from be inc reletcscd throur;h tlw trad:i tionai prograr:nne> but it' is nlso our strong belief that there ,;hould be the opportunity for otlwrs to be re1cascd direct from the llni t.

f> Ul":Yif\ll Y. -------'l'he Secret:u-y of State in hin Gtatemcnt of l'londay 13 February 1978 said: 'it icc my intc·ntion th,,t the '·:ork or the Unit shoul' r continue mld that the broad prineipl en on wllieh the Unit hu.,,; been run r:hould be r;:,intained l-Ie hope th:Jt the ~iorkinc; Party in refcrrinc; to the ciceretary of Utnt:e 1 s statement above v;LLl aceept the collective exreriencc as out1inc-c: in thif:; do(',UHJnnt, from D.ll a;·:;~.oci~J..tod 'd_i:th the d::-tY to day runnin;:: of tl:e Un:i.t O!..i ;·Jci 1.1: t-f~ ··:o:·, n.c-.-·"'nP·: ,n 'q~··ic: f 1' ~-l"r• f1t":;n··p l'ln~·~~~r~l·tr.w- ~ ,,'

CcJ1:-; b_~:vc e1ect:ci(·~~1 J!O:int:.~._

N otc:

HC:tFl"~::r::;--; ... ~-~-~ .. ~--'-~

CJ(Y_~ 1BTNG,. --~·~-~-.,~--

VIf~~-~N-~ .. _,.._,_._. ___ ~ .. N(J; rc:_.;tr:i.etic:n.s on the nu!nlH~r of vi::;it~3.. A v:Lr:i t JK-:·~-:;s mu~~t l·e mc-tdc out by inu;-,·~c for eaeh visitor and. niv;ned by staff mctu1)er.. V:L~;it~1 take pltH in ccJlE"'

Visitor:3 nrc allo1·1cd to lw:i1;.g small amounts of crwh, food. rmd tobacco for inrn~_:.tP:-_1 ..

1.PET -~:r·t!ou:t~: .. ---·-~---.------

Itunn.ter; :1re rr11(YI·!ed to t~::.lk briefly to ineon~inf~ callers, under ~nlpnrvis= to eonfirm vir~it .~Jrrrrn~;:ener.t~_; ..

One surce•:tion for discussion is whether a pay telephone should be fitt1 in the Unit.

Vlt\GE:.:.~ ----Irmn. t:cs are 1mid in eallh £1.77 per week.

FOOD.

Dry rations eollecled from lfl:lin kitchen :i.n lbrlinnie PJ·inon. TheGe are S1lpplementc·d 1\Y inmntcs cornl)in.i.np; thc·ir \•Jcokly \-.rageg in order to mak_e a more intc:r:e::::;t~YlG diet. lin inmate:. :ioes the evolc:Lnc~.. "-

IiEC::;,;;\'l'JCN. --·~~--

Billiards, darts, enrds and coleured television nre available.

1.l'hc:rT: t:_: t!.(: cv11, ~:t \'"' 01' f:eL ( t,L \:c: ;:111,, {.l;\'/,. ;,-;(Y!'L 1~-' nn :i.ru.!_!-..Jidu.:.d. (:hfY1cc: .\rt;':l (}l)t-·iJ UnLvcrr;:LLy, - .\i·qc:tt-iun.:·t.t C ·:Jt·::._::.,, '--.-00d\',·cu·l.':l ;_;L'<-J_f't~:; 1 :i 1

(. 1: ;-; "

r11hcr:c· .. Lfi

. t:Lc·:,y,.

fE~:?.~:l::~2- ~

U.run-:·-, 1 c~; ·i nvoJv!_:c~ :in ·i 11dividua1 !tn~<{~ :.':_;;_:l)Cn _::i l·il_-~t;y- :for -r.hc:Jc ~

tcr~:~~-:t:3 v1hcre th(;:t(~ ;:; the v;-_;c o.f tco1:_:~

~:~~t-l(:J'·(: ir·-; no (1at1y ~~ liAdO'd l;o:~-~ ,:i. ~~h,-;c·t ..

Al:~. e;_I~.cLpmt}H t; to due~)r:::.t-:(:~ in~nn. Le:;' cc] ~!_;.:;, the use of electrical good.:-:5 7 clot hi ne; cte.. ;_.,:.ce al.L pald fo.t· by the: :l.nmn tes.

'l'lk co.lonreJ T . .;:tcvi~;ion is po.id i'oT, by vrcckly eontr:Lbution from staff e.nd iJ!mntc~; ~

..

rphc Un~_t f..>L:-tff ~-::ce mu<~e up frc:u r;n1('::-~-te(::]~ in t}H) Un_i_t :.~:: ;~ r:o:-: _ _n~; 0 ., "J1'"'(' ,-.\.-1 ,, r-, ,t :'} ~:·t;t h:llJ_(~_ ~ tho dcl,y-to·~d:J:,t ~/!orkinc: of tf1e "Uni·::: ~--;-~~--~' :i_-~~~- .:f;l)::ncr:-·.l vhil o:;oph,y ~

li'l·1·i ~· On"''OI' 1'1'nJ' ty 1 . .-~ ,-:··i v·c.n ir~ r).t·dt:·r: Lo ,.-.--.:L·vo f)taff n. ch;_:;nce tv u.UDC0f) the .... ~ -~- ,_) . ~-- - ~- c. . _, . - ·-- . ,... -- J • ...

pot(:nt:L~ll of the Unj.t ~1D.d nl:::~o :'.8 a T:tC<.\n::; of givin;-~ indivjc:ual~~ ~~or:i8 idea of tJh:.~t i::; exy;eei.~cd f:cor1 :>tnff emr<1 G.Jed :in the-: Un:~ t.,

Vol untce:c a-,_qJJieant~: nrc ::cJ·c(~ncd fo:!·· ::---i tne~:}~:; to '!!ork in the Un:i t by In0::tn~.i of di:t•,·;t_~ t interViC';! '.\i ~;h a 1:o·::(·c: CUH~po;_;cd o.f H Con~n.tl tnnt P~_:yehi~lt.r·i:.:t .:J.nd Psycholog:L:-.it and the Un:i.·t Go\lcrno:r_· nnci Ch:Lcf Hur~~e

z Officer.

A crit:LcnJ :factor in the Uni.t 1 r: :.tevelopn<ent hn;: ·been related to tlh) ctn.ff:i.nr; i~·:Bue~ 'l1ht:: _princ.ipJc of t}J.(; i:;tnf.f be:l.n['; nt~lcctc:<l f.r·om volunteer;; :L~::'"'con:-;idc:r·cq vital to tttc 01it-:rnt·i_()n:~1 rc(lUil'einents of th(; Un.i t and indeed, it hac been con:,;:l.:3;f.c.:ntly cuggc::;tccl that the Governor should also eomo frorr. tho,>c: who vol untuc:c.

\ye colW.L<kr it ec<Eent:inl th::t .,.:taff continuity should be prer;erved and \ve concur vlith the vicH tl'X.]'J'<'''"ed in tlw :_.:orking P;orty ileport of 19'?1 which DU[TC,_:tcd th:e.t thoro mw~t lo on:Iy limited movec:ent of Gtai'f. l·!e are of trw opinion th•;t Etnff v.•ho v1:i.sh to lcavo the Un:i. t c;hould be nlloVH}d lo do so 1 l)ut v1e [.:.rt~ convinced th:-:t there r.nu-;t be no set 1 cut off 1 time for individual len.•;th of service in the Un:i t. Our expcr:Lenee tenc!.s to prove thht the best value ;~a:inecl from individual ~;taff i~: provided by those '&ho have the benefit or a fairly long experience of ;.·ode in the Unit.

Ar·rENDIX G.

ADI'-1ISSIONS ..

•. J<urther to the 'E:tat(,ment de,,cribed in the admiusi on of :Lm:,,tcr,: to the Un:i t, it should he rcmerr.h•.:·cct th:l t the Uni,t 1 s aim :is to provide a service for the rc::.:t of th0 E;y;;ter.l nn<c it is a matter of concern that more use is not made of tho facility p1·cvided.

'rhere haw,, in fact, h"en 16 admissions to the Unit since it opened: "10 servinp; indeterminate sentences and 6 scrviYlg determinate sentences. Of these, ? are still in the Unit.

(

--,-r- .,, .--,r } I :

the cr_i_HH-: of

vulrlel·a.l>iJ.J.t:/ of its mc·::n:t•ers pn_:c·ticul:;rly in 'J'CL:-,y:d to

Pn.rty vr,_~-; th~-'rr-foT'e ::.let 11p \-rithin l:lte ;:.cot·tif_>h Hume :Jnd

Health lJcp::trtm(;Ut to coru;:i.der· the t:ccn.tment ot' eertr~d.n male

lon~'/··tcrm pri::(Jner:.:J and potentia] 1~y v:iolent pri!)OUPr:-; ..

of the~ ~-_-:.cott:i ;;;h Pri~:;on Hnndqunrt;er~;,· a con;:,:.ultnnt pHyehi;_.:ttr.•i;:-:.t '1

tHo nr-1 ~•on ~·-cvernorn c-~nd rc_present:~_tive~3 of the Lcotti!~h Prison

Officers Associ}ltion.

' '11ho \.Jo:r:1~inc; Party took oral evidence from senior medicn_1

r;ovc~:norE in the follovd.nc

in:::>titutionr3 ~~ Perth Pri~.;on, Peterhc2td Prifion, Inv(•rne~_;s P·rison,

Pcrkhu;·;_:t Pri~:~on, 13ro:-~dmoor Hor;pitrtl, Grendon Unde-r·\·roo<.l P:cinon ~ ~

and the ~tate llospitnl, Carstnirs. Pr~ctice in other countries,

p:u•ticul,:crly Jlenmilrk, where capitol puni~:·hment hus not •been

used for vrTy rnr1ny years, vms ,., lso r;tudied.

The Problem. -<----·~

Violence in the penal setting ha:3 existed ar; lonp; as prisorw

have exi::;ted. 'l'h:i.s ir; underr;tandable since vei'Y few men will '.

accept lightly the losr; of their freedom. 'l'o that lot>G they

may react in many different wayB of which violence ac;rd.nr;t

themselve'>, their felJovl pr•ispners or their custodianro is

only one, but it can be considered as the moGt serious.

It should be recorded,however, that the incidence of violence

in Scottish prh;ons is, comp:u:·ati vely speakinr:, very small.

'l'his i" all the more remarkable \·:hen :i.t is considrlrecl a[jaim>t

a penal population 1~hich has incre<:\r;ecl stoaclily since the ,end

of the second world war ;mel the increasinc; number or crimes

of violence in the community over th<? same period. 'rhe problem

of prison violence i~; very much a personal one, specific to the

individual who is violent. To

label for thitl type or prisoner

attempt to produce an omnibus

Houlcl not only be mh;leaclinc;., but

c..ottld l t; dn_nf-':C'l'OU~_;, ~-dncu pconlc! '} ;-,n-< perb:rp:; ·nri~>OYL(:J:!_-J in

p:1x_·t-Len:t nr, hc~vc ;-1 tendency to tr;y ;~utd live up to tl"!e

rCJtUtnt_i1'11l (o:e 1~-J-Jc1) pJn .. cod on thcu ty otht:J:;-; ..

\lith the abolition of capi t::J. punic;hnent tlFo :;cct ti.~Jh Prii;on

Borvice h:-td to ()_ecept th~··t it ',iou1d be ca1Jcd upon to kcop in

cu::·, t oc::y ~; or:1r: IJC :r-nonr: ~:;en t cne ed_ to :i n.d ct (; rw:~ n~·\t e JiCI'i od ~' of

dt::tcntion, fo.r_· vr:r;y- lonr·: te.:c·m~;~ i .,f·: .. - in t:Y:ecsr; of twenty yco.:cs,

the ~-~<-:rviee h:.:c:_ no l:xperi('nce., Ho~·J v:i11 a _pr.if;oner ro~Jet h'hcn

he rerdi::-:en thaT. eventual :r.·oleaue iL un1i1<:oJ.y or,at 1;~:~-:t,is

· 1'.1 1 ( ,'-... <! <;-

In thr: 19th cent11ry in LngLtncl and \.'ales violence tJY "~ priuoner

\'WS uc:ua-! l':'f met v:ith violcnc c; in the form of corpoc·al pun.1 Clhment.

This,howcvcr,did not apply in Scotland, where, until the setting

up of the Prison Commission in the L'.tter half of the century,

prison~c> eiere loudly admini~:: tercel and no utatuto:·y pm·;cr to

inflict corporal pun"1Glment on prisonel'l5 for offences nc;ainut

p:ci r::on di Dcip1 inc Vletf3 available" 'rhe ui tu.c;tion was al tcred,

but only in a limited fashion~ 1dth tlle opening of Peterhcnd

Prif;on in the l8BOt::i.

1'he building of Pctcrheacl Prison vlas authorised by an Act of

Po.rlJ.:c,mcnt, the main· purpose of which was to build a lw.rbour

of refuge at the fishinr; port of P.eterhoad and' for which convict

labour wan to be u(wd. Pctcrhead Priuon vms therefore operated

under the ruleu ;,:h:Lch A.pplicd in English convict prisonu; and

one of these rules empol'tercd the then prison nuthoritir:u to

inflict corporal puni::;hment for eertuin offences ngainst prison

discipline o! which violence to ~embers of the prison staff was

one. In the 60 or E>O yearu for which the power to inflict

corporal punishment •tmu 11vai1able it was seldom used ancl fell

into dinucc after 1933,althour;h it \'IHS not finally a1)olished

until l':Y+9. , ]'rom 19Li-9 onwards acts of violence by the i~mate population were punished by variouu means such as loss of

remission, forfeiture of privileges, deprivation of a~Je>ociation

and pcrhapu restricted diet. Th<' heaviest penalty of thene

was forfeiture of remi~3sion since, in serj_ous cuses, pov1crs

exintcd to deprive the prisoner of all remission and,in the

r1t G:cendon Unc:,,~J'\'/ocd nnd the !::~peci;:\1 ho::;r;i tal~:> r.1.t .Eroc_;dmoor

and Carstair:J ~ In ::Hjdition the eh11:LrJntn1 of the ho:r·J;;::i.ne; PHTty

had the opportunit:y in Jurw 19?0 of study:Lrw DD.ni,;h r:tcthodD

()j, ·'·"r····ti n••· ·1 ctrt•"-'·r·rrn Jl''i•:,..,nc•J"" .. Lt .. -'-~ .•• (l ......_. (.) v --- -. ~-\-~ "'-' ..

Vurd <t.:.;ncnt ~n·.d t·ce:d~rnc:nt <}

--~~·~---~--~--~-----~---~-~~-~-~------

Genern.lly np<:al·inu; the rmbl:i.c con:;iders tho.t ttw function

of tlw priiJOXl :i.:; puni"hment. Pnni.:Jhmcnt or offenden-; iu a

funetion of the eourt. 'l'he p.~·ison has tvJO funetionr;.

'l'he first to implement the puni <Jhmerrt; imposed by the C(JUl't

by d(;pri virJ,f~ the offenL~t:r of hin liberty. rl1he r;econd., equally ' important and much more difficult, :;o to tr·e:tt the offender

tlwt he will lead a 1 f~ood and uEd'ul life 1 on role ewe. vihere,

however, tlw reaction of a per~; on to imprh;onrnent is cmch that

he commits offences within the in10ti tution, tho pri~;on w:LJ.:l .. nppCcli' to take on a pu11iti ve role. And yet thin puniEhrnen t,

in so far aa it Eeeka to pernuade the pri10oner that his laek

of eo-oprorntion is unlikely to assist hh; rehabilitation,

docs k1ve a reho.bili ta ti vc · clenwnt. But where the vrisoner

reacts to punL;hment 1Jy committinr~ more serious o.ffenees, the

question ia raised whether thi:.J form of treatment i.E countcr

producti ve. In accepting that there could be no e:wily

discernible line bet\·lecn punit;luncnt and treatment 1 the \forking

Party :oour;ht to cc;tall:Lsh why certain prisoners behaved violently

in prh;on and to consicl er, from the :i.nforma tion gained, how sueh

violcnec mir~ht r·e eliminated pr, at worse, rcdueed and eontaincd.

'l'he ';forking Party' t> enquiries ~c;uggested th·: t there vwre a number

of eauGE)r; of violenee. Decpair and frut>trntion at the beginning

of a lonr; sentence arc not uncommon causos,but violence caused by

these tendt> to ·be of a minor nature and clisanpears nftcr \he

first year or' BO when the prisoner Bettles clovm. 'l'he immaturity

of tho psychopath, or some other form of personality diuorder~

ean manifect :Ltnelf in serioug violence and VIhilc the degree

of d:Lnorder may bG im;uff:Leient to vmrrant tranr;fer to a mental

hor;pi tal the ~iorldng Party felt that some provision ;;hould be made

In the vie\'i h'ns: ;i_ ercrd;J on of thf~ pr:ir·on ~-~ul.J---cuJ.turc ·Lt:;c::lf., t. notor·io1J;:;

crim.i_nnl cotnmttted to pT'i::-'.on innnt·(l:i<ttc1~y 1·c:eomes r:n ol:jr:ct of

reupec·t nne) aJmir3~ion l1y the~ Jcc~or cr·in1in:1Js in the prison

popul.8ti.on~ If he wi[;hes to 1·e·tn:in th~1t rcspect>jt is necessary fr,.r· ld m to demcn:_;t1·td~e t;h:--!t- he :i :; n_mone; the top men in thn p_c:i.uon ..

He m·ly do thi~--- 1~:y cb.:-'lllenc)n£~ thf' c-:.:i~~t.inc; leader or lca<leJ·;:.;')tut

rnol'e li.l{~:ly l)y c·vc-:rtact.i.onn ag:-tin:_;ltbc pr:i..non authc:cit:\.c~}.. 'J!he

mor·r~ r:;cJ·iou~:; tl1e offence, the r':r-c~:tcr rer~pect \·:ill bo · nccorded

l ' \. 'c• f' ,., 1 1 ' ·n -,·' r·oner•e y I)L, - C.L 0;. ,.J _L._, -, ,,. Hov;cver, lw v1ill Gnly u;d_nta:i.n hir:

position 1y frequent dcmonst~ation of his prowess; by acceptin~

and n:eeti nr; the demands of inmc-~ te Jlres~_:ure.

'l'hc adm:i.~:sion to pri:;on of n notor:Loun criminal i:l nlso carefully

ob:-::.crved 11y ~~t~d·r.. If, a~:; a rcuuJ.t of inew.te pJ'eL~:.;urcs he bchnvcr;

as s.bove, or even in nnt:Leipati<'m of any trouhlP, :;taff ~>Jill ([Uite

r:Le:ht1;y keep a ve:r·y close ',vatch of £;;uch a pri~",oncr.. ;.::uch elo~:;e

:;urvci::!lnnce way well b• seen by the prisoner. not onJ.y as • l. 1 1- ,, f ~, .. f ·.-t--' ·~~'tO:--. li'rCf~G11F~, :HJ"t::; <. ..... OJ.m 0. VJ.Cu.ln1lb(j._ -.1.ull, in other word:;, staff

prenEure. The \-forking Party cauw to the conclusion that some

menno; had to be devised of placinr" such n prisoner in n settine:

v!lwre rccuch pren:•.uren could be reduced thereby 1\'cH;eninr~ the chcmces

of violent otrt1Jrc:ak::-,; ~

In concludin!': their report, the \:oi'kinp; Pnrty incl udecl the fo~_lowing

reco!I1Rwndations:-

1. A special unit should be provided •.dthin the ~icottish penal

system for the tre:ttment of knov:n violent inmates, those

comlidered potenti:o lly vi o1ent and selected long term inmates.

2. Adequate v:orking :md recreational facilities should be

provided both internally and externally and the unit,as a whole,

should be completely Gepnrate from the main prison.

). lnitiaJ;lY the stnff to man the unit should (le recrui~ted from

voluntPers.

4-. f.ltuff should be a mixture of discipline and nurnin" officer~J

1-:ho, except for strictly nursinr: duties, v:ould be vlholly inter-

changeable.

5. 'J~he Unit nhould have its own Governor v:ho v:ill be independent

of tho main pri[;on and his appointment should be mflde well in

advance of the openinv, of the unit so th!lt he may con~idcr nnd be

involved in tho trn:Lnins of the staff.

()~ ri'hc· Govc~:'nor ~~:hou1d lH: elo~~t~]~.~ nuppoct~:\:_ -hy (' c.un~~ 1J1t:_nlt

p:::ychi;;l:r.i.r~t cmrJ.oyed on a pnr-t., t:tmr Y<;s_i_s ..

'7. '.l'hf), ncnior l:lCtnber of the uni1:.'o.r·mcC. ;_-~t~-d~f ::;llouJ d l'e H chief

nurf30 officer.

n.. rl.'ht: ch:i e.f nur::;e offiecr nhouJd 1H~~ ~::.:uT)por·ted ·r,;y t\-,~o princiJHll

officCJ'S and t'\'JO ~:><~nior o;·.ricer::;, one of cn.ch of v;hom ~;hould be

rll-'.c~;c t:t~ained ..

nnver lefJS than 11. off:icer" on duty ''t nny one time.

9. <>tuff shou}d obtcd.n experience i.n tlw trcntn!ent <)f the

r.wnbd.ly diEJordcred.

10. Hepl ncem~ntof f>taff f3hou1d be c;ro.duc;l am' not more than t•11o

at any one time.

11. '.l'he traditional officer/inmate relntionnhip Dhould be

modified to upt\J'Ox:i.mate more c}o,;cdy to a therapi,;t/p: tient

1 . f' ) t . ' i" ' . f . d' . ) . f· )aGJ-~3 :or re ~a:trung a :trm I)Ut _·nlr _ :LSClp .J-ne s;y-~;\:em ..

All of the l'ecommcndatiens have been implementcdjalthou[';l1 not

necesBarily in the form envisac;ed by the viorkinr; Party. Thn ...

preroent unit is housed in vJhilt •me; formerly th(" \·:omen 1 s flection

of H:;rlinnie Prison. 'l'hif, accom:nod8tion is fr:r from ideal

but from our experience of operating the unit in lesr; th:cm

satisfactory conditions, the deuirsn and lay-out. of n purpo,;e

built unit can be deviiled.

'L'he recommendations of the vlorkinr; Party v:erc accepted by the

Secrct~try of ntate .. After inve,;ti[~ating various po>;sibli.ties,

it waG decided that, to provide the unit as quickly aG posr;ible,

the former v:omcm 1 s section of Bsrlinnie l'rifwn should be adapted

for the purpose. ''OI')c started on the ndaptat:i.on in the early

autumn of 1972 and was completed in· Fobrunry 1973. 'l'he Unit

staff intervieHed and nusessed those rlrisoneru who had been

recommended as suitable for such a unit and_,by the 'her;inning

of !•larch, five prisoners had been transferred to the Unit:·

InitinJly the relntienships betHeen staff and inmateG v:as strained>

but th:Ls wau very soon overcome e.nd the mnjority of inmates

became involved in the paintinr; and decoratinr; of the unit.

A basic· concept of the unit h; to involve the pr:i.soner not only

in his own trentment,but also thnt of his fellow inmates.

During the 1El months that the Unit has been in oporntion the

involvement of both staff and inmater; hn.a developed to the point

thnt they no,,; ree;:1I'd thr:m!:;c:Jves r_ ; n. c:i.nf:Jc- comt:'1Hni ty \-;herein

e:iC!i he:~-: cnu·-J] V(Jtj_llf~: no'.-,'c;x· ;-)_

!~H:•:r:·:_('l'~-; Cf !;111:-! COJ:lH!UI1ity a:t'C ;,ccuunt:~i :~c t~O \.:ht~ \'TCt',z.:lJ' GUC::Hnity

n:ectJnr-: r~nd in the ',,!o·;·d:::; of nnr:· of the Jir·:i<-urtcr;:;; 11 _1_1' r-:owecnc:

do(:.~:_; ~30J!lf3 t:hi.ng detriucntu1 to the~ com:nuni L;y he ha~-~ to unr-;wc:r:

to t;lH~ cotlfntu.tity anct it i~) no :::ecrct t;h:1t the: 'hot ~::t~TL' c:.~:_n be,

and i~o, n har:r'O\·d.ng (-'!Xperiencc nnd i~-~ r:1Uc~h rnore (d.'i'ecti.-ve then an;y·

Governor:' s puni~~hment .. 11

Imprir,(mr.tent doeG not onJy deprive a mnn or hie 1ilwrty, but

l:;N;rmse he mm•.t confo·:··Ja to the rnutinf; o+' r1n :i.n~;t:i.tnt.ion, it

<"J.lEo deprivP~; him of the n~~cd to take many of th{·! deei~ion~)

which are an every-d;ty part or lifl~ ouLGide. On the other

side of th<~ coin, s tnff ure accu[~tomc:d to mn}:ing the doc.i~";ion.s

nnd l:nvin['; tlw inmate'' curry them out. 'l'hercfore, both nto.f.f

and inmates had to adj\Wt ther:welves to a coi tl.w.tion vilwre nll

were involved_ j_n the docision-makin(~ pro~rcss. to Lhc q1.w:0tion:i.ng of many lonr:-nccepted prison prneticec;. 1\n

example, eax·Jy in the experience, of trte Unit, vnw the rme;r>;.E:c.:tion

that the "[>ilent enlJu (dec;igned to hold recalcitrant inmates)

r;hould ·be done m·:ay v1ith. Some of !he ctaff ·:~ere anprehenr.d.vo

al,out thic becauCE' o~ the par:t hintory of r;ome oi' Lhe inmate;;.

llov10ver, the J:wjority 't~as in fnvour of doinc; Rviay 1>1:ith the cell

and nfter the Jll(Wtinf~ the door of the cell VIHG tnkcn off its

hinges. At preGent is is used as a weight lifting room.

IJ..'he nned {o:c .its orie;i.na] u~~e han not ar:u_}en$

The inmates 11re, so far as the phyGicnl limitntionG of the unit

allov1; encouraged to deviBe thPir own 1-:ork pror:rar•:ne and their

own hours of work. 'l'his has ref·:ul ted in their v;o:·kinfj lonc;er

hours than urJual and in a hie;her standard of' work. ~L'or;ethcr

1'11 th staff they have dravrn up their recrention proe;ramne \·thich

relies heavily on outuide

Other forms of recreation

speakerB from various walks oi' life.

involvinc the co-operation of outside

experts have resulted in one of the inmateB, who is both the moGt

notoriouB and most violent, dincoverinr" a tnlent of a very hit~h

order for sculpture, and this i,; beinp; encournc;ed. •,

It is not yet possible to draw m:my conclw;ions from the opc•ration

of the Un:i t. It is rcmarlwble, however, thnt since i tr; openine;

there have been no SiTious asr;:mJ ts on staff nnywhere in the

Scottish priEon Dcrvice.

What the Unit holds for the future.

So fnr as c:m be ancertnined, the Unit lG unique in penal prnctice.

ItH ex1wrimental n::ture \·:ill the:t>efore eontinue for some con"iderabh

;--_:

,,_r·

Un.i.L <.;~,_;,;-;.,~::J.i L,::t tc:c~ 1 y j_:1cicl(:n-;.:;;

op~~-c into

11J'r··i .-,(l·ic i;\j-,:;p·-r~v 1 b·t -: :~ho-·n Ll;c vaJuc cJ' ut:iJ_·~_; -~Lf'_: the:: -~)revicu.~_; c·/;:(:;;:~ic~I~C(~;_.;'-·;)([:r-~t:hc-;·.~:_; 1::ho 11:··vc \_:L!(!ex·r:ni~·:: c:c:i ~-~c~; ;:itu:_it:Lou:~~ in h~,-·ln'"l·•· l-}H,.-~c· H)-lq ·,·,·~· P1'P··t·nUl1-··qc'(•T'?'·n·:r:-'" Lht?L~ :t·~ \·:.J~-: felt

''·,_,·-'-'~i, Ll.-'•:r ''',' '-'--'·•· 3 '-- '~·· ·~ .. :'-':'-'--t_-,<-'.:'-.1 _ , • ~ ·l~l't•;~" '''"-j'l'ln·'·i-1''~'.·-· 1'j]'''"'·")'''"·--·~-t--,~Jr" ·t·t··----.-· ... ,-,,-,,-,1 c·h·-,ulr 1 1-r, p-v-·;(11''!t1C''')·"ed "~ --·-'-' ,,,___, l.-.- L._, _•,i1: __, '"'-'-~- ,~._,_, ·-·~-'-J (> .- !.,_,_, J.l , •.•... ~-'-·\ -'·'' ,;,_ - "}-· · •- . · •'-'-' -·

vtith to ru ;;:t-_:~:;:_:; ·Lt~: induct:~.o~1 v:~:Lu,:·. tut t'lr:t feu:~' ':.'ord_d b.:) the -. · -~~-..--' :t. _._-, t·,·· '--~-,~-..--.- .. -..... -........ 1 .,.;-.,l··~(-r\" c·-,.-.",.,..,,.1 -I·J·t·-)· ,-·n nu:!tCCJ' :tf1"~/\)_,,-.-l:•J .l J L!lC ,L\.1-L.LI..J'/;,!J_l~_--, J.Jt;_l J.•V.·\;•_,v. _) :____, -'-'-~J'I..,).l~---'---- i.J I>.

':.'h{~tht:I' tt lH~\·: pri~JorH:r or n nr_H;,r ;-:;t;d-'J' mcn~t.H:r is t:~·tc ~--n;l·Jcc':.t ..

;:,xpc:r·ic:necd ~~t.~11'f

P_·:-_·_i :.3oncr <~

(b)

T,'vr·''I'l. <··,-,,.., ·,cl l".·rr' ',',OTI\'·'' .l .... ~_-}c _-. --'-'· .v~. __t -

~Pl'ln rc:centJy ~~-Trived moml)r:r E)hoUJ(_~ h~1vc vracluntcc! from hi~~ '1.1-~Gr(Ll.p' ~ 1

.i-_1hc rnt i(_1nr: le i~) th ';t a 1:nlnnce if_~ mn inta:~_n(~d ty

the ex1:(-;riHn~c~d ;::,t(·:.f'f c~nd pPi;;cncr \·rL th pOEGi1)ly the more :r'eGcnt ,.,-,-',··t·J·ir·\·.·. ·in ('J" i:}"<' C'tJ~',_,-,·L<'I"<·'yl+·,~,T')r ;,-.-,--.--.ll'J r··c·r"hc-·r ,._") • I ' .. .!.. •tJ --'· j l. ~' ~,<Ill- '•-' ,_,__ '-' ·-~ ! ,' t_. 1- U ;j- ~ • »

Prior to the n:r·rivr1.1 o.f the nnv! r:1er:1bc:c or the COLil:lur:ity, the three cxi~:tinr.~: mcr:1-bur::i oi' the ''1 Group 1 aTe dc;_;iFnated c.tt :: mf;etingl> rr;·it-: taf_:k f--nd ref;9on:·_;ibility of the t:;:.:·oup i:J t 1:/0-··fold:

(l) IJ:!L;TJG'-L'IOlT: ----~-·-

'l1he ne\'i(!Omt~r iB introduced to the~ daily pror'·r::n:Hnc and the nvents in the eo:tmun:i.ty.. HoJ1o':liD? n:ip;nific:1.nt cxpQr:icncc~s, i~e<) cor:;:·nun.i.t;y mcetin[~~3, c·tc .. , it i.~::; l~1e re~;ponf::ibility of tlH-~ ;~roup to expJ:.cin 'c:hat; ho.e h:mpcnnd in the ccnt(':Xt or the dcvelopncnt or the Unit~ 1l 1be ncv:comor should" l:-e mnde to feel free to ask nny c;ucr.:tion:: lmt it E:lwulcl not le nr'EUlnf:d th:\t r;ecnu:;e thr:re are no :·:ue;;tions th::t t!wre ir; not;hinc to be exp1nined a:> there ir; D natural re1uctance to eppoar if~nor·rmt in mo:;t people.

Another· vitfll function dur1.nB the initirtl period j_s assesf;ment, i$e$ idcntifyinc: any proU.nms v1hich nay neccl to be conr;:i.derod to help the nov1comer :;ettle in, any interestn \·lhich shou·l d be oncourar;ed, rtl1.)' pen;onal difficulties in adjtu;tine: ·to the Unit etc. rl'be :length of life of a p:·rt:Leular ''1- G;·oup' Has not fully detorminod but it may l:e th:;t n t lea;;t once dn:Lly durin('; the first mc:nth t:houlcl be the minimum with the length of the :;es;;ion detcnnined by· d;ti1y contingencies; follo;,inr; that at lenst once weekly or more if it js felt of value in particular instances during tho next two mon trw.

APPFNDJX 2:

I,ist of individuals contacted duri.nr•; the Plnnnirv•;_:;nd Executi~~.of the 'h:in.

A. Oversens contacts:

Hegional PBychiatric Centre (Pacific) Abbotsford, llritiBh Columbia, Canada.,_.--·-------------

Dr. Chuni Hoy, l'ledi.cal Superintendent/Director Mr. Roger Marceau, Research Psychologist l"lr. John Boileau, Actin(.'; Assistant Director of Security.

Department of Criminolor~ Simon Franer University Burnaby, British Columbia Canad=~a~·------------------

Professor Duncan Chappell Dr. \.Jilliam E. Lucas

Regional Psychiatric Centre Kingston, Ontario Canada

Dr. H. HroVIn, l'iedical Superintendent/Director M "h II. 1' . I' . . 1 J' l 1 . t nrs .. o aron ~·~1 '.l.all1'5, rlDClpa .. ;;;yc 10 .or;:t.s l"ir. c. ~·urner, Director of Security.

Hegional Headquarters (Ontario) Ministry of the Solicitor General of Canada Correction Service of Canada Kinp;ston, Ontario Canada

l'lr. Hoss Duff, Hegional!1anar~er ot: Security.

Correctional Staff College (Ontario) l'linistry of the Solicitor General of Canada Correctional Service of Canada Kingston, Ontario Canada

l'lr. 1'1.Eo!1illar, Director !1r. C.Q,. Burton, Regional 'l'raininr; and Development Officer

Federal Bureau of Prisons United States Dep<J.rtment of J'ustice Washington D.C. U.S.A ..

•

Mr. J.D. Williams, Assistant Dircctor,Correctional Programs Divisio: l'lr. George Diffenbaucher,Executive Assistant to Mr.J .D. \.Jilliarns Hr. Hobert PO\d.tzk;y, Chief Psychologii;t 1'1:·. Gar·lanc Jcffern 'l'rainin ,. Prop•2ms Development Officer

\

AwJtal ten ved IIcrGtedvcster IlerstedvcEtcr) DenmP,rk

Dr. Marianne i3chiffler, Medical Supr:rintendent Dr. J ¢rc;en Ortmann, Psychi:: tri st

Dr. Henri van der Hoev.en Kliniek Utr·echt, _'l'h_c_:t£<:the rland"'s'------~---

hr. J.R. Niemantsverdriet; Director

Pieter·Baan Centrum Utrecht, 'l'he Netherlnnds

Mr. Thco van Iorsel, Psychologh>t l"lrs. L. Laverrnan, Social \4orkor

Institute of Crirninolorw Un:i.versi ty o.f Cambride;e, C_n.rnbrid r;e, Enr~land

Dr. Donald J. Hest,Professor of Clinical Criminolop::y l'1r. Nicol 'dalker, vlolfson Professor of Criminology and Directox·

.. o.f the Institute of Criminolop~y.

Radical Alternatives to Prison (HAP) JJondon Ewdand.

Mr. Tony \-lard

H.M. Prison Grendon Grendon Underwood Aylesbu17, Buckingharnshire Enro:ln.nd.

Dr. R .L. J illett, Governor/l"ledical Superintendent Dr. Brian J. Barrett, Clinical Director Mr. Stan Smith, Principnl Hospitetl Officer (F. \ving) Hev.Paul Hobson,Chaplain to H.M.Grendon and H.l"i.Sprinr;hill Prisons.

Broadmoor Hospital Crow thorne, Berkshire Enp;}and

Dr. P.G. l"icGro.th, Physician Superintendent JVIr. D.A. Black, Consultant Clinical l'Hychologist, Dept. o.f

Psycholoa Dr. D. 'l'idmarsh, Consultant Psychiatrist.

l

Moss Side Hospital Ma~hull, Liverpool } 'n ··] "n" -'- {, .(-, u

Dr. 1'1.P. Neill, Chairman, Hedical Advhwry Con;mi ttoe t1r. J. Eric l'ostler;, Executive Officer, l'lc::s Side and Park Lane

lloGpitnli> l'lr. Barry hshcroft, Principal P,;ycholoe;ict l'lra. Sheila 13cott, Pr:ine:i.pal })ocinl \/orkcr Mr. W. Carter, Chief Occupations Officer Mr. J. Stewart, Jlivisional Nur~;ing Officer l"ir. G. Knock, GeniOJ:· Nurrline; Officer

Park I,rme Hosnital Maghull, Liverpool J::nvlnnd

Dr. ~1i"lcolm ,T. l'lacCulloch, l"ledica.J. Director l"'r. Brian Pedley, Chief Occupr• tions Officer l1r. Dominic l'lurphy, i)enior Nurr;inp; Officer Nr .. Norman :Pearce, Benior NurBing Officer Ms. ;r anet Maher, Hend of lJsyeho lo[';y l1r. Joe Gmi.th, Conunissioning Officer Mr. Brian Davies, Commissioning Officer 11 D tl B . lb C t · 11 M Side and Parlr Lane ·rs. oro .1y 1.e y, a er~ng ",annger, uoss ~ ~

Hospitals

Scottish Prison Service Scottish Home and Health Department St@ Margaret~s House., Edinburr•h Bcotlnnd

Mr. Richard c. Allan, Controller of Administration ~1r. Alistair 'l.'homaon 1 Controller of Personnel and Services

Parole Board of Scotland St. Margaret's House, }~dinbur("h, Scotland

Mr. Phillip Barry; Chairman

H.l'l. Prison Low Moss Glasgow, Gcotlnnd

Mr. Ken Murray, Principal Nurse Officer

Special Unit, H.M. Prison Barlinnie Glaap;ow, L>cotland

Mr. Andrew Gallar;her, Governor of Barlinnie Prison .Mr. Alec 'l.'homson, Governor of Special Unit Mr. David 1-JcCallum, •)enior Officer Mr. Malcolm McKenzie, Senior Officer Ns. Joyce Laing, Art 'rherapiat I'Lr. Jimmy Boyle, Eesident Mr. Bob Brodie, Resident Mr. Peter Campbell, Hesident Mr. Hup;h Col1ina, Heaid.ent Mr. John Elliot, Resident

•

'·

191.

J1 /1.lg I~/;.!;J;: 1In;·;p:rri1Af) - Fll:\!·;r~ I Pf\i:v.J;:::.1 .... --·•··~----·-·---••••__,__, ____ ~-~---•-·••--·-~-··-·~-·v-·--~

rHU~ 1fO~-~Pirl1/\I1 enci l~c} eel ·uy o. \-lttll G;t:_ met:('(~D hidt toppe:ri vri th r:.- {;~111de:l' b(;t:d vn-ti.'""" ;c---~yj·;~:~?·-~-J~~~V~iee (~-~1 rt" to·tnJ) \·rill rn·ovide nur::;ing r:tn'-t: nnd n. i\tll rc:nl;c of' p:.;ychi~1.tric :;crr.rtce::; for the tn:attnr:mt of ,100 DatiPnt:n in fl. vcr;r ~>ccur(~ environ....., nw~t" Tt 'i·ril1 ·o:t'(•Vido IT~tch ne(•.C._ed. rx.:J iel to ·u~,Jr;_:J.1:;~our ~;recla1 Hor;pitrd. '·:here t~wrc are ot;:;..i'fi_nf.~ end. ovel'Cl\)\·:dinr; problc:mro: ..

f'!r~~--I is tnt\clc up of 2 v<}..:i :c~3 of linked '·:i:t"Pd}J nu.mr:d as 1rill l~t) nll the later . one;") ~\fter PI'OBJ:i.nent fig-nres in }J:r:1if-~h litcr~::bn'eo~ rrtw linY.:iltfr. of 'lanlf;' pc:ttnLtH tho clor:ing do\·;n of one exnl the coneentra.tion of u.ctivitii"!H i11 it:--.: nei{~:hhonr '·1hcn tlw lnu.jox·ity of pati('n-t~; nrc olset·:he:cc C{~ ut V!ol'k or J·ocreution, r.rhit; ill tun1 relcauo!J 1-zu..rd st;;o.ff for dutic~.-; clneuho:ce and ~lo cconomi~-:e:1 in 1!1::-;.nf/,)'oler ..

1~ACH HArm u:rovides na·ti.::nt:;; up to a rnzv:imum of 25 Hith their oHn iwlividual self-·c@t-Ld.~·l ~o1n:;,. 1l~e ln.T{~t~ comrrr..1na.l :t·oomf.J hr:."'.ro nll l)cwn clCH:ilf')1e(l in the intorcstB of c:ro,nomy uxtd efficiency to f-;crve mor·e thc.n one pUlj)oGc.. 1)JH~ (lininr; room iu equipped tio n:-:: to make it (ill iclcal :r-Bception room Hlwre })atientr; mn.,y cnt(~rte.in

] vifiitor~3(f Simil.:.:rly tho telcv.b.>ion l.{)llH{!;O provider:; "the sottinr~ for {':f'(ll.lp p:;yeho-1thero.py and r:;imilcu.~ thor~:}Jetd;ic activitieG Hhich feature significttntl;y in the trt:~a:bw.ut ·p:ce~JCl"ihed for J;l<.':n,v P~".:ticnts" 'llJ1e library iu not only a ~!uiet room llhcro pntient~-; r:l£-:'t re(-:. . .cl e.~1ll nt'"u.dy or Ht·ite J etters but 1.1<\Y cdf;;O l>c ur:ed for case confercnocL>1 ~~ta.ff 'trv_ining t·nd other croup ectivitier;., rl'hc centra.l l't:crec.tion nrca provi.dcs n;nplo ~pt~ce for gene::; of snooker tnil "tt~b1e tenniu rnd for coci~l evcrrtHo '.Phc p::nc:ra.1 sp,::-•.ciou:;;ness of the L~·-rr~or :r·oc11as al1ovn:: r,ood bu't unobr;tru::.;ivo observ«tion of the pntient;; by their nnl'e>cm.

Tli'JSRtOfl DlcCOHA'J.'J:mr has been influenced in the mein 1Jy the need to keep wcintenBnce "C;c;2·rf~~--;;;-ioH -;;·~;;;~1silJle \·ri thou·t over exposing the ncc:urity feBtures ernbodiod in the r;truc"tu:r'e• __,J\.1.ir faced ~bx--ickYIOrk1 ox·poced Uee,:-:wy ~Jainted concr,_'!te r..>nrfaces & . .nd melamine faced 1\t:t·ni ture are cases in poin-tq fJ'he long· life c.:\rpcts bonctcd. directly to concreto floor:J v.ro r;tain r'Caish.:1t entl. cu,;y· to clcun or repe,i.r,

lff~A'l:niG of tho honpitv.l uill be from 1~' '~eparate 1Joilor hour,c,; coch scrvi.nr; B.

S'inf~ll group of buildinGs ond burning ['.P.:1-oilv ~1he fuel \vith 3 raonths Te:_~ervo uill be stor-ed ccntr2.lly rmd pipo;d ·round the ~-i tc,. in n.dclition to it:o flexibility the rrrce.t e.dvunter;c of this scheme is the elimination of the co,rt e.nd encr('Y cl:h:sipetion inherent in a fd to heat d.i stri but ion syetcm.. ~Phe o.:nou ... 'rt of rer~ular maintcnrcnce required llill be sotall e01d both tho clual purpose lmrners and fuel <listriuution pipcf; arc equally su'Ltablc for natur11l gas should gau-<Jil become too expensive or d.l.fficu1t to obtain.

Sl'!CUJ?I'.P'{ is inevitably " very important factor in a.ny Special Hospital cater:inr; ";,;;-rt;;;'U"st for pa.ticnts Hi th cl~nr;e:rous violent or crimi.na.l propcm:.i ties. At the nu.rne time tho visible lcvcl}3 of security must not be so ovorpoHcr.i.ng a~; to be cot.Lvtter productive in mo..lci11{( patients tv.ke cxt:te1:l0 ri[:;ks to e:>cnpe from an intolerable cnvironr:wnt" Successive Sccrctf!.rics of State have' given assur2nce~3 the.t there Hould be no cor.tpromisc in the levels of secur:i.t-,v in the noH hor;pi t~.tl so not only in each Hard a secure building in i tsclf but Hholo sections clO\·m to individual room8 con be securely locked off acco:rdinr; to the level of security :required nt eny given time. 'H1e nurse. call and other «larm aystct"s e.l.l. incor~ porate printed circuitry for rcl:iabili·ty rnd cane of r:lP~intonGnce.. Provision 1;-:.n e.lso been made for the icole:tion of r;crv.i.ccs to e patient's indivi<J.x..~-ai roo:n s toulcl his mental condition ~.tt any time me.'<c this necossn.r-s. .

F!HB PH8VFN'PIOH AHD SAP,<:TY HEACXTR;<;S have been incornorated extend vely both in tEe7tX:Uctm:a-or-:ti1c-'b'U.ifcti-,:;r;s ~in the :oatc,·ialu. used for furniture. Corridors e.re protected by t:Ja(;TieticPlly held fire doora 1·:hich close uutomn.tically i::Jonediately en alarm is sounded" Fire hoscG cs.1)?.blc of rec.chin~ the farthest n::,int in each build inc a.nd emcr·c;ency fire cxi ts fi'O<n eech eree have been provicled. '

~.OSC~Pnrc has heen uned to improve the vif:;ual eJncni ty of 1m othcr<rise fee.turcl~sa El te, 'l'o soften the impact of the r;cc:uri ty Hall on the lendscapc there ~all (tl.so be extcnaivo tree pluntir>r; outside the Hall especially on the northern o.nd eastern botmdaries.

(

APP~~NDTY~ ~'{) ~ ~·<><·-~~~c•••R••"'-'~'~

a.~ Jn:d; ;Jj.ty 01' cJ_L.;abJ..lity in fonJing l.UJtl sunt<:,J n~:_ng ou:tiufnctory doop emotiont\l r{-:l~rt.ionEhip~;,.

b~ :":n:;.hllity to pe:rceive onn 1 u mvn L>J{?dg in rel~ttJ.on to the nooiiu of o·t;hnru -~ cgocentr~,_c:L'tys

c" 1l1ho p:caot:Lee of impuluive oxt:rewn bcht.nrimxr·v cuch ao violont U;!;tackB on o.!:horH 1 o:t' prcpe-x-tyf or rwlf"

d. Pw·u:Ldent rcpetiti vc U''Gtruc·tivo ox· dGlinqucnt nets YThich on o:JV;Winu:t:).{)n oho-;·r lr:ck of ;judgment~

o, DirJpl2.cc::1~;n·li or <lcvin,t:i.on -of emotional d.:civc::J 1 eg violonco~ sex9

gf'.rn1Jl:i.ng} drink~ druc.~ abusop dolil1qucnrt bch.::r~.dour~~

2. :t::P!~!:~~~: ... 9JJ'~~2.~£2" Ho tnko people \·dth eve-J>y t,YJJG of offonco, suol: o.s P~""son 1 dl'll0 ubunet all 1-hc mD.ny vCLrietios of oex:ua1 offoncua 2 Hith the except:t.on o:t sex offoncos &{;cd.n;:rt; ehildY'cn Hhon the offender in ovor the tLge of jO.. History of violent offences d.ocD not exclude treatment at Gr·Gndon.

(

P0~-3I'Jl:[V£ TIJ'~f\SDH;; J?Ci'\ J!!VrPr:t?IHG GTU~UI'A)J! ._... ........ ~=-·-~-h---"-·'""''-~ ............. -·'--··~·...__...--._,._..,. __ ....._..._.,...--...-._.

!:.~· Younger ago groups in genornl aJ~o mont runmw.blo to treatment.

l12E.:tel'!· Some decree of insight or undorutanclinrr, oven though he has been unable to put thio into practice, or h<"s not uislled to, can be of vn,lue DlJ a poaHivo recomm(-m.d.\J.tion for t:reo:tmont .....

f.lotivntion. ~'his is very h11rd to es·timato. If a p<Jrson agrees to como to Grondon . 'ti7:i:S-{;-Bt;f:ficicmt, He have found t!Jat motivation Hill increase 011 treatment a.nd

u.ndorGtanii.ing dove lops. 'l'ho pntient vr.Ul be askeu to decide whether he chooses tren.tment or pr~rolo, H is desirable if this question is put to h:Lm bofOl'O he oorncu to Grcndon, tho patien·t should not come to Gronuon peurli.ng a parole revi011 or parole decicicn,

Drive, Some c.o.':i.ve cvc1 aggressive. ~'!lis can be seen as a pmJi.t:Lve attribute ao tl~Odcntructivo a.gc;rcscion ca."! be directed :into creative uml conntrudi.vo behaviour.

§.:!,n;p.._per~<:..S .... O..!'...!~Sl).t.s~:'11lS!'J.• If a pcroon is t~tally unachieved in the la:to twenties ox· thirtiou, ir; totally ins'LitutionaHsed1 is grossly overdependent on nuthority figures 1 he dodJ not respond 1wll to treatment.

Criteria f'o~ Ufm:n, lin well as the above ori'teria, timing of the lifo sontence Til1!np;;;::t;:;ilf:"'--f.fewi.ll accept people early in sentence under cortn,in conditions, depending on the nuturo of tho offence, in order ·to enable the peruon to enter into tn;atmont "hHo hicJ memory :ls s·till alive to his cmotionn,l state prior to and at the tilte of tho con::nitting of tho offence, He will receive people serving a life oen·teMe :in t!Jo middle of their sentence if they arc undergoing emotional strain of a non-puychotic no.tm'o. •rhe third, uo accept as they aro moving along their lifo nentonco t.nd it is apparent that fol101dng a period of treatment a release is being com:idorcd, _ Thin ·~hird group is the most dceil•able to en·tor Grendon,

Over the last 3 yct.n He have been accepting people to Grendon 1~ith less rigid criteria as ue h.:wo I<Ld an opero.ti ve ru:;seosmentjinduction unit vhich has be on able to screen suitable oa.nd..\dc.teo. In general \'TO havo tfik:en 80...90% of all referrals. If thoro irl any furtller information needed in a particul~:~r caot'J n. telephone discussion \'lith the r.lcdico.l Superintonuent or GMO will clari.fy.

13 J J)arrett JiiB ChB DP!·! ClinicEil Director

)

' '1 ,-) • I '-;-;·'' -• ,_ ·- _ --~•·• ·~A~-·rAo"·• •-«

1., 1\c!::; of -...i:i·)l,,::·;-~,;e:·· ··- -~~- ·~ ·~·-•""" ~~-·~

(J) HnitfJt:r: vcrb:-~·1 nor _plly;::j<:;-_d_ r·c.::-;-vocati:..;n i3hould be ju~:>CJ.ficution t:L) rc~~o:t·t t\"l vio1;:~·n.c.~:: ..

(?) Viol(:~)GC' -iL\ def:ined a;·: nr;-:3-.il~:·.~t pc:r:)on or rc~rson:J not 11 thin[(;'' ..

( )) \·JhcrH:\Jf'l' po:~riib1r.: any irJ.c:i.dent th:tt could ;_;o:;.);:;ib.ly be c.Ja~;~-r.d a~ v11 ;1~~1~ o1' vio].12JlCe be l)rOtl~ht to the win~ meetjn:\ for diSCLlHsion ..

(1:.) \'ihc:a nctc (3) al;ove ar·p1ics 1 a vo-ct.\·:i:Ll be taten b,y the Yl:lnfr; to decide if the incident \'la:::l';.J..nt:.·; t:r:rn1~::.fu::e ..

(l) If llDY n1ember· of *Bt W-~nu· wj_shes to teriliiD~t.s !1is • " - - • <)

trc:~J.tn·,~;nt ~inti l'n trnn1:;ft·:t':t'i:~d~ tht:: follo\J:i._:t~; pr·oeecl:L..tre must be followed.

In the If the t>er.son

fix·ct in!Jtance discuss on your sm~tJ.l group~ '1''·'. 0 ·•··t· 'll ,. ch·H' tO >·c ''I"•]' <•f'••~I'' ' t 'l()' P<: ~:-)(IX, .. , __ , ,l, \\l.Ll --: •;' •J v _c ... L"' ,;.,_ __ .:.:(<. 1 d

\VJ.J l t.hf;n 1nform ll:LS small v;rottp ..

(:)) IfJ_t\.fte:r. di~:eusgiou o~ group>application Jcr a tranbi'er is ;:;till v.rn.nted~ the t.tpplicant DHJ;-·_rt thc-:_n inform the winp; on a wing me etins: ..

.. Once the appJicatlon he.~-.i been to th<:: wingt :i.t; l.H an irrGversi_ble 6ecision~

(1) Anybody on 'B' \'Ji.ng iB free to quote nnyLhir1r~~ he rn.i~-~ht lwve seen or henrd,

I)J.n.ctic DiDn(~r P1ateB and Mea·!. 'l:ra:-ru .. ----......... --~~"----~-----~~-·~~~------·~-

(1) Dinner· plates and metal meal trayB ar,e not to be taken Ul.) <' v, .; · .. "

,.__) o,.,..,_..\. ,__-, ~

(1) Before" a labour chanr;e frolil the shop to a job "off" the 1•1.\.nrj, a persDn·must have served at leuc;t three months :Ln the shop.

(?) BootG or shoes must be wm:n to work in the shop •

• ' 6. Chairman:-

(l) 'l'he Chairman is e lee ted by the communi ~y with a 50% lU£-~.jori ty *'

( 2) A Chairm,in mu~>t have r.erved at least six months on 'B' '·I' ' J.ng.

I] I •

J

0)

( ·' ))

,,, -~···· ~.: :e,::1i 1.:-:; ,_,_ 1 - ,, ,. of , -;;:L ;_,_

c·:l.:;e; 1" Li:-·; •)f \-.l:i.nr_': 1"~,-:c;-;_: 'tnc·:;.~ Ci:' l''iur~da;;t:3 nno !:'-.-·_i_c_::·_;"f

(d) fj_'}t(;

v.'hf'~J n

1 t ·. c' '·.·y j+ f' COJ"' .. '\1 ,. ' 1" e.,(:C t; _!. 1\ /ll.· · ... t. d.Lt•J

(a) Asr.;i~st:inf:~ tftt:: CJ1~::i.::··man und 3tundinc: :i_n :~~o:r- him -;-Jhen it: is :C.C:'Cdcd.,

) (h) Chuirill;"'; \·.;t:cl.ne;_;d:1y \-fj_ng Ncctinr::::.,.

(d) O:cr:;.e,ni::.:ir~~~ u. c;;_~]l b.nd :::.l.l ce11 t'u:rnit1,i.re for each ne~ reccpticn~

\'Jith

'?tL~ ~-~ccretnry ho1ds ti1D.t posi tio11. on the c.on:;u:L ttee for :; mnrrth~> ...

( 3) 11h("" r)ecrctnry is rcsponDible for:-

( ' \ J.j

( ,,I , .... _,

(h)

(e)

'·

Orf~D.ni ~:d ne; the rt_:>Coption croup~3 wi t;h the Vice· .. Chai:crnc..n,.

Puttjn;>; noti<Oes on the boa"d when jobf> are -co· be vOtc:d on.

Compo~:;ed o.f the six men v1ho hG.Vb been on s_·,)~~· t!'HJ 1onr~est period of time, plus the Chu..i.rman ..

(2) j~rr·f person m;_J.y- eal1 a :3enate at any time, after fi:r~'t eon::;uJting with the Chairrnrm.

~~:~he -~~cno.te con only l'f-:coen-r.end to the \·Jirw~ ccurscs of.' aetion ..

( ~ ' ,_ .L)

( ;) )

(

'< \

J.)

YctiL' 1!;eu1.,cr~~ to be· c·] .. :ctc,:_~ 'b:y the ~.i:Lnc: .-:ith u. r·,('·'''. 1----. -ir-1"-1' ~-~r On;::_! ,,r ~:1--1 !-,,:r~ l:o t;(; thn CIJ .. T'rc:.n.t _.;_, .J>-'-<j'••j -'"•!'" ---. -~ .! .. __ ," v. - .

Cb;~d. r·:T·:_(l ..

TH)n L rru:; t t 1:i n;·; ..

(;?) lie in r\'~L;pon~lib:t c fo:e cornrcyin[': ;_:r;y J.·e.<-l:::>onrtble eowpln.tnt!:; to t'u(; Crt"ler:i.l-~,·- Offi,:_,;r"

(1) Elected by the Wing for a period of throe months.

(2) lJJ.:.lJ.seG betvteen the fi1m comrni ttee and Vlinr;~

(l) Elected 1JY the \-Jin[c f(Jr a period of three months.

(2) I,iaises between the P.E.I. and the ~!in[r,.

(~J) I:J r·espon:J:Lble- for orv;~-~rn.slnt~ nny \·!inc ternn .for officittl sports or g;~JJnes ...

GROUPS AND f'IEETINGf>. ----~-·-·-----~-----

(1) These fall into categories:

(a) A special meetinc of one of the small croups

(b) !\ Senate

(c) A npecial Yline; meetingo

(d) The Chairman'c> approval is required and the r;roup is compulso1:y.

(e) 'l'his is recoerved for special circmnstances and c:m be I'<'quested by anyone. 'rhe Chairman decides v1hether it is neces~;ary. 'l'he urmc1l Ufle is a pr;rticularly vehement arp;ument between two or more men, dic~cuc;sion of v1hich catmot 1"ai t for a normal r;roup or normal Hint; meetin[;. A Senate

. l •

(f)

group J.s compu sory ..

'l'his can only br: called anyone may request it. is compulEory.

by the Chairman, althour;h A special Wine meeting

If any per~)on mirl~JOS two or more consecutive r;roup~~ of nny de"eription, throuc;h any reac>on, other than thocJe beycnd hie> control, i.e. vic;its, hoc_;pitfll, etc. it v1i~ll be seen s.s optint~ out oi' tren.tment nn.cl '11 1(\I'!fJ~'EH will fo11o·.·i autom~1tically~

'"? J, •

l-'f"r,,-,..,<i~,--y~ ~·l·rl ]rr·l· (t··l-v ···-v·r~ (Jn,-,.(1 i•' .. ,,,t··i 1-1n·o V!r-~(-l.,l(''-:-d·:·y ·i"" ,-;. if),, P . ..__ <--.J.~ ······-~ <-l-1.~- ·!_'-•• ,.><_.1;,._,_,1;_;•·),.. · v-•-• ''·'·'--'-v ··--~> ~

bt.u__::inr::::~~~ mec-d:;inc: :~nd if_; eh.··tiY·cu l:y thu V.icc Ch;·drma_n,.

( :) ) If ther·e i~1 u-r·r;en t ·bu:.d_nt~ :~_~i.: to ·he d_eD 1t with then,. c1t tltc ChairntDll~n lL\~_;crctic_;n; thi:Jlllay-l)c dc::llt \lith on i"londn.y ox· :b'r:i.d~:ty"'

il~1~:~t;;:::;::·,ment Con:nd.ttc-:n .. ....,..,.q~~-··--,__.,.~-~~~--~-·-~--·

tr.w;t be propof>Cd. a roinilfll.!Jll of the meetine; ..

(1) Ctuox·tun is tho foU]' elt~c·t;cd rnc:.nnbert1 und a mini~llllnr of four pcrmo.nont r;taff. It' this it> irnpot:;;:iblo)l{UOJ.'UIU may be dropped to threea

(?) Vi:;:itors to the w:inp; may attr,nd at the uncmirnous app:coval of every por~-;on being asse~3sed ..

( 3) Attendance >Vhen due for as~c;essment: is comlmlfJory.

Eve1- effort should be made to see that a man ~ J . beinv, assensed hau hiu r_:roup offic(~r present .. If '-·b·i v l. r l'lO·t ')'1"''' ·,.,-1 t" t'rll' "Ub<·t itu·',·e '')1Cl"'ld "'""'·"_) 0 J'-•-••-1-.Ll,t; __ ,., _..._, ~J._ ,.,_J '-'1..

b8 p:r·ovidod frorn among his group memberD <;-

(1) Consists of the Chairman, nf.:~seGsment member~ eecL~etary 'J plUf-3 one reprf; ~~f!n.ta tive of each small f~I'oup not re;n·ogentecl by either the nsse~:;sment member or the secretary.. Any staff members that are ave.ilable are to attend..

(2) Any v:isit'orB o.re allov1ed. to attend.

1/l,(; 1:1~ ;_lt;';-;Jf'~'.\v;_: 1 <.tHt·i.·- . .F.i0L·~J. h2h:_ni~..-!U_r· cJ tY:;~!L (.·I tb- ·i_n::·.ntc:.: ·in !~_r-._-on.iu:·~~ '~L.J.

tLcJ.~(_:;',-;r(: C·!l (-:t·d: ,;_~n;;:_, (;{'l_n [){j ~~liOtlt~Lt or' <H~ t(;.:) c:~:..-td.~·J.J:((; l;·,·:i·u;v:i.:)"L;l~ or

,p; ::w~ ~. ·t;·: ,] ;,:, ~~ '";:;; L ~: ~l: ~ :; ,·:,: :i .··:·:,:;,:,;," ~~;. ~:~;; ;, ~.~: 1 ~·':· ; : > ,;::: ~~ ; .. ; ~:.~, V,l, (; ;;r/:,· .. ]):; ~::, :;:;:~~~: : .. " .. ,, ~··.:V.t.JHL iH.l.J.d,.~,. ;,..::, .•.. l.uUl, _-,ll_,o.lvl ...... T!r f-t~1l t,!,!\._.J_ Ccl·J·t:-; n.:' cril ..• lJ .l L_,,J.a .... (,u_,

hr1d di.t~t'..lrL~:d :~ocl~.l functiu:·t.i.rvs ce.n be nc·•.:rl .in tJlj!; ;·::.<:'-/•

1\;ivc.,, tbo Gi>l'J'<)C'C c:nv:tl"-"'"•·'C!t, there .j" ,, r;d•'•''"\1 L<Jl'!UC'H''Y for '"''''' l'Jtlii:C•L ,,oin~;:J to (~L'O"'P, ~;~'!d ·iJt ;-3-or.,.; m_-\y l~o Dtrivc ·Le·;:Grd3 n·::.·~~- u.n:;•

:tr·\vu c...-:n prov·i.·.i<: <.J.:J .'\tr,:ospho-.2~ oi' tol.:nnnt~.:.!, :-:ce,..::r---:.:~u~e-.-:: <:nd WlJ;:n·~·_;t:n"!din/~, VJd

l\,:_l:y f~·~cilit:lt<-' thin tcn"d.Gncy, \'ih_i].i) nci:no·;;lcd[~inr; ·L;ul ':iC~ COW-) '.''·C.f f:_\J' :-J~·- r·t, of 8'.-l.J:.\l"!lyi:Ig tlk ·:::r:l.(·:!.m-.1~ CLJfic:l(;ncie~l und d·3pr.i ;,::tticn:J ,:_.·xp.:..::::-:1 .-::r~~!::-_,c: b.J' a1;_y ono indi'ti du:.-J ~

In gin1(;J.':-_.). our lr:<:!1 ::aV(J rer;i<Jnality ;l\;-~f::·ctn ~ "but t! :;:._'; r,hy;j1C<llly h(:rd. t;hy, ~trd

nrG !:·:-~, in.:::nb~Jly i11. 'l'hc:.";:':'£\J.t~..:: thoy ux·.: nvt tr .. ntcd n;-; 11' ·th(;j nr(~ sick. Oppc.>~·tnrd. t.::.c:-J- t"ll'0 r.rov.i.dc-d fer thc·:a to ;_,_-_;~~:r-::l li Jyq·,i_; ~.:h:;;~;~~<-1 vt:s J f;nd to (l(~V( lop e n;:'i<:::(! (,;_· J't."::":;pon~ribi.Lity for ~1··.-:·;: tlhJY l:;dtrth:::. 11:-:·.:Jthy u:c~).oct) a~;;--~ r~r~

Lt.titud\_! of Hj,t 1 :-:i UI· to ycu ~ c<.:·t on nith it JC'Ll'[_>. .. :-lf11 ~:re tb:: und.,_~:rlyin{':

f.l!3D\.~CI,n 0f :30 c.::~J.!c~d f)8l'f:d.tJHiVC:l~:~z,g. . .. OIJC..·n, }!DnO:-Ji. conu:1Ull:Lcnticn, ~.nd i\:.::J.~~1ucl\:n., gi v;:_, <'~ L'IU .~: picture: ol' }-;.y,,- hi.:J b~:hr·viu,u· -!.::~ uff(s.0ting oth.;_.:-·d, ;uhl ·:.·lwt flOJ'L of iL::-. ;t; ;i .. : Gl..'C<:ttl~~;. 1<~.-.:~ally

u~eh I:J.:;~~. :~u ·in ;~ (~nrtinn~il u:;::t:.! of u~_:.;juGtl:l<.:rrt - .~-:v·~ :v'!l•-~:1 to\·::n·d~-; 1.),-:.:tt::r -~·t;lct:ic.,nsh::;K~ vt.i-~.h cth •. n·:·_;, 1oas :i.rr:pulsivi..: <J,~,~;lnv,;Ll·.lc ht.d.nv,i.(Jur, •~nd r: l.itLlu ::h~H'U r;:!l~~;;>·.:,;rL;n('::_l t,::·;;;_:r-..1:3 oht.;;inir;g LCC-.::pL_d)ll·! ,;:c;-~1~1 ·~ C·.::; I\"J~;-',;\:;::.inr; ·lr: ;-1 J-'J't.l f~-;r H J:..:.t<·~~~ tj:·:;<;;"; l_;[:~;il j}:i"'(:V:'..':->l~;..~::;, 01" \"I'J.:·lcln;~ fer ,'_111 < .• -.h_(r.!~tlicn.:.d. qu:\Lif:~ce.ti:.:'n.~

1l'iL~uo a~;:.:.l ,'Ire t,:, so;:,.::; ...:xL.:nt r~:~line::! .,.. thus :J :·<l~l. ;·:j_!_:~ ;1 hiatc:ry rJf v:L;.l·--·nt, li[;i(,~~~;~::Ji'/U /.:. __ :1;:-!V:i'l\l1.' l;:::c.C::C1 G 1·2:1U illli'ULJiv.-: 1 ;;:.-J.1.'C r\·~J<.:!~Cdr nn:_-~ [,·,c-J:·i J:.)t;;.l

ttu:e:Ld;(;d b.}' cnnf.~"'._:E.-~tl't-io~s) ;n· :.1 r;:;_,_n ·:.-Lo ~Lt;;-~ n.-.::.·~;:_· ~;;i·:'J-''-"i in n jr,b 1':.:,;~ <::o:!'t: t}i(1ll n: ~,;f:-:;:rt :iu(· .!.3 abl,.~- to \lUrk fer 2 .f<;.::n .~~~-:nt-1-:.: ·ic ~-:-r;_; oi' tlk .shop.';. Cc;;:::ru.nicr:L.O!'i Lit:!. ;:,::,;r.~.i·~~C~i~Jt r·.:r)I).Lo..; :in h::;:; li:'-: i:::!l'~\'1<1- hjr;, fYll'!J!lLJ, •,:;-lr.: c r ~7 ~.rl fri ... ~nJ., eLi 1~\.J\·n, :n~d ~~.t~t~hority.

It is e:.:~:d.d;_· t~> E:~:/ ·;:Lo nr..:! iL;t snit~lhle. 1i'ht..: cri tc··t.i.t: .:n'd H()t cl<.!Trly J.:.·.t'incd, blJ.t :1:!~·:-: 1x .. ·cr:.r:rLng ::J01'<' ~ ........ Jn fC.It·_::r~l v1o pc;;;i'~~l' l':c.·t .:~\.,. nccept J:n:l i.~ tho i'oll<_,-;,':ne ca t0[-;oric:~':

1. McntcJ.ly di~Jtu::·b_;d~ pg;Inhotj_c :::em.,

), 1:10r: n:i.tll m·, :L'I b>:.L'" 100 fitd tl~o l'cJ;·i:o" difl'ice>lt to cope; riiih, (18

gc::nc·.!:~tllJ' th..:y n::u i.!W.·L~d r.o ur.<l0rshtnd ':vh:!t i1J hnppcning, r:nd t,·,:~d to bo -:-:-:~de n b\,4tt rJi' b:{ l;h•:._ ether lr~:-:"!':-\t(!tJ.,

Men \:ith r;ot!~in,:_:;- to l:uil:l en - ,;g n.:> f'::\c;i~y ::•r cih':;r r.:!lnt)or,ship::ij t:;dt.:.c:Jtiorv.1l t..r·,c~,::;round :·~nd no p1.::r:-.:i:Jt,:·:nt ..-:crk :re:ccrd.

pocr •

). l,~(:r: -.·:Jth £~ lcL!~' :_~:-t:CC(.'! uf cri;~dn:;J_ l;.:)uv·i.uut·, .-•nd nor~; th;-:n tuo or thrc.:J !"10::'itY!D Of 'i!~ii_J1'] .s::mr:J•}l',l;, .:'1HJ-' u:::n_ (;\'..-,.·1~ ,1U yc·:<.r:J of D{"...; •

. '

(-.• L\:n -,;he ('!<:n::nd ::;!;!u~·;· f:)';:.'!~!:) v;_ t.r.:r.tJ:1; nt, :P.idJ .. , .. :Tll,:;~: ;·l·h.l'n.i.UJ !;h_,_~l'--l5_JYI

ol' :i.ndivi--}ln:L j_)!i,'/t-:!~u-tl:~.:-r::r.J.

'/. ?.k_.n 'ltL] cr::·:not .:h:-cc:vt tl1o J.'0cr:_t'~r-:::::r:r;!;:J o.)f th,/ r,··t'i.::-~ ... op· __ .n co!:.;:ndL~C'1-Licn, )!i.) GDH~'itl:.-J;~:·i.~:1.\LJ 1 (tt.t',:_-.;Ll'·m_~·;.:.: 0:1 ~J::i.-_J.l <"-~-T'()Up:J ::;td '--~(J;,;.::H~;·,-l_S;y :H;~;;t.i.n;~;s.

b~ ~.J.,:.:Jl r.:c,;:;ir 1t-; tc (;_(• .. :r.d.on -.-;ith a lcn,:; __ ~k:nk·n~.~.:_!t ~L".,'f :.<:.:·~-~ lh:n1 2 y.:;;~~rG 1 a!'iC :d of tltL·::;;; nnd li ft:r;j ~

~\ p~1·io~i cJ' ti.;:,o !.:··:y \~1:i;):.>r.: 1K:fo.r ... ~ <:_ ::un :id r.:~:ti".>-~'~urd:l tc hc: t~n~n.;:;.t.r1bl :~ ;_,;; :ii.; t~·;kv:; t!CJ:.:.:: -~.i.J>;u _::'or- hin 1..HdtJl'ly.i.n[5 C'.iLitu:L:~,_: ~l!ld c-.p.--;c· 1:.:::t-i(':;li!'i t:c >_-:;;1(_~r(;e. In 1LLis StJtt:.'C n r:''- n i::1 Ut;Ju.r e~:;ntinu~~l :1.:.>:::'---·ssi· ... _mt IH~t.i, hy !·:iiJ !i·:~•u·.:; :lid by ti~--~·b\..~r:J '1· 1' ··-_n · · t·· 1'1' o L.v 0 ·'···

t;·:r;::·:~·._tG~l, ·;·.'ho lt\8 !n;:i, ~.;o;::v cxp..::.-:ricr:co C1.C th: ~:~_,_--:.:is::dt:td···n of li1.'-:. H~! .:--~i!(Jilld

h-~vo .:-:lY1 I·:2 of (;'-/~:r lCr,>~ ['T~d hC'.VC t..:n::...: !..:Jn~.-~r: .. ic;~·:.L :~r::h:L::---,rci;;l·:nt ,ev!:l) if n11t..l!:.:1r: J::C1 .!~~~ tl1.::~n :.~ l'0,:,td:n· :·~ttcn.-..V~nc~.:.: tt ocb)cl, lL: ~JI:c-l:1d h:!Vi~ s-_:.n· THJnlLJ.vc :c.;l~-~t:io:·;:,;;d.p ::.n ::-iu 1:1.~'<_, .. :>:itlh:r with n t~t__;mb.!t' c'r it~r; r·--._:··d_]_~: or :1 r:F·Ll~Jt.:r ol' 1;}-::.·j r,-1-~l~')~:;.i tt~ ;..:~:.:. 'l'b • .:rc-: should h0 ::.;c:."'l;__~ :.il.d·j(-.·.~-~:ion t:lL:t h(~ iu ~\bl~·:: tu Yiork <!!Hl

k.:h.~p :) ~iob. He ~lb)nld not h:1v0 hr;cl ;~.cr0 than ?. Ol' 3 p:rcriouB pri:3~~,n s.:.:nt:.'nC~.!L ..

rTb.-) trc".iJ;K:!'Jt EC)nt~· \::1'0 the Si~>-::11 thnrClpcutie gronpD1 cr:m::l\tni ly twutir.f:';n, .'.:-tn.d :i nfc>rr.J:.ll ::o;: t : ... etn 1k l;·.,•,:_:-_:n c!ll Jac:.bcrn uf t!i.J y,·in/;.

l. '.fh0:r,_:: rtT•,: l\J,; :-;~;nl'l t.h;;~·npt."!Utie g:t'Jnp:) p;}r' -.;~ek fer c:·tcfr in1:t.r.\t' . .:~ l~r~ch [1.'GL1;:J Cl)!':~li~;t.;; Gf ':\b~:.ut ~..:·i;~t}:t i;;f:l'~:t.CS 1 :tnd ;,'(,. __ r(: pt..<Ssitlc~ is t'1kr.;n by t·;1c t~,__;c:bc~rs o::· tl':-:] :_,t~'.f_~. l'}h) gr~)Uf;~; .:n:.~; for :: li ttl.::: ov.:.:r .:m houc ~·

!;:dr: r-... u:~-)~;t n;.;v.:;_r_:o .~.r:·m:~fc: .. r free: gr·:oups to ~~::.·:-ur;n.

2. 1!'!. ·r0 ft.l\.: tli:"'Cd cv;;·~::'!l__l:Yi ty !;10.:.!1,. :d~E:s- _!h:::' wed:. f>:c.:!-1 of thc~s·:· r,l;ntin{~S ~;t~~rts vli.th -.~ f•.:~~tl-.tv:.:k rdi.~l.--r f:·o::~ r:1J. c.f tho t~r:::t]. (-;rmt!)!'J, fro;rt the Lq:·_:in·.·-·-~

st~~ff 1:lu...:t:i:i{-,;:.:j O!~ .!.'ro;·; othel' ·grc~t•f.·a cr .::v.:.:·nt.:::. ,',ft•:r tlL, fertT.'.l rr.:::d---· rx.1:~t..s Ln~;;J hi..'C1 C·)l;.pl ... ·t.\;d i,h ... ~ ::i•)(•tinr :~:3 C~)-..::1 te ::~1.1 I:le;;;[.(!J'fi cf :~t to

dicr:us:J ~;.rty ·1;0:f1ie t;~,;.::' ·.';:i:~h.

. :s. 1 i'lh!~.'(- in r:r:(; cth;Jr ~·:·~.::'-:1J1 .•_-:r·:·n.<·-~- t:hiG!~':i~J '.,',,lur!V·.ry. ~rhi~l in,, \tvr:r:n 1 s

4.

tf!~·;t.ip st:.-:rtc·:l ;)y !,b.'s ·:.L\ llo:;:· ~3LJith. ~·L.:.J h .. H; 1)l~<!~l ~ lo:::·sel:r or:_;anisod cpcrt t";tulc:d. t;rc .._:,p :::tfh; np of d::ff.:.•J.'d-rl~ ·,·o::JE.:r: rl'l);;: Hw:~Lir. CuJ 1.::(.:! in Oxf:)rd ~:>.d ~; nm:1t.~.<c -.-:--i' ::!en i'l'V1:1 t:w ·.:iir:g~ Its r./:ir; tJU!'j .. ::>Jc f!nd .:.d.'ft-.ct in i-') :i:;;p~ .. :.-.-v..: th...:: .:·:'td.lit.v z:.f -t;hv J::t .. :n to cc·lf:1D\.:.ni.::::tv nith 'liOi::•::n. ,\h~-ul oi.ght r;:.:.:n <:!r;d . .:;-:.gbt ~·Io;·;:,__;n ntiv!HL

st;1f1' m;,:·\~tinL:s r-·L·r "~·:{:l~; onu 1Jn e::.1c11 ·,·;or}'_ inc d:.-:.:;.' ~

brief iltfCl\:--:.~1 :1t:1.ff r·;,_·t.1tin:;~; nft0r c:~ch C()::::-:funity fv:::r:::al atn!'f r:1out-Ln;{s h'l:-j ~t ~hf£'.:-.!r-L:nt I,ur·p•Hh1 •

•

(d) :~cl·.· :iu L:~\.;_;~1 m:. ·,:i·~ 1J f.J~<l·-l<l{..::ku ~:rn;11 .::;::tch gr:·n1p 1-:<t<L::r n!Jm:.t the ~;;:;:'.] 1 {_;.f(; .. iJ'~).

(b) t_lnc: :L~; '1 ~~;n)tJ·."lrt ~,~J'Olr~--~ :i.r'- ·;1hicL l:,rob.L;ns c.t' ::;(;:d:'f J:'l:l;_.·,tionuhlps c~:Ht bc:na ... d.cJr ~1r.:; r:.iHCUf~r:u<l.

(c) C'n.:) i:3 ~ Lu.Hi·1c~,~~ :T:oti~tr.~~ :i.n '.Jr~.ch pr::ct;.ict:l J;:;,t;l;;;I's to d.l) with ti:u :i r1r-:~.~ t ;j ;.;r.e:--: r-~ s Lo1:·,.:; 1.3::-/G :' eben~;,_; nf ~L: hJ u.2, :}r . .){.:.r.:;r;;:3 1 and rmy IJ'_.ht:1' ..... ·<:C~~;} c!.:· -the ~:i_f.: of_ ttw GO!::~:Mll·:.t,y :·u·u :tir,;cuu~:;i._;tl.

(d) ~l nc,_i.:::ic:l1 11 :::cc::.;it:;~; ::-,t \ihieh .:.1. rt.::'.'J :!:·.;:Lt.:.:: ·i:-J :it!tcrvic·::e:d~ or one y;ho :}as l<:cn on thu ,_:;·.in:; t'x-o::: •JlL> to ·.~l;..r~.::..: i;~unt.h~"'' ~~-s su-2n :.:rnd h:i..s }J~;:·:·rr~:·c~i'~ ;l'~:~CU'J;_:;G(:~ C:h:c cr :;nc rc;;;.·~:>0d-~·:rt·Lv::.:~-l fro.;~ th11 x·.~;c,:;pL:i.ou

[;r:):tp -.:'t't'~-.-:d r:it.~-1 the; nc:; :i.111;:~ti;. ~,.ny in:~L~~J v:ho ifJ po[:ing ·;1

!__~robJ c:L ::.-."!,y ;_:..::: -~:-sl<"--" i tu :.-d:~:::-:0'1 thi;." ::,dc-Lin,;i or lH:! r;-!Uy .:.luk to cowv on lh:.: ;;t;•.(f ::~'.::'.·'-;,;in~: ltir.iSGlC.

((,) ~P!.v fin:tl ~:, . .;, __ ;l:i!:t:: of thv \i(:0k .i.D u•:-;.::(;. t,--; lcok at thu prog:rt.\fnin8 for t!10 C'o:;:ir:g ;·u:cl-::) 1<.r·.k(: ~.ru~"l; gr'JUp~:: .'Jr..:! cvvorc~d whon the lec!dc:r8 Hr\.: on 1 cn.v(: o;,.~ :lr,'ny ~ r:ntl note r(:c,:r.'~to;lS, dinch:-::rg\:::3 1 and visi to:cs cxpuc1:c;cl.

~Phc~ }J(J~Jt-cof;u.1ur:i t-j r:~o:::t:>1r:~s 1.-;rc uhvrt mccLint_r.s :i.n v1hieh the ronc.-Lion8 to thd l'<..:c:crd; cun;:n.tni_·L,y r;J01YL:~nG !:~J't'; rd.ro\'1, Glld. nny ~points of viuw about nh . .-~t hns hr!pp(·ncd ur·.:: Lle~~t:Lcnud..

In uddi L :Lon 2·).:::h n~~w inr:~~\ :_ . .:;: ::~ ttcr.d~; thruv l'C~C·)pt ion Groupr; vthicl-: ~tro r:ndo up of :1 ropre!:>.:.:r~t::I;J.·/>..1 fr .. ~rr .. anch.,.s::;·_~-u thoro.peutic {;roup. i,n nttor·;p't. is m:.1dc to iJ[Jsens n ::!a::!'::: r,ui_·V~btl:i ty fo:." G:!"'cndon 1 ~nd D. rc~;Drnifl(:nd.Tl:i 1n~ by subj.:;ctiv.J critcric; {!Ld pr..::s..:,nt erOU]! size, j_fJ pt~t fOT\-'i~U:•d a:.-.1 to '1/~.idl Dtn:Jll group hu slwuld h:.., c,_~n.

:.s much <l:1 pvrn:'libl\; im:,.:;tc p:·a·tie·~.pat;ion :i.n tho ~;t··:ff r::.:ctings, npart fron th(: .;ll·tc•l·~c··'··!c·I""~ ·-) ,..,., .. : 1~--,. i<-• nnr-•-J\1·,.-.,-,,,,-:,·l .-,;~,;l "ll'f ·•,,,.,-,.,t' ···}•n 1' c.· 1 'G1·n;_ rl·1' SCU'~<~r.J 1'o ~ - ~ ·.t .t..;. ..... <.;t,.----.~···)' .-'"-' '"'...... ~"t::'-''-!J ''•. <.:1 .. •• •• t,_: ,v •. _; ... , 1-J-. t-> ""' .:;!.)\,.; >)

::t.JkcJ tiJ C-Jrk.: tl' t:·\-'.J ;-::,-,cd .. ~-n~::. r:nd. ·r:o t·1k0 pnrL. '.I11<)X'<3 oclnG.:tLion, ·.:.'ork, etc .::1;:·o he::.nf~ GC'1 :l:d_d~:-:-r:.:d, ·..:~.l~ .:.-.rp::•op:ri~tGt..: J:~ci~;b0r of Dt<tff \I.Lll nlso bo nskQd to :1 ~t0DlL

~111y vi:3i to:~s '."lho -:a··-) ·lfc1r_k~.:ni~ tJn tt~; vlin.~~· f()r ::-:ore' t':l;:tn :_: d<1.y n.rv .:-:ut:n:J..'1tically i:nco:r·po:~·).tc~d ir.to th2 _,;.:..::-T.t rt_·.;.t.:' 1 ~-~1il ·;:·~tend til..)' v:.n~_i_c)us uoetingus and nrc; ;~:ntj.tl8d to c::.;-~_,·t.'<.?.sD thci·c ~.;r .. :i.rtin of 'li:.:"!\'1.

Prohn tJ.on Ofl'ie..:;l'!.i c:;n\.t :::umb JTD OJ~ th..) .f::un:i.l;y- Sl'.ch :.ts ·.-::lvon or ~Xir~..mts ~r0 ::1lso ns1.;:cd i;(l cr:,J:\·.J to ~h:! f!:X')U 1)f;! ;:;n r:t 1-:.~l:;t -~rw Ol' th.roe ·JGC.::Jr:>i-Jn~; d.u:.'ing tho rnnn's period 1~-1, G.r~;:tdcn.

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Report of Inspection of !'!ental Health Care Facilities

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Transcript of Report of Inspection of !'!ental Health Care Facilities