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The difficulty in the efficient administration of psychiatric work in the courts lies in the Insanity Code. In most of the United States the law considers the ability of the accused to distinguish between right and wrong and to understand the nature and consequences of his act as the sole test of insanity. Dr. Guttmacher calls this definition ridiculous, since no species of mental disease can be clearly circumscribed by words that will
fit all cases. Mental disease is the peculiar reaction of the individual's personality to the total situation.
The author recommends complete psychiatric clinics in conjunction with adult and juvenile courts as well as penal institutions, and that psychiatrists act as medical officers. A psychiatric examination should not be confined merely to cases where frank insanity is suspected but where personality distortion exists.
The division of state hospital systems devoted to 'criminally insane' should be under the directorship of the court psychiatrists, who should make intensive studies of difficult cases and report their findings.
The error has been that law has concerned itself with concepts of diagnosis rather than those of treatment. Penal institutions need psychiatrists to function as therapeutic agents rather than to classify prisoners.
The author believes that law can only be liberalized through the vehicle of psychiatry. He enumerates the noteworthy results obtained with delinquents by Alexander, Aichorn and Hartwell, who used various analytic techniques, and evaluates Bond and Appel's method of changing the environment. He feels that more work is needed under rigid scientific control before any one method is selected. Dr. Guttmacher does not subscribe to Dr. Alexander's doctrine that most criminals owe their illegal activities to unconscious conflicts.