AN RIFLCRATCRY STUDY OF REFERRAL

AND INTAKE PROCEDURE WITHIN THE

PSYCHIATRIC CLINIC AT TEL STATE

PRISON CF SOUTHERN HICHZGnN
By

Kenneth Reginald Lavis

 

 

 

n EXPLORATORY arm or mnm m 11mm: PROCEDURE
WITHIN rm: Psrcau'rnm cum: AT THE
sum PRISON or SOUTHERN mommy

By

Roan-tn Reginald Davin

A PROuEGT REPORT

Subtitud to :1. School of Social Work
Michigan State University
in Partial Fulfillment of th
Remus-0:0: the Dust-u

MASTER (I SOCIAL WORK

Jun. 1957

 

MM‘Pfi-m/tfi—h I
Dinetor or School

W'\
1

LIBRARY ‘
Michigan State
University

  
    
  

 

THESIS

G z/7/Cr/
5293'”

ACKNOWLEDGEBENT

Acknowledgement. are gratefully extended to
Dr. Lucille Barber and Mr. Manfred Lilliefors for the
valuable assistance which they have given to the aufihor
in the completion of this report.

Sincere appreciation is expressed for the extra
inspiration received from Dr. Gordon Aldridge, who
supervised the author in hie endeavor to write this

report.

For their support and consideration, the author is
also indebted to Dr. Warren 3. Ville. Director, and to
Mr. Harold Dukes, Social Work Supervisor. both of the
Psychiatric Clinic, State Prison of Southern Michigan.
In addition, sincere thanks are expressed to the entire
staff of the Psychiatric Clinic flor their willing and

able assistance.

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LIST 0?

CHAPTER
I.

II . ‘
an

IV.

V.

TABLE OF CONTENTS

Page

TABLE S O O O I O O O O O O O O O . O O O O O O O 1'

IMRODUCTION O O O O O O O I O O O 0 O O O O O 1
Reason for Study
Review of Literature

PROBLEM, QUESTIONS, AND PROCEDURE . . . . . . . 6
Problem
Question.
Procedure

SETTING O 0 O O O O O O O O I 0 O O O O O O O 10
Physical Set ing of Clini
Reception-Diagnostic Center
Professional Clinic Personnel

PRESENTATION AND ANALYSIS OF DATA . . . . . . . 16
Sources of Referrals
Cross-Classification.of’Sourcee and

Stated Reasons for Referrals
Statue of Referrals Following
Initial Contact
Clinic Contacts with Referral sources
Professional Staff Representing Clinic
at First Contact

SUMVIAEI AND CONCLUSIONS e e e e e e e e e e e e 36
Summary
Conclusions

APPENDICES O Q I I I O O O O O O O O O O O O O O O O O O ‘5

BIBLIOGRAPHY O Q 0 O O O O O O O O 0 O O I O O O O O O O

~111-

LIST OF TABLES
Table

1. Sources of Referrals to the Psychiatric Clinic.
State Prison of Southern Michigan, October 1,
1956 . DOCCIbOP ’1. 1956 e e e e e e e e e e e e

2. Sources and Reasons for Referrals, Ps chiatric
Clinic, State Prison of Southern.Mich gen.
OCtOBOT'lg 1956 - D.¢.lb.r’31. 1956 e e e e e e

3. Referral Sources and Status of Referrals
Following Initial Contact, Psychiatric citric.
State Prison of Southern Michigan, October 1.
1956 ‘ D.’..b.r 31. 1956 e e e e e e e e e e e e

k. Clinic Contacts with Referral Sources,
Psychiatric Clinic State Prison of Southern
Michigan, October i. 1956 - occc-bcr 31, 1956 .

5. Professional Staff Handli first Contact.
Psychiatric Clinic State risen of Southern
Michigan, October i. 1956 - ncccntcr 31, 1956 .

-1'se

CHAPTER I
INTRODUCTION

A study of referral and intake procedures in a
psychiatric clinic is one means of gaining understanding of
how's clinic relates to its community. Certain emphasis
should be placed on the intake process inasluch as the acti-
vities of the agency are directly related to those cases
accepted or rejected during the intake period.

The intake process in social welfare agencies is the
initial contact or series of contacts made with the client
or patient for the purpose of helping hilxnove as realistic-
ally as possible towerd appropriate help. Hamilton stressed
the inportance of helping the patient to progress toward help
when she wrote, 'Techniques have been developed to induce the
person to move fro- readiness to ask for help ... toward

readiness to use help."

During 195#. John Davis, a second-year student at the
Department of Social Work. Michigan State College, conducted
a research project while completing his field work at the

 

1 Gordon Hamilton, 'Hel ing People - The Growth of a
{gzgessiog§;, Jgggnal 9;, o ‘ Qaseggzg, Vol. XXIX, No. 8,
I: P- o .

-1.-

-2-

2
Psychiatric Clinic at State Prison of Southern Michigan.

John Davis. who began his work in the Psychiatric Clinic as
a student social worker one year after the clinic was for-
sally organised, became interested in explorilx referrals to
the clinic, their sources, and the reasons for referrals, at-

teapting to examine the intake process at that tine.
Reason for Study

The writer discussed several research possibilities
with the Social Work Supervisor at the clinic. One possibility
was to conduct a follow-up study of the referral process to
the clinic , comparing the findings to those of John Davis'
study. This writer chose to conduct a comparative study of
the referral process at the Psychiatric Clinic. State Prison
of Southern Michigan. since it was felt that the findings
could be of value to the clinic in re-exanining its intake
process two years following the previous study. The writer
had an interest in such a research project in that it helped
hi- to become better acquainted with many of the functions of
the agency, making the field experience there a more neaning-
fnl one.

 

2. John Davis, "An Exploratory Study of Rcferrals and
Intake Procedures within the Psychiatric Clinic at State
Prison of Southern Michign' (unpublist Master's Research
Project Report, Department of Social Work, Michigan State
University, 1955s)

-3-
Review of Literature

There is a vast amount of literature available about

crime and its dynamics. The wave of prison riots which came
to a-head during the early 1950's stimulated public awareness
of conditions existing within prisons.

The prison riot of April, 1952 at the State Prison of
Southern Michigan supported charges that dangerous inmates
were often housed and mixed indiscriminately with the general
population of the prison. The need for more psychiatric
services within the Corrections Departnent became apparent.

It has been estimated that at least two or three per-
cent of all prison admissions are psychotic, and that possibly
an equal number develop psychotic trends during confinement.

While it is generally agreed that much is to be desired
in achieving penal reformation. writers such as John Bartlcw
Martin have exposed to the American public the conditions that
have existed in penal institutions.“

With the advent of various refer-s after many bloody
riots throughout penal institutions. it was to be expected
that more facilities would be forthcoming which would hepe-

 

——

3 “Paul Tappan Contem orar Correction New York:
McGrewbHill, 1951, p: ICIT"2“‘TI '

5 John Bartlow Martin B ak Down 212, Wall; New York
Curtis Publishing Company, 165 . ' '

-L-

fully focus on rehabilitation rather than punishment of ins

mates.

Literature about our prisons has emphasized the need
fior trade training and more adequate preparation of the in-
dividual to take his place upon rejoining free society. It
has been recognised.that psychiatric services could be of
great help within the penal systems. However, it seems evi-
dent that rehabilitation has not been put into effect nearly
as much as it has been discussed. Robert Currie, who also
completed a research project at the Psychiatric Clinic, State
Prison of Southern Michigan, while a second-year student at
the Department of Social work, Michigan.8tate College, found
that there were only six psychiatric clinics in adult male
prisons in the United States which had a professional staff
consisting of a psychiatrist, a psychologist, and a social
worker, engaged in practicing the clinical I'tean" approach.

There is a lack of literature dealing with psychiatric
clinics in prisons. This may be explained on the basis that
there are so few clinics operating in prison settings. There
is a tendency to finance physical-structural changes first.

With so many of our prisons from fifty to one hundred years

5 Robert L. Currie, ”An Exploratory Investigation of
Personnel Standards, Social Service Practices, and Current
Trends within the Psychiatric Clinics in Selected United
States' Adult Male Prisons" (unpublished Master's Research
Project Report, Department of Social Work, Michigan State
University, 1955), p. 2b.

-5-

old, the need for expansion and newer facilities becomes
one of the more pressing problems for legislatures. Al-
though there seems to be recognition of the services a
psychiatric clinic may offer a corrections department, it
scene that capital outlay for bringing penal institutions
up to date is directed toward improvement of needed physical
structures first, and examination of psychiatric services

Etta mm s

CHAPTER II
PROBLEM, QUESTIONS, AND PROCEDURE
Proble-

When the present study began, the clinic had been in
operation for three years. Numerous changes involving staff,

policies, and attitudes had occurred during this period.

This study was concerned with examining the referral
and intake procedures of the Psychiatric Clinic, State Prison
of Southern Michigan. The central problen was to deter-ins
if there were any differences in the referral and intake pro-
cess for the sonths of October 1, 1956 through Decuber 31,
1956 from those of the sans period in 1955.

Questions

A leading question was whether the inception of’a new
ReceptionADiagnostic Center onFebruary l, l956‘would.sodify
the source of referrals to the clinic. It was felt that aany
emotionally disturbed inmates would be detected during the
"screening" process begore their assignment into one of’the

Corrections progress. The writer wondered if the relation-

 

6 A psychiatrist serving threeofifths tine three psy-
chologists on full tins, and four full-tine social workers
‘were employed in the Reception-Diagnostic Center.

.6...

-7...

ship of the Psychiatric Clinic to the Reception-Diagnostic
Center had caused changes in the intake procedure of the
clinic. Secondly, inasmuch as it had betn two years since the
last study, a question arose as to how various departments in-
terpreted the clinic's functions since they had had an oppor-
tunity to becons better acquainted with the clinic.

Procedure

The central probleu was to determine if there were any
differences in the referral and intake process since John Davis'
study in 1951;. Beginning this study with the intention of
comparing findings with those of the 1951. study, certain prob-
lems arose. In attempting to use John Davis's schedule, it be-
came apparent that a new schedule was necessary in order to
examine current referral procedures, in view of the lack of
available data which John Davis encountered during the first
year of the clinic's operation. Therefore, the present study
cannot be considered a comparative study, since a different
schedule was used and different data obtained. The writer
will compare data of a similar nature when meaningful.7

In order to determine the sources of referrals made to
the clinic for the last quarter of 1956, it was necessary to
exaaine file cards which list inmate numbers and dates of re-
ferral. There were found to be 299 referrals made to the
Psychiatric Clinic during the last quarter of 1956. Duplicate

 

7 See two schedules in appendix.

-3-

referrals carried over from a previous month were elimin-

‘tOd e

Using the inmate numbers located in the files, the next
step was to examine individual patient folders which were
filed according to number. All patients referred to the
clinic had a folder started with their first contact. It
should be sectioned that at the time of the 195‘ study only
those patients who were retained as in-pstients had available
records indicating the dates of referral, disposition, etc.
No records were kept of patients who did not remain in the
_clinic.

is a means of selecting appropriate cases to be used
for the study, it was decided that patients who were receiv-
ing psychiatric treatment or services on a call basis would
be omitted. Generally, in order to avoid duplication, pa-
tients receiving psychiatric services were not included as
referrals, in that a regular schedule for treatment already
existed. After a number of patient folders wore examined,
there were found to be many re-referrals made within a rela-
tively short period. Often, such re-referrals were made for
incidental and non-clinical services, but were included sta-
tistically as 1"new" referrals. Each new contact by the
clinic is designated as a referral unless the patient is on
a specified plan of treatment. No referrals were used more
than one time during the three-month period. Limitation of

-9-

the number of times a referral could be used was necessary
as a result of some referrals constituting a disproportion-
ate number of contacts with the clinic. In a sense, this
group was similar to those patients who were on a call basis.
They were receiving regular psychiatric treatment or services
and were not considered referrals as such. John.Davis'

study also eliminated patients in treatment, and is compar-
able to the present study in this respect.

CHAPTER III
SETTING
Physical Setting of Clinic

The Psychiatric Clinic at the State Prison of Southern
Michigan was formally established on October 1, 1953, with
Dr. Warren S. Wills as its Director. It is located within
the fifth tier of what is known as “Tap 6', and includes an
adjoining area located on the upper floor of the Rotunda.
The writer will refer to "Top 6" and ”Lower 6' as a means of
distinguishing the Psychiatric Clinic from the convalescent
block beneath the clinic. "Lower 6” has four tiers of indi-
vidual_cells below the Psychiatric Clinic housing some 363
inmates, many of whom are epileptics, seniles. and some with
emotional disorders in need of psychiatric services but able
to function without being in the clinic. Many of these in-
mates have been.fbrmer in-patients of the Psychiatric Clinic
and continue to receive medication and psychiatric treatment
from "Top 6", while others are convalescing and undergoing a
period of’observation which "Lower 6” offers. Some of these
inmates spend a good portion of their sentences in "Lower 6'
within its cellblock and adjoining outdoor play area which is
fenced off and not in direct access to other inmates. Some
eat and perform various chores within "Lower 6". ‘Very few

hold jobs in the general pepulation, mainly as a result of

-10-

-11 .

their mental or physical conditions. This results in their
sitting a great deal of the tin. except for recreational
periods. It is recognised that lack of work within the in-
stitution, not only fbr this cellblock but for the entire
population. is one of the more pressing problem of this
institution.

It is felt that the majority of these inmates are able
to function at their best with the type of supervision
'Lower 6" offers. The custodial officer in charge of super-
vising this cellbleck works closely with the Psychiatric
Clinic, attendin occasional staff meetings in the clinic.
and discussing the individual patients as to that can be done
to help then. The attempt has been made to alleviate some
of the pressures these inmates have been unable to cope with
in the general population. since many of these inmates are
unable to adapt to prison life within the general popula-
tion, the protection ”Lower 6" offers in the for- of direct
physical contact with ”Top 6" in the event of needed therapy
is valuable. The less rigid upholding of institutional rules
and regulations makes this cellblock a place in which indivie
dual allowances are made for inmates with certain physical
and emotional difficulties. The attempt has been to offer a
therapeutic environment with some degree of isolation from
the general population so that the inute may regain his emo-
tional equilibriu. Some are never able to make a satisfac-
tory adjustment warrantix placement outside this block.

-12-

Many of the senile and epileptic cases spend their entire
sentences in "Lower 6". However, it is more common for these
inmates to be moved to blocks representing the routine of
prison life than.to remain within the confines of'this en—

vironment .

The fifth tier. or 'Top 6". which houses the in-
patients of the Psychiatric Clinic. contains 31 individual
cells. Another 30 beds are located in the Rotunda in what
is called the 'open ward“. The open ward consists of a
dormitory arrangement for sleeping and a play area, each lo-
cated in the Rotnmis. Such games as pingpcng, checkers, bad-
minton, and shufflebcard are utilised. A small library is
also located in a separate room of the Rotunda. An occupa-
tional therapy class is offered to in-patients as well as to
out-patients who are located in "Lower 6". An inmate con-
ducts these classes, assisted byuanother‘inmate and supervised
by a member of the professional staff. The "closed ward"
consists of 31 individual cells of which three are equipped
for housing the violent patients who may hurt themselves or
others if allowed out of their cells. The closed ward houses
the more disturbed patients who are able to come out of their
cells periodically, but are prone to become upset more easily
than patients who stay in the Rotunda. Patients on the closed
ward live in the block directly over “Lower 6", and have indi-
vidual cells instead of the dormitory arrangement used in the
Rotunda. Most new patients are housed in the closed ward

-13 .

until their behavior warrants placement in the Rotunda,
where most patients mix freely and are able to socialise
with a minimum of acting out. Eating arrangements are separ-

ate, as are other necessary facilities.

There are 26 inmates employed in various— capacities
and living in individual cells in “Top 6". Of this number,
seventeen are inmate nurses, there are four clerks, one
"runner", a barber, a recreational therapist, and ten occu-

pati onal therapy instructors.

Separate offices are available for all members of the
professional staff, and a new staff conference room has been
added which doubles as a meeting place for group therapy as well
as a movie projector sound room for Sunday movies.

Radio and television sets are available in both wards.
Patients are encouraged to participate in outdoor activities
at “yard time“, which occurs about two hours per day. The
same separate yard for outdoor activities is used by "Top 6'
and ”Lower 6*, at different intervals of the day.

Recepti on-Diagnostic Center

Adjoining both 'Iower 6" and 'Top 6" is Cellblock seven.
This block houses the Reception-Diagnostic Center, otherwise

known as the quarantine block.‘ Inmates sentencedto state
penal institutions in Michigan are procehsed through this cen-

ter and assigned to one of the programs within the Corrections

DCP WCHte

New inmates receive inoculations to prevent diseases.
They are also tested to detenine personality characteris-
tics, intelligence, end achievement. Their program may be
largely defined by the results of tests taken while in quar-
antine. The length of stay for inmates in quarantine is
about 30-55 days, and after this period they may be transferred
to any of the penal institutions in the state.

The staff of the Reception-Diagnostic Center is com-
prised of a psychiatrist, three psychologists, and four social

workers.
Professional Clinic Personnel

The Psychiatric Clinic personnel numbered 39 at the
time of this writing. Of this number, 13 were non-inmate em-
ployees. There were three psychiatrists, one serving as the
director of the clinic on a three-fifths time basis, a resin
dent psychiatrist serving on a full-time basis, and a consult-
ing psychiatrist from the University of Michigan whose

services were available two days per month.

There were three full-time psychologists, each having
a Master's degree in psycholcg. A fourth psychologist
served as a consultant in psychology from Michigan State
University and was available for consultation twice monthly.

The social work staff consisted of a full-time psychia-

-15-

trio social worker who assumed supervisory responsibilities
for social work students and also directed the social work
functions of the clinic. A social work student was employed
on a half-time basis while completing second-year field work
training in the School of Social Work at Michigan State Uni-
versity. in electroencephalogram technician conducted all
electroencephalogram examinations and supervised the occupa-
tional therapy program.

Other non-inmate staff members consisted of two civilian
male nurse supervisors and one secretary; the balance of 26

people employed by the clinic were inmates.

CHAPTER IV
PRESENTATION AND ANALYSIS OF DATA

There were 299 referrals made to the Psychiatric Clinic
during the last quarter of 1956. Eliminating duplicate re-

ferrals and those referrals regarding patients receiving
psychiatric services, there were found to be 198 referrals

made to the clinic which met the criteria for this study. Of
this numb er, 107 were new referrals and had had no previous
contact with the clinic. The remaining 91 were re-referrals
who had had some type of previous contact with the clinic
prior to this stuly. The total number of 198 was substano
tially higher than. the 135 referrals used in the 195'. study.
The extent to which this nusber was higher has possibly been
due to different criteria which this writer employed in de-
termining those referrals to be used.

There were 69 referrals made in October, 79 referrals
were made in November, and 50 referrals made in Deedber,
constituting the last quarter of 1956. These numbers did not
appear to reflect any great significance in tens of nufiers
made for these individual months.

Sources of Referrals

The sources of referrals, indicating whether they were

new or re-referrals, are illustrated in Table l.

-16..

-17-
TABLE 1 e

Sources of Referrals to the Psychiatric Clinic,
State Prison of Southern Michi an
October 1. 1956 - December 31. 953.

 

 

 

 

Referral Sources ‘ Total BOIEEEP1! filiEEEEJI
' Total 198 107 91
Self...................... u 19 23
Custodial Personnel.......
cu'tOdyeeeeeeeeeeeeee 2‘ 12 10 u 1‘ &
Discipline Block..... 15 3 12
Halpitalou..u............ 31 21 10
Receptionabiagnostic
Center.................. 29 26 3
IndiVidlill Treatment...... 31 A}. Lo.
Classification....... B 6 2
COWBC10reeeeeeeeeeeee 15 7 8
Parole Board and Warden...

Pam’s. Board......... 10 u 5 i 5 Lo-
WENCDeeeseeeeeeeeeee 5 0 5
Other Imtitutiom.......u 10 k 6

Miscdlaneoul.............
Work Supervisor...... 2 5 Q 0 1
Chapluneeeeeeeeeeeee 2 1 1
Other..'.............. 2 O 2

 

 

 

 

Self-referrals were the largest source of referrals
made to the Psychiatric Clinic during the period studied.
They totaled £2, with 19 of this number new referrals and 23
re-referrals._ These re-referrals were usually made by inmates
'writing a note of some nature to the clinic, requesting an
interview regarding a problem.

-13-

Custodial personnel followed closely behind the leading
number of referrals made to the clinic, with a total of 39.
Included under this heading were the great number of’custodial
officers within the institution as well as the discipline block
which consists of a separate group of custodial officers in
charge of maintaining its operation. Although these two group-
ings, custody and discipline block, were basically members of
custodial personnel, it was felt that the groups should be dis-
tinguished, inasmuch as a number of referrals were recognized
as coming from a block in which discipline is made more rigid
than that of the blocks making up the general institution.

or the 39 referrals made by custodial personnel, 13 were
new referrals and 26 were re-referrals. This referral source
would have the most contact with inmates within the institu-
tion as a result of the nature of theix'jobs. Referrals were
made from.the deputy in charge of custody down through the
ranks of various correctional officers employed in the institu-
tion. Custodial personnel re-referrals made a substantially
large number, twice the number of new referrals. This may
have been due to haying contacts with ex-patients whom custody
felt needed further services from the clinic. If it was known
that a certain patient had been receiving services from the
clinic, any further emotional display on his part might result
in a re-referral. In the 195k study, custodial personnel was
the leading source of referrals to the clinic, followed by

self referrals. It is noted that their positions were reversed

1n thi 3 Btndye

The next largest source of referrals were those made by
the hospital. This source consisted of 31 referrals, 21 of

them new referrals and ten re-referrals.

The Reception-Diagnostic Center followed with 29 re-
ferrals. 0f thisnumber, 26 were new referrals, with three
re-referrals. This new'source of referrals made the fourth
highest number of referrals to the clinic. The bulk of_its
referrals consisted of new referrals for psychiatric evalua-
tion and treatment. A great number of these referrals re-
quired electroencephalogram examinations as a result of a

history of "dirty spells" and "seizures“.

Individual Treatment was the next largest source of re-
ferrals with 23. 'This number consisted of 13 new referrals
and ten re-referrals. Under this referral source were included
the Classification Committee and the counselors of the insti-
tution.

The Parole Board and Warden referred 15 cases, of which

five were new referrals and ten were rs-referrals.

Other institutions made ten referrals, four new referr-
ale and six re-referrals. In this grouping were included the
Marquette Prison, Ionia Refbrmatory, and one of the prison

cupa e

The last referral source was a miscellaneous group

-20...

totaling nine referrals, six new referrals and three re-referr-
als making up this group. Within this group fell work super-
visors, Chaplain, and in one case an inmate's wife who made
the referral via the director of’the clinic.
Cross-Classification of Sources and
Stated Reasons for Referrals

The same groupings for reasons for referrals used in the
1954 study were used in this study. ‘In many instances the
same terminology stated in the referrals to the clinic'was
used in this study. In other instances it was necessary to
interpret what category the stated reason for referral would
fit.

Table 2 indicates that psychiatric evaluation was the
most often-stated reason for referral to the clinic. Accord-
ing to the referrals, psychiatric evaluation was meant to
effect an evaluation from the clinic in order to assist the
referral source in making a decision regarding a particular
case. In many instances the terminology used was a means of
helping an inmate to obtain treatment of some nature, rather

than for evaluation purposes only.

There were 77 referrals made for'psychiatric evaluation.‘
The Reception-Diagnostic Center led with 18 referrals in this
’category, while the hospital followed with 17, custodial per-
sonnel 12, Individual Treatment 11, Parole Board and Warden 11,

self four, other institutions three, and miscellaneous sources

-21-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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-22..

last with one referral. Self referrals sometimes requested
electroencephalogram tests as well as interviews in order to
alleviate any doubts they may have had about their mental
stability.

Referrals for treatment was the next largest group with
‘26 cases. Individual Treatment and the Reception-Diagnostic
Center each referred seven cases. The remaining 16 referrals
‘were distributed rather evenly throughout the remaining
sources of referrals, with the exception of custodial person-

nel which made no referrals for treatment purposes.

Non-clinical inquiry was the next grouping of stated rea-
sons for referrals to the clinic. Under this category fell
numerous requests for cell changes, new Parole Board hearings,
reclassification, and other inquiries of such nature which
were not the clinic's function. Self referrals accounted for

the entire 25 cases in this grouping.

The next group of 20 referrals was made because of ner-
vousness. Self referrals made for this reason led with six
cases, custodial personnel next with five. hospital three,
Individual Treatment three, miscellaneous two, Reception-Diag-
nostic Center one, and other institutions and Parole Board

and warden had none.

Bisarre behavior was the reason given for 18 referrals.
Included in this category were such examples as inmates at-

tempting to commit suicide, sleeping under the bed, and other

-23-

such behavior. Custodial personnel referred eight cases in
this category, while other institutions followed with four re-

ferrals. Of the remaining six cases, the hospital referred
three, self one, Reception-Diagnostic Center one, Parole Board
and Warden one. There were no referrals from miscellaneous

and Individual Treatment sources.

There were 17 referrals made as a result of inmates be-
coming emotionally disturbed. Examples of this group were
inmates who experienced delusions and hallucinations. Cus-
todial personnel referred the largest numbeerith eight, hos-
pital and miscellaneous sources followed with three referrals
each, and the balance was distributed throughout the remaining
referral sources, with the exception of Individual Treatment,
other institutions, Parole Board and Warden, who made no re-

ferrals for this reason.

Inability to adjust was the stated reason for nine re-
ferrals. Of this number, five were made by custodial personnel,
while the remaining four cases were referred by self, Reception-
Diagnostie Center, Individual Treatment, and miscellaneous
sources. lo referrals were made for this reason by the hospital,

Parole Board and Warden, and other institutions.

"Other“ reasons included seven referrals made for a
variety of reasons which did not fit into any of’the previously
stated reasons for referral. Under this grouping were such

examples as an inmate's wife requesting guidance as to what she

-25.

could do to help the inmate, and a request from the referral
source to contact an outside agency prior to making placement

plain.

Although custodial personnel referred the largest number
of cases in the 195$ study, it was the next largest source of
referral in this study. This source referred nearly half of
its bk cases for bizarre behavior in the l95h study, while
psychiatric evaluation was the leading reason stated for re-
ferrals in the present study, with bisarre behavior and emo-
tionally disturbed each having eight referrals.

The significance of Table 2 seems to be the contrast of
77 referrals made for psychiatric evaluationéas compared to 26
referrals made for treatment. It seems that most sources of
referrals view’the clinic as more of a diagnostic agency than
an agency for treatment. Consideration should be given, howb
ever, in those cases where it may be felt that the referral
source would feel the clinic should decide whether a referral
needs treatment or not. This source would tend to have treat-
ment as the objective, even.though evaluation was the stated

request.

Table 2 illustrates to some degree what the custodial
personnel interpret the clinic's function as being. The
majority of their referrals were made for ”acting out“ be-
havioral problems that would tend to upset the routine of the
prison. Although their referrals did not request treatment,

-2 5-

it is significant that they requested an opinion or evaluation
by the clinic in dealing with inmate problems. Custody made 39
referrals, of which 12 were for psychiatric evaluation as com.
pared with the 195$ study which tabulated k5 referrals to the
clinic of which only two were for psychiatric evaluation. The
former study indicated that 38 of the it referrals made by
custody were distributed among the categories of bizarre be-
havior, emotionally disturbed, and inability to adjust. The
present study appears to show custody at a period nowwwhere
they tend to state reasons for referrals that would indicate a
desire on their part for obtaining the clinic's opinion regard-
ing the disposition of’an inmate's prdblems. This also could
suggest that referrals were made for psychiatric evaluation be-
fore an inmate came to the stage of'acting out! his problems,
which later could result in bizarre behavior.

Status of Referrals Following Initial Contact

The status of referrals following the initial contact
with the clinic were almost evenly divided between those re-
ceiving a single contact and those having more than one con-
tact.

Table 3 indicates that of 198 referrals 96 cases received
some type offurther services following the first interview,
while 102 cases were closed following a single contact.

Self referrals tended to terminate after a single con-
tact, with only 13 of #2 referrals receiving further services.

~26-

 

 

 

 

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-27-

Custody had 25 cases which received further services, possibly

because a greater percentage of their cases were re-referrals.

Other institutions referred ten cases, with that number
receiving further services. These referrals were usually made
because of circumstances requiring extensive psychiatric
examination. Often it was because the inmate had experienced
a psychotic episode and was thought to be in need of treatment,
or in some cases it was because of future parole plans, and
I’clearance" from the psychiatric viewpoint was needed as a

result of some previous contact the inmate had with the clinic.

Transfer of an inmate from one of the other prisons, re-
questing some type of service from the clinic, usually entailed
in-patient status in the clinic while the service was given.

If treatment was involved, the inmate would either be treated
while a patient in the clinic or in the convalescent block
referred to as ”Lower 6'. Chronic mental patients also could
be transferred to the Ionia State Hospital for the Criminally
Insane in some instances where treatment seemed to be indicated

for an extended period of time.

The types of services given those referrals who had more
than one contact varied with individual cases. There were
four types of treatment plans used to describe the status of
patients receiving services from the clinic following initial

contact:

-28-

(1) Evaluation could generally include interviews,
psychological testing, and electroencephalogram examinations.
Patients being evaluated usually resided in the general popula-
tion, or were new inmates from the quarantine block receiving

these psychiatric services.

(2) Unscheduled out-patient treatment services
usually included treatment of some nature on an unscheduled
basis. The patient was expected to contact the clinb when he
felt the need. He usually resided in the general population,

or sometimes was assigned to "Lower 6'.

(3) Scheduled out-patient treatment insolved at
least a single contact with the clinic per week. In some
cases patients had more than one contact a week. Patients on
scheduled out-patient treatment status often resided in ”Lower 6”
and were considered to be receiving more intensive treatment

than those on unscheduled out~patient treatment basis.

(h) In-patient treatment consisted of the patient
being confined to the clinic for treatment. In-patient treat-

ment was considered to be the main focus of the clinic.

Table 3 shows that 25 of 96 cases required some type of
evaluation services following the initial contact. ~

Individual Treatment and self referrals had six and five
cases respectively which received evaluation services after

the initial contact.. These same sources of referrals had two

-29-

cases each receiving unscheduled out-patient treatment. The
remaining three cases were divided proportionately with one
each to hospital, custodial personnel, and other institutions.

There were six cases which received scheduled out-pa-
tient treatment. or this number, three were self referrals,
while the hospital and miscellaneous referral sources had two

and one respectively.

There were 58 cases that received in-patient treatment
‘ services, over half of the total 96 referrals receiving some
type of further services after the initial contact. Again,
custodial personnel had the leading number, with 20 cases re-
ceiving such services. It should be remembered that a large
number of referrals made by custody (26 of 39) were re-
referrals, and inmates who may well have been former in-

patients requiring more intensive services on a frequent basis.

The Reception-Diagnostic Center had the next largest
number of referrals receiving in-patient services with 15
cases. The professional services available at this source
would suggest that more in-patient treatment cases would be
referred, as did occur, as a result of their having available
diagnostic services. Patients retained in the clinic from
this source tended to be affected by more serious disorders
than were custodial personnel referrals. These two sources
of referrals had over half of the 58 cases receiving treat-

ment on an in-patient basis.

-30-

Hospital and other institutions each had eight cases re-
main in the clinic on an in-patient basis, There were seven
cases receiving in-patient treatment distributed among the re-
maining sources, with the exception of miscellaneous which had

none.

It appears that Individual Treatment referrals received
more evaluation services from the clinic than any other ser-
vice. This could be due to requests for further information
regarding plans by Classification and the counselors for Jobs,

outside placement, and educational assignments.
Clinic Contacts with Referral Sources_

The clinic's contactswith referral sources varied con-
siderably. Table h indicates that there were 6t referral
sources not contacted by the clinic after the patient was
seen. From a total of 156 cases, 92 referral sources were con-

tacted. There were l.2 self referrals omitted from this total.

Of the 92 sources contacted. 77 sources were contacted
within two weeks, while 15 sources were contacted after a two-

week period.

Custodial personnel referrals had a good share of replies
from the clinic, within two weeks in most cases. Some of
ntheir referrals came from sources where no objective could be
gained by a reply, which accounted for some of the fifteen
cases not contacted. Officers in the yard on night shifts

'making referrals would be an example of this source.

.31.
TABLE 1.

Clinic Contacts with Referral Sources
Psychiatric Clinic State Prison of southern Michigan,
October l, 1956 - December 31, 1956.

.--—-..-..Wl..-w——m__~.fi-m.-.— —_..._.

   

   

 

 

 

 

 

e erra ~curses
C nta te \ ngerral
Elapsed Time urces
Referral f;"“ Not
Sources Total r.¢.1w"%§§1“ Irw;r Contested
a Heggg__ a
Total 156‘ 92 77 15; ‘ _ 6). _
Custodial Personnel. 39 25 23 _l 15
“O'p1tdseeeeeeeeeee 31 21 16 5 1°
Reception-Diagnostic .
O'RtCreeeeeeeeeeee 29 10 5 5 19
Individual Treatment 23 16 16 O J 7
Parole Board and
"N.neeseeeeeeees 15 1‘ 11 3
Other Institutions.. 10 3 2 l 7
m.¢.11“.omeeeeeee 9 ‘ ‘

 

 

 

 

 

 

”a - Self referrals numbering 1.2 cases were omitted.

hospital and Reception-Diagnostic Center'were sources
which had more cases in which replies to referrals were made
after a two-week period. These two sources also had a consi-
derable number of ncereplies to referrals made to the clinic.
The Receptioneniagnostic Center appeared to have requested nu-
serous electroencephalogram examinations, which in.sost cases
were not followed by'a reply fren.the clinic. The hospital had

a considerable number of‘no-replies to referrals made to the

.31-

TABLE h

Clinic Contacts with Referral Sources
Psychiatric Clinic State Prison of Couthern Michigan,
1. 1956 - December 31, 1956.

October

 

 

 

 

 

 

 

Contagteg Referral
n.t.rr.1 1 Elaesed Time , Sogrgos
4 IR ‘ 0
Sources Total Total “T3 n “:1. Contested
. "0&4 “0.5!
Total 156‘ 92 7? e 15 ,L 61.
Custodial Personnel. 39 2a 23 ",1 i 15
HOCP‘tneeeeeeeeeeee 31 21 16 5 10
Reception-Diagnostic ,
CCHtCrseeeeeeeeeee 29 10 5 5 19
Individual Treatment 23 16 16 O 1 7
Parole Board and
"I“.neeeeeeeeeeee 15 1‘. 11 3 1
Other Insti tuti one. . 10 3
”80.11“”"eeeeeee 9 k ‘v

 

 

 

 

 

 

“a - Self referrals numbering 1.2 cases were omitted.

hospital and Reception-Diagnostic Center were sources
which had more cases in which replies to referrals were made
after a tweoweek period. These two sources also had a consi-
derable number of no-replies to referrals made to the clinic.
The Reception-Diagnostic Center appeared to have requested nu.
merous electroencephalogram examinations, which in most cases
were not followed by a reply from the clinic. The hospital had

a considerable number of lee-replies to referrals made to the

.J)

-32-

clinic. Because a close relation seemed to exist between
certain staff members of the clinic and the hospital, it could

be that direct contact or telephone calls accounted for some

of the no-replies.

Individual Treatment appeared to have had immediate re-
plies to completion of their'referrals. All were contacted

within two weeks.

Parole Board and Warden referrals had nearly all of
their referrals completed with the source contacted, in most
cases within a twodweek period. There was only one case in
which the source was not contacted regarding disposition.
Other institutions and miscellaneous referrals had a number of
cases in which the clinic did not contact the referral source
upon completion of the referral. This was due in part to the
transferring of records and the inmate to this institution,
often resulting in some cases where there was no need to con-
tact the referral source. Under the miscellaneous grouping,

the maintenance supervisors were seldom contacted.

By and large, a good portion of the referral sources
were contacted after the clinic had completed the referral
and a disposition made. The length of time before the contact

was made appeared to be within the reasonable time of two weeks.

One immediately notices the contacts made by the clinic
from those referral sources of Parole Board and Warden. There

were 1L out of 15 referrals in which there was an immediate

-33-

reply within the twocweek period. This might suggest a certain
amount of importance put on these referrals. However, this
number is not so impressive when viewing the entire picture of
clinic contacts with referral sources as shown in.Tab1e k.
Professional Staff Representing
Clinic at First Contact

The psychiatrists represented the clinic during the
initial contact in nearly half of the 198 referrals. Table 5
indicates that 80 referrals were seen by a psychiatrist. Of
the 80 cases, the psychiatric resident saw a good madority of
these cases due to his employment on a full-time basis, as
well as making preliminary admission notes which were con»
cerned with the possibility of medical problems.

TABLE 5

Professional Staff Handling First Contact,
Psychiatric Clinic,
State Prison of Southern Michi an
October 1, 1956 - December 31. 95 .

W

 

 

 

 

Professional Staff Number—
Total 198
Psychiatrists................... 80
Psychologists................... 59
Social workers.................. 36
E1‘%3Z§£f§2§§f§?§ff1........... 23

 

 

-3;-

Since the director of the clinic worked on a three-fifths
time basis, he did not handle as many referrals as the other
psychiatrist. It is also reasoned that referral sources would
be more apt to refer cases to the director or to a doctor in
the clinic than to other mmbers of the professional staff.
This seems particularly true in reference to those referrals
from the hospital, Reception-Diagnostic Center, and the Parole
Board and Warden. Nearly all of the referrals from other in-
stitutions were seen by a psychiatrist at first contact. The
possibility of need for medication would.undoubtedly account

for many of these contacts.

There were three psychologists employed in the clinic,
who handled 59 of the 198 referrals made to the clinic. The
consulting psyaologist represented the clinic in a few cases
at first contact. ‘

Social workers represented the clinic in 36 of the 198
referrals. A full-time social worker, who also acted as
director of social services in the clinic'handled the majority
of these referrals. The writer, a second-year graduate social
work student working on a one-half time basis, saw a few of
these referrals at first contact.

The electroencephalogram technician represented the
clinic in 23 cases, usually conducting his examinations at

first contact.

 

-35-

The staff member representing the clinic at initial
contact changed considerably when comparing these data with
the 1951. study. John Davis found that psychologists, with
three full-time and two half-time staff members, represented
the clinic in 108 of 135 contacts. The difference in addi-
tional staff, which compares with three full-time psychologists
at the time of the present study, would probably account for
the leading figure. Also, the fact that several psychologists
had had tn to three years' experience in the prison at the
time of the 1951. study and were well known, could well account
for many referrals being handled by them as a result of their
familiarity with many of the cases.

The social worker represented the clinic in 15 of 135
initial contacts in the earlier sttmly. There were two half-
time workers and one full-time staff member who haniled the
same number of referrals at first contact as did the psychiao
trist. In the present study, social workers represented the
clinic with the third largest group of first contacts, 36 of
198 referrals.

The study found that the electroencephalogram technician
represented the clinic in 23 of the 198 referrals during ini- .
tial contacts. The 1951. study did not report the technician
as representing the clinic in any initial contacts.

CHLPTER V
SMART AND CONCLUSIONS
Summary

This study is concerned with examining the referral
and intake procedures of the Psychiatric Clinic at the State
Prison of Southern Michigan. The central problem was to de~
termine if there were any differences in the referral and in-
take process for the months of October 1, 1956 to Decnber 31,
1956 from those of the same period in 1955.

Beginning the study with the intention, of comparing
findings with those of the 1954 study, certain obstacles
arose. In attempting to use John Davis' schedule, it became
apparent that a new schedule would be necessary in order to
examine current referral procedures. It was necessary to
modify the procedure because of the lack of available data
John Davis encountered during his study. As a result of de«-
vising a new schedule, different data were obtained; however,
comparisons were made whenever data sought were of a similar
nature to those obtained in the former study. In many in-
stances, this writer made no attempt to compare data as such
because of the different information obtained as well as the
change of structure in which some of these data were utilised.
The tables particularly reflected different findings than’l‘s'” _
those in the study completed by John Davis.

-35-

 

 

-37.

The data found in this study pointed toward a number of
significant changes in the referral and intake procedures of
the clinic, as compared with the earlier study.

First, there were 198 referrals made to the clinic dur-
ing the last quarter of 1956. This number was somewhat larger
than the 135 referrals made in the former study.

There seemed to be no appreciable difference in the

number of referrals made during any one month.

The study disclosed approximately the same number of
new referrals as those referrals which had had contact with
the clinic prior to this study. The previous study also had

a rather even distribution of new referrals and re-referrals.

There were eight main sources of referrals, in which
self and custodial referrals were the two largest categories,
accounting for 81 of 198 referrals. Self referrals numbered
more than those from custody, which had the leading number in
the findings of the 1951.. study. The remaining referrals were
distributed in order similar to that of the 1951. stuiy.

With the exception of the Reception-Diagnostic Center,
which was instituted since the 195). study, the sources compris-
ing the remaining nmnber of referrals were the hospital, Indivi-
dual Treatment, Parolc Board and Warden, other institutions,
and miscellaneous, with the largest numbers arranged in the

same order.

~38-

The Reception-Diagnostic Center was the fourth largest
source of referrals, with a total of 29 of 198. This referral

source was new; however, a close relationship seemed to exist
between this source and the clinic. Numerous contacts were
made by the Reception~Diagnostic Center for purposes of fur-
ther evaluation and treatment. This source did have a consi-
derable effect on the intake procedure when one views the
sources, reasons for referrals, and the services given by the
clinic. This source had nearly all new referrals, with
approximately half of 29 referrals receiving treatment on an
impatient basis. With the exception of custody, which had
20 of 39 referrals receiving treament on an in-patient basis,
the Reception-Diagnostic Center no the leading source of re-
ferrals, accounting for 15 inc-patient cases. The services
these referrals required, as well as the number of referrals
made by this source, had a definite impact on the intake proce-
dure of the clinic, when comparing these findings udth those
of the 1951.. study.

The stated reasons for referrals seemed to have under-
gone some changes since the time of the former study. In
using the same categories of stated reasons for referrals, the
writer found that psychiatric evaluation remained the most
often stated reason for referral, with 77 of 198 referrals.
However, treatment was the second most often stated reason'for
referral to the clini c, with 26 cases. This stated reason for
referral was used by the Reception-Diagnostic Center and

.39-

Individual Treatment sources in over half of the 26 treatment
requests. Custody made no stated requests for treat-ant, al-
though it used psychiatrie evaluation.lore than any other rea-
son, which seemed to indicate a tendency to use the clinic's
services when making decisions regarding inmates with problels.

Approximately half of the referrals were made for pay»
chiatric evaluation and treat-ent, and were considerably lore
than those referrals deecribing behavior which indicated overt
disturbances. 7

Various departmente nee-ed to View'the clinic in a difb
ferent light, whidh would answer further questions posed by
the writer. That is, it appeared that referrele were being
made as a reeult of the sourees requesting consultation or
opinion fro. the clinic in helping thea.arrite at decisions
regarding certain inmates. fhie view of'the clinic's function
was different in.that the fbrner*study tended to illustrate
that many referrals were made because of extreme emotional
disturbances. The present findings indicate that some in,
mates were being referred to the clinic before they became
seriously upset. Another possibility is that.those who did
exhibit extrene emotional disturbances were referred for
treatment and.eva1ustion rather than bizarre behavior. elo-

tionally disturbed, and other stniler reasons.

Self referrals had many contacts wdth the elinio for
matters of non-clinical nature. That in, they tended to

request services whim often resulted in only one contact,

and required less intensive services from the clinic. How-
ever, it is encouraging to note that the largest source of
referrals came from imates availing themselves of the ser-
vices of the clinic by self referral, which indicates positive
recognition and acceptance of the clinic's functions.

Custody had twice as many re-ursferrals as new referrals,
which seemed to indicate a tendency to re-refer former pa.
tients to the clinic. Bess of these. patients undoubtedly had
been on an in-patient status at one time. and many were re-
admitted to the clinic for treatment upon re-referral.

The hospital had half of its referrals receive sons type
of further service after the initial contact. The majority
of those referrals receiving further services sentenced some
type of treatment. ranging from in-patient status to unsched-
uled out-patient treat-ant.

Individual Treatment referred the majority of its cases
for psychiatric evaluation and treatment. Less than half rs-
ceived any fellow-up services and those cases which had IO!"
than one contact often received some type of evaluation ser-
vice.~ Only one of 23 referrals from this source became an
in-patient. Individual Treatment seened to use the clinic's
services, for the most part. for diagnostic purposes; however.
there was an appreciable increase in the nunber of referrals

by counselors. as compared to the former study. Classification

-Ll-

was included with counselors, and most of these referrals rev-
quested evaluation from the clinic merely for the purpose of
placement.planning. Few received further services as com-

pared to counselor referrals.

The Parole Board and Warden had less than half of their
referrals receive further services. These receiving further
services were usually of an evaluative nature. The Parole
Board was the source that made up the group having more than
one contact. Warden referrals tended to have a single con-
tact and often were re-referralc which were awaiting cone type
of service that had been scheduled at an earlier date. As
an exanple, a routine examination would be requested after an
inmate had been seen by the Parole Board. This examination
would be requested from the clinic by an innate. however,
such examinations were not made unless the request was made
directly by the Parole Board. What resulted was that the
inmate took his request to the Warden, the verified the facts
of the case, and thu the referral was merely a re-rcfcrral
of the patient by a new source for the purpose of evaluation
or possible treatment.

Other institution referrals had more than one contact.
and usually were made for treatment or evaluation. Many of
these referrals remlted in treatment on an in-patient basis.
In most cases, inmates who are transferred fron other institu-
tions are received directly into the clinic. Evaluation

-42-

services generally call for tests and a period of observation
which makes it more expedient to have them in the clinic.

Miscellaneous sources of referrals were nearly always
cases that were completed by a single contact. These sources
appeared to make referrals as a result of inmates becoming
overtly disturbed.

After referrals were completed by the clinic, the source
of referral was contacted in most cases when warranted. he-
ferrals that came from custody, the hospital, and the Reception-
Diagnostic Center had the majority of Ito-contacts after cempleo
tion. In many cases, the source was contacted in the form of
a telephone call or an individual contact by a member of the
clinic staff. This information was not written in the folder,
which would make it appear that no contact had been made upon
completion of the referral.

In most cases, referral sources were contacted upon con-
pletion of the referral. The time in which most sources were
contacted was usually within two weeks.

The Parole Board and Warden were contacted after com-
pletion of almost all of their referrals. Most contacts were
made within two weeks. This seemed to indicate that an ex-
tended effort was made to inform this source of the disposition
of their referrals. In another light, the referrals made by
the Parole Board often were concerned with releases and evalua-

tioms regarding parole and discharge plans. This type of

-43-

referral would tend to require contacting the referral source

after completion of services.
Conclusions

The writer found distinguishable differences in the
intake and referral procedure of the Psychiatric Clinic at
the State Prison of Southern Michigan when it was possible to
make comparisons with those findings of the 195). study.

The establishment of a Reception-Diagnostic Center apc
peered to have some effect on the intake and referral proce-
dure of the clinic. This source of referral accounted for
the fourth largest number of referrals made to the clinic dur-
ing the period studied. A majority of these referrals re.
quired extensive services and many became in-paticnts. The
writer's question as to whetha' the referral and intake pro-
cedure of the clinic would be modified due to this new source
of referrals appears to be answered by the findims.

The sources of referrals seemed to vary in their inter-
pretation of the clinic's functions as compared with the find-
ings of the 1951. study. The writer found that psychiatric
evaluation was the stated reason most often used in referrals
to the clinic. The former study revealed similar findings.
However, in 1951. the majority of referrals were made for
”acting out" behavior rather than for any specific plans for
treatment. The present study saw psychiatric evaluation and
treatment accounting for half of all referrals. These findings

4,1,...

would seem to indicate that referral sources View the clinic

in a different manner than the 1951. study would sxggest.

The writer is of the opinion that further studies in
this area would provide an excellent basis for perpetuating
a record of the Psychiatric Clinic's relationships with the
various departments within the prison, and the Corrections
Department as a whole. And further research, interpretations .
and comparisons of such findings might prove valuable~ toward
implementing the aims of the Psychiatric Clinic in rendering
the services for which it was inaugurated.

-45-

APPENDICES

l.
2.
3.
h.

5.

4.6-

SCHEDULE USED IN COMPILING DATA OF CLINIC CONTACTS
October 1, 195A - December 31, 195A

Number Referral Date _Referred By

Stated Reason for Referral

 

Initial Contact . Date
Prior Contact During Preceding Year
(a) If so, Nature of Contacts

(b) Reasons fer Contacts

 

(c) Disposition of Case

 

Chronic Mental Patient or Series of Contacts Prior

to October 1, 1933
(a) Prior Status in Clinic

(b) Disposition of Case__

 

This information applies only to Contacts of Three Months Prior
to period. October 1, l95h - December 31, l95h:

1.
2.

3.

7.

Who had Initial Interview
Further Contacts

 

Same Person A__If Yes, When__ __By Whom
For What Purpose
Was Case Staffed_____hhen_ Formally___Informally___
Status of Case During This Time: (a) Call Basis

(b) Visitor (c) Out-Patient_____(d) In-Patient___.

Disposition: (a) Released (b) Carried on Caseload

 

 

(c) Treatment ' (d) By Whom
Diagnosis

 

 

2.

3.

A.

5.

6.

7.

-47-

REFERRALS TO PSYCHIATRIC CLINIC
October 1, 1956 - December 31, 1956

Number New Referral Re-Referral

 

Referral Date Referred By

Stated Reason for Referrall_

 

Date of Initial Contact With Whom

 

Single Contact Further Contacts (within 3 months)

With Whom
(a) Types of Contacts:

1. Evaluation 3. Scheduled OF R:
2. In-Patient Rx h. Unscheduled 0? R1

Length of Time Between Referral and First Contact

Did Psychiatric Clinic Contact Referral Source

 

If Yes, Was‘it:

(a) Within Two Weeks After Completion of Services
(b) More Than Two Weeks After Completion of Services___

Diagnosis:

 

-43-
BIBLIOGRAPHY
Books

Pox, Vernon Brittain. Violence Behind Bags. New York:
Vantage Press, 19 .

Tappan, Paul. Contem ora Correction. New York: McGraw-
Hill, 19 .

Martin, John Bartlow. Break Down the'Wall . NeW'York:
Curtis Publishing Company, I§§§.

Articles

Brancale, Ralph, and Heyn, Louis L. "Detection, Classifica-
tion, and Treatment of the Youthful Offender," zederal
P obati n, March, 1957, p. 33-k0.

Glueck, Jr., Bernard C. "Changing Concepts in Forensic Psy-

chiatry," The JOurnal of Criminal Law Criminolo and
Police Science, 70. #3, No. 2, July-August, 195k.
p. 23" 2e

Powelson, Harvey, and Bendix, Reinhard, “Psychiatry in Prison,"
Psychiatry, Vol. 15, February, 1957, p. 73-86.

Hamilton, Gordon, "Helping People - The Growth of'a Profession,"
Journal of Social Casework, Vol. XXIX, No. 8, 19b8, p. 294.

Unpublished Material

Davis, John, ”An Exploratory Study of Referrals and Intake Pro-
cedure within the Psychiatric Clinic at State Prison of
Southern Michigan." unpublished Master's Research Pro-
Ject Report, School of Social Work, Michigan State
University, 1955.

Currie, Robert L., "An Exploratory Investigation of’Personnel
Standards, Social Service Practices, and Current Trends
within the Psychiatric Clinics in Selected United States
Adult Male Prisons.” Unpublished Master's Research Pro-
Ject Report, School of Social Work, Michigan State
University, 1955.

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