Recidivism among treated criminal psychiatric patients.

Until recently there was a poverty of treatment effort devoted to criminal offenders who were housed in the public mental hospitals of this country. In a nationwide survey of such programs published in 1969, the most frequently mentioned treatment modalities used for" most or all" patients were recreation therapy, drugs and religious guidance. I Recently, more money and concern have been devoted nation-wide to the forensic patient population. At the same time there has been general pessimism about the effectiveness of rehabilitation programs in any area of the correctional field. Others have shared the conclusion of Robert Martinson, who, after reviewing 231 experimental studies on the treatment of criminals, reported: "With few and isolated excepti.ons, the rehabilitative efforts that have been reported so far have no appreciable effect on recidivism."2 There is little basis at this point for arriving at conclusions about the effectiveness of hospital-based treatment programs. Steadman and Cocozza (1974) were able to locate only three published studies of offenders released from hospitalization in this country.3 In addition to Steadman and Cocozza's study, we know of only two other relevant recently published studies, neither involving a strictly hospital setting: Kozol, Boucher and Garolfalo's 1972 report on Dangerous Sexual Offenders at Bridgewater, and Steadman's (1977) recidivism study at Patuxent. 4 Yochelson and Samenow (1977) have reported at length their fifteenyear effort to understand and treat criminals at St. Elizabeth's, but they present little statistical information. 5 Recent efforts to study treatment effectiveness of forensic programs at Colorado State Hospital at Pueblo and Utah State Hospital at Provo have produced unpublished reports. 6 The study reported in this paper took place at the Forensic Unit of New Hampshire Hospital. The only state-supported mental hospital in New Hampshire, New Hampshire Hospital has long served as the sole facility to which forensic patients are sent in that state. The population has included men referred for pre-trial evaluation, patients committed as Not Guilty by Reason of Insanity, Defective Delinquents (an obsolete mentally retarded statutory groups), Dangerous Sexual Offenders, and patients transferred from the correctional system.