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NOTES, COMMENTS, AND ABSTRACTSi

THE PSYCHOLOGICAL FACTOR IN

DELINQUENCY. AT a meeting held at Friends House, Euston-road,

on Jan 23rd, Dr. Isabel Wilson, who occupied the lchair, explained that the Committee on PsychologicalMedicine of the Medical Women’s Federation hadrecently discussed the subject of delinquency. As aresult of this discussion it had seemed reasonable toarrange for a meeting between the committee andcertain probation officers who were interested in apsychological course given for them at the TavistockClinic.

Dr. MARY BARKAS (The Lawn, Lincoln) said thatthere were two points that she would like to heardiscussed: What is being done ? and what oughtto be done for the different types of case with whichprobation officers have to deal ? A certain proportionof cases were sent to remand homes or put into super-vised occupations ; a considerable number did quitewell under those conditions. Psvchiatrists found thatthe difficulty with their patients was often mainly oneof environment, and nervous disorder might disappearif the environment were adjusted. There had beenmuch dispute about the problem of the existence of moral deficiency. Dr. Barkas thought that there werecertain types of high-grade defectives with a goodgeneral intelligence whose capacity for developingwisdom and judgment did not reach beyond the stageof reward and punishment. She would like to hear theopinion of probation officers on how these cases

responded to the various methods of treatment.They seldom benefited much from individual intensivepsychotherapy. It seemed that some adjustmentof the reward and punishment mechanism was whatwould lead them towards the best citizenship of whichthey were capable. A second difficult type was thepsychopathic or neurotic delinquent suffering fromobsessions, compulsions, anxiety, or morbid fear.These definitely responded to treatment if it wasavailable. But if they were to be treated they neededto be in some protected environment while thetreatment was going on. Dr. Barkas would like toknow how far probation officers found that there was alack of facilities of this kind. There were very fewplaces where a child could be sent for this sort oftreatment.

Difficulties of the Magistrate. Mrs. RACKHAM (Cambridge) said that in looking

back over 10 years on the bench one of the things Iby which she was most struck was the contrastbetween the court as a machine for finding out whetherthe prisoner was guilty or not, and the court as amachine for finding out anything at all about theprisoner. In the first capacity it was very good-notperfect, but as a rule it found out the truth. But-and a very big " but " it was-it was a very ineffectiveinstrument indeed when it came to knowing anythingabout the prisoner, especially about his mind ; whyhe did it, whether he was likely to do it again, andhow to prevent him from doing it again.

Magistrates found it very difficult to know in whatcases to seek expert information. They could not tellfrom the look of the prisoner-nobody looked his bestin the dock-and unless he presented an imbecileappearance the magistrates did not know whether hewas a mental case or not.When was the best time to call for a mental report ?

It was agreed that this was after the case had beenproved and before sentence was passed, At that pointit was possible to obtain the prisoner’s record andsometimes to gather useful information from itemsin it, such as the school standard reached and anyhistory of institutional care.The question arose : Where was the examination

to be made ? The only place to which a prisoner couldbe remanded when he was over 16 years of age wasprison-a very unsuitable place for a mental examina-

tion. The surroundings might be equally bad inthe home, where the relatives might be hostile to thewhole idea of examination. There was a very greatneed for some more suitable place to send cases onremand. There were homes for children under 16, butthese were very often at the police station or at a poor-law institution, neither of which was ideal for thepurpose.The next question was : Who was to make the’

examination ? There was a difficulty in securing amental specialist, and the obvious person was theprison medical officer or police surgeon. In a smallplace he would be a practitioner of the town, whomight not have special experience in this work.A further complication was the question of fees..Having taken the trouble and expense to get a reportthe magistrate did not now know how to act on it.-There might be no local facilities whatever for treat--ment. If the child was to be taken to a child-guidanceclinic there must be somewhere for it to live whileit was attending. Against all these difficulties therewas the temptingly simple alternative of proceeding topenalty.The Committee on Offences against Children and-Young Persons had found cases in which a man hadbeen sent to prison for the same kind of sexual offence10, 13, and 15 times with a occasional flogging thrownin. It was essential to find some better and morescientific way of dealing with problems of that kind.Another difficulty was that all magistrates did notyet grasp the importance of this kind of mental work.They were apt to regard it either as an attempt toshut people up or as an attempt to undermine andweaken man’s responsibility.j Mrs. STORMONT (Probation Officer, Gt. Marlborough--I street Police-station) spoke on types of delinquent anddescribed her work with shoplifters and prostitutesin the West End.

Mr. CHINN (Probation Officer, Birmingham) spoke-on theInter-relation of the Magistrate, Doctor, and

Probation Officer.There was great need, he said, for cooperation between’magistrate, doctor, and probation officer in thetreatment of delinquency. It was apparent that therewas a growing concern for the right treatment ofdelinquency, but a wide diversity of opinion as towhat constituted right treatment. A small minorityof advanced opinion was concerned with the scientificapplication of expert knowledge to the problemand, on the other hand, traditional repressive measureswidely used. In between these two extremes wereseveral experiments, more or less developed, theaim of which was the reformation of the delinquent.Probation represented the community’s attempt toreform the offender by a process of re-education in hisown environment. Such a process would depend forits success on the coordinated contributions of whatmight be called the " healing " forces of the com-munity, which would include the magistrate, thedoctor, and the probation officer, and it would have tobe used with discrimination. Probation should neverbe used without first taking into account the personaland environmental history of the offender and hisphysical and mental condition. There was still animpression in the minds of some magistrates thatprobation might be all very well for children andyoung persons, but it was useless applying it to adults.It was even exceptional for investigations to be madein children’s cases apart from one or two of thelarge cities children were tried and dealt with forth--with. The only method open to the court needingmedical advice was often to remand the offender-in custody for an examination by the local prisonmedical officer, but even where this was done thequality of the advice given might detract from itsvalue and the court soon lost confidence in unsatis-factory reports. Certain local prisons were listed as

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observation centres and had mental experts on theirstaffs. Such centres were more often used by thelarge towns than the rural districts and their scope waslimited. The period of observation was bound to beshort. The doctor’s report might contain an accuratediagnosis of the offender’s mental condition, butit rarely contained a practical recommendation and noprovision was made for treatment. Treatment, of asort, might be obtained from the poor-law authority ifthe offender was destitute or could be made to appearso, and certain obvious cases could be dealt with in thecounty mental hospitals. There was evidence thatthe administration of the Mental Deficiency Act wasfar from satisfactory in many counties.

The number of mental experts qualified to give eadvice and treatment seemed to be surprisingly small,and they were seldom available outside the large cities.Mental experts too often confined themselves to adiagnosis, and gave no constructive help on treatment.

If the reformative material available was to beused wisely and effectively it was essential to realisethe interdependence of the court, the doctor, and theprobation officer and to ensure their cooperation.

The Clinic for the Delinquent Child.Dr. FLORENCE STACEY-CLEMINSON (Hull) asked

whether a clinic for children would not be betterstarted from the educational side as a school clinicto which the courts could send children rather than inconnexion with the children’s court. The childrenwould not then be branded. Hull was trying to getthe education authority to set up a clinic, but therewere financial difficulties. At present, cases were sentto the psychologist attached to University College,but there was no definite clinic.

Mr. CHINN said that in Birmingham there was asyet no place to send children for psychological treat-ment, but it was hoped that one would soon be startedby the education authority. It was much better foran outside authority to conduct this than for the courtto have its own clinic.

Dr. WILLIAM MOODIE (London) said that neithercourt nor school authority was the proper person toconduct a clinic. The work could not be done byany one individual, either psychologist, doctor, or

social worker. These people must be available bothseparately and together, and they must cooperate.Every child was an individual and at the same time.a school child, and had two aspects. One could bedealt with by the doctor, the other must be dealt withby the educational psychologist.

In his work at the Child-Guidance Clinic lie hadfound that the vast majority of delinquency resultedfrom environmental causes and not from a causeintrinsic in the individual. This introduced a thirdtype of investigation-skilled social environmentalinvestigation. What really seemed to matter was theenvironmental factor, and by manipulating theenvironment and the education it was possible toalter the behaviour in the desired direction. Hewished to stress the point that the examination ofdelinquents was not purely a medical question.A number of probation officers and magistrates

took part in the subsequent discussion and contributedtheir personal experiences. There was very generalagreement on the need for increased cooperationbetween magistrate, probation officer, and doctor,and for the education of public opinion on the veryimportant problem of the psychological aspect ofdelinquency. It was agreed that further meetingsshould be held.

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VICIOUS CIRCLES IN DISEASE.Ix an address to the Osler Club on Feb. 13th

entitled " The Dynamic and the Modern Procedure.of Diagnosis," Dr. A. P. Cawadias opened with a.

tribute to Dr. J. B. Hurry who " with one foot in thegrave " had worked on general ideas in medicine.Just before his death Dr. Hurry had asked him to helpin the preparation of a new edition of his " ViciousCircles in Disease." The basis of the modern con-ception of disease, said Dr. Cawadias. was the know-

ledge of the integration of the human body, which weowe mainly to the work of British physiologists.Man is integrated to respond as a whole to anyadequate stimulus by the psychoneuro-endocrinicsystem. When the response to the environment isperfect, the various organs and functions whichconstitute man are in equilibrium. This is thecondition of health. When adaptation is imperfect,either because the environmental changes- are toointense, or the power of adaptability of bod y or mindis insufficient, disease or functional dissociationresults. Each diseased individual represents a chainof morbid events in which four links are to be dis-tinguished. The first is the link of external eetiologicalfactors and represents the modification of environ-ment-invasion of microbes, toxins, meteorologicalfactors, &c. The second is the link of constitutionalfactors, the third that of psychoneuro-endocrinicsyndromes, and the fourth that of the organ syndromes-functional disturbances and anatomical lesionswhich follow the disturbances of the psychoneuro-endocrinic system. This new conception of thegeneral mechanism of disease is intimately connectedwith a new procedure of diagnosis, the neo-Hippocraticdiagnosis of the person, which determines the fourlinks in the chain of morbid events. A completecollection of Hurry’s scientific and other writingswas displayed.

UNOFFICIAL AUNTS.

WE have been reminded of the existence in Man-chester of a panel of voluntary unofficial aunts (V.U.A.)who are willing to do such useful services as stayingin the house in charge of children to enable the parentsto go out together for an hour or two ; to take childrento the doctor, dentist, or hospital ; to vi "’it old or feeblepeople, read to them or play a game with them, and sooccasionally give relief to the one in charge, to sewor mend garments. We are told that the V.U.A. arepurely voluntary workers who accept no responsibility,but do their best to be of service, although not preparedto replace ordinary domestic labour or trained nursing.The service is done without subscription or paymentof any kind. Information is spread by an occasionalopen meeting such as that to be held at 7, Darley-avenue, West Didsbury, Manchester, on March 27th,at which the Lady Mayoress will preside. Applicationsfor information or help should be addressed to Mrs.E. W. Hardy at that address. (Tel. : Didsbury 3331.)

Births, Marriages, and DeathsBIRTHS.

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GILLESPIE.—On Feb. 8th. at Bentinck-street, the wife of Dr.R. D. Gillespie, of NViiiipole -.street, W., of a daughter(premature, stillborn).

ROBERTS.—On Feb. 1.5th, at Fairmead, Formby, to the wifeof Dr. E. L. Roberts-twin daughters.

MARRIAGES.WARNER—ALLSOP.—On Feb. 14th, at All Souls’, Langham-

place, W., Edwin Charles Warner, M.D., M.R.C.P., ofDevoushire-place, W., to Mary Dorothea (Dora), eldestdaughter of James Allsop, Esq., J.P., of Putney.

DEATHS.FELDMAN.—On Feb. Ilth, at Hodford-road, Golders Green,

Dr. Israel Feldman.HORNER.—On Saturday, Feb. 14th, suddenly, Charles-Julian

Horner, M.D., of Orford-road. Walthamstow, aged 67.RUSSELL.—On Feb. llth, at The Oaks, Yateley, James Russell,

M.D., M.R.C.S., aged 79.TURNER.—On Feb. 12th, at Ascot, Arthur Ernest Turner,

aged 35, of 15, Litchfield-road, Sutton, youngest son and formany years Assistant Manager to Percival Turner, of4 and 3. Adam-street, W.C.2.

N.B.—A fef o/ 7s. 6d. is charged, /or the tMserHott o/ Notices o/Births. Marriages and Dedtits.

NEW MATERNITY WARD AT RAMSGATE.—DameJanet Stancomb-Wills presided recently at the openingof the new maternity ward she has presented to theRamsgate Hospital. The maternity department is now acomplete hospital in itself, containing 25 cots and-beds.