RESEARCH NOTE

RATES OF IMPRISONMENT HOSPITALIZATION

AND PSYCHIATRIC

1N T H E U N I T E D S T A T E S *

(Received 18 April, 1978) ABSTRACT. The relationship between penal and therapeutic custodial populations bears not only upon theories of social control, but also upon the validity of prison population rates as social indicators. Separate regression analyses of interstate variations in institutional populations for the year 1970, interstate variations in rates of change for the period 1967-73, and variation over time in nationaUy aggregated data for the period 1930-70 imply that the two custodial systems are essentially independent. The findings suggest that rates of imprisonment, when employed as social indicators, need not be adjusted statistically to account for contemporaneous variation in rates of mental hospitalization. Most modem social institutions are characterized by a high degree of differentiation, and systems of social control are no exception. But the history of this differentiation has been brief indeed. As recently as the 19th century, authorities relied predominantly on the criminal process in response to extreme deviance, and upon penal institutions to confine those persons whose presence at large was deemed intolerable. Prisons often accommodated not only convicts, but also paupers, orphans, lunatics, and the aged; specialized facilities for the non-criminal, whether therapeutic or simply custodial, were relatively small in size and few in number. (Rusche and Kirchheimer, 1939, pp. 6 2 - 6 6 ; Griinhut, 1948, p. 27; Kittrie, 1973, pp. 3, 57, 63.) Perhaps the most striking development in the modem history of social control has been the emergence of a medical response to deviance. Prisons have relinquished their function as the predominant warehouses for society's undesirables, and there exist elaborate processes for identifying and sorting individuals according to their apparent state of mind and treatment needs. This study will explore the relationship between rates of penal and psychiatric institutionalization in the United States. The approach will be explicitly macrososial, limited to a statistical analysis of confinement rates. As such, it does not purport to contribute to the literature of law or psychiatry. Rather, the aims of the study are twofold: to assess the extent of functional interdependence between the two social control processes, and SociaIIndicators Research 7 (1980) 63-70. 0303-8300/80/0070-0063500.80 Copyright 9 1980 by D. Reidel Publishing Co., Dordrecht, Holland, and Boston, U.S.A.

64

RESEARCH

NOTE

to explore the degree to which the use of mental hospital facilities bears upon the validity of the rate of imprisonment as a social indicator. This latter issue is of concern not only to scholars who make general comparisons of rates of imprisonment (Waller and Chan, 1974), but to those who employ the rate as one measure of the magnitude or intensity of a jurisdiction's penal sanctions (Blumstein et al., 1976; Jasinski, 1976). Existing theory and research suggest that the two custodial alternatives tend to be mutually exclusive, and that rates of the respective populations may be expected to vary inversely. Rates of imprisonment have been shown to vary inversely with the availability of mental hospital facilities across the states of Australia (Biles and Mulligan, 1973) as well as across the nations of Western Europe (Penrose, 1939). Procedures for involuntary civil commitment differ markedly in their stringency across jurisdictions. In setting where involuntary hospitalization is more readily accomplished, there may be a smaller potential clientele for the criminal justice system. (ENKI Research Institute, 1972, p. 188). Alternatively, there exist eminently plausible theoretical bases for both positive and null relationships between the two rates (Black, 1976, Ch. 6; Waller and Chan, 1974). Polities may vary widely in their tolerance of deviant behavior in general. To the extent that there is a rough parity in the development and use of penal and therapeutic systems within jurisdictions, an overall positive relationship should emerge. Moreover, movements toward deinstitutionalization have characterized both correctional and mental health systems in recent years (Scull, 1977). It hardly seems rash to speculate that those societies with well developed probation systems might also be characterized by extensive outpatient treatment of mental patients. A null relationship, on the other hand, could result from the influence of numerous factors. Sex ratio differences between the two institutional settings, the relative size of age cohorts in the total population, and the availability of alternative facilities for juveniles and the elderly may vary significantly across jurisdictions. It is, moreover, quite apparent that procedures for involuntary civil commitment notwithstanding, large numbers of people go to psychiatric hospitals more or less voluntarily, while few, if any, enter prisons on that basis. The respective institutional populations may well be drawn from largely distinct and independent subsets of the general population, to the extent that no consistent relationship between rates of penal and therapeutic incarceration may appear.

RESEARCH

I. D A T A

NOTE

65

ANALYSIS

The relationship was tested with three different sets of data: institutional population totals by state for the year 1970, obtained from the 1970 Census of Institutions; institutional totals by state for 1967 and 1973, drawn from the Departments of Justice and HEW sources, and nationwide time series data for the period 1930-1970, also drawn from respective departmental sources. 1 There were a number of reasons for analyzing three different data sets, each within a different spatial and temporal context. The data are of questionable validity, and findings which obtain within any one set might be significantly distorted by measurement error. Many of these sources of error are identified in the data sources themselves. Perhaps the most troublesome problem is the general lack of data on inmates of local jails, who often represent a significant proportion of a jurisdiction's custodial population (Waller and Chan, 1974). Such data were not available for the time series analyses, but were employed in the 1970 cross-state analysis. General descriptions of the populations under investigation are provided in Table I. It should be noted, however, that the sources of error do differ across the three data sets. Thus, findings which might consistently appear in each of the three data sets may be invested with much greater credibility than those emerging from any one set alone. In addition, reliance on both cross sectional and time series analysis significantly reduces the risk of results being influenced by artifacts of a given research design. While less than conclusive, simple bivariate correlations between penal and psychiatric institutional populations provide support for the null model. These findings are reported in Table I and Figure 1. Although the rates manifested a significant negative relationship in the 1967 cross sectional analysis, their covariation was clearly positive in the two time series contexts. These latter relationships no doubt reflect the marked increases in both rates during the 1930's and their equally pronounced decline during the 1960's. In only two of the cases did the percentage of variance explained exceed 10%, however. This suggests that in general terms, the use of one of these social control systems has but little influence on its counterpart. Moreover, much of their positive covai'iation can be interpreted as reflecting similar responses to such general factors as budgetary constraint. The relationship merits further examination, however, given the increasing

66

R E S E A R C H NOTE TABLE I

Bivariate relationships between rates of imprisonment and psychiatric hospitalization (per 100 000 population) Date

Context

Sources

Correlation coefficient (r)

1967

State felony prisoners; state and county mental hospital patients (N = 50) Inmates of state prisons and local jails; all mental hospital patients (N = 50) State felony prisoners; state and county mental hospital patients (N = 50) State felony prisoners; state and county mental hospital patients (N = 50) U.S. Annual Totals: patients in mental hospitals (federal, state, county and private); prisoners in state and federal institutions for adult offenders (N= 41) U.S. Annual Totals: patients in mental hospitals (federal, state, county and private); prisoners in state and federal institutions for adult offenders (N = 40)

(a, b)

-0.33**

(c)

- 0.05

1970 1973 1967-73 (percentage change) 1930-70

1930-70 (percentage annual change)

* P <~ 0.05

(d, b)

0.02

(a, b)

0.18

(e)

0.42**

(e)

0.30*

** P~< 0.01

Sources o f data cited are as follows: a. U.S. Department of Justice, Law Enforcement Assistance Administration, Sourcebook o f Criminal Justice Statistics, 1973 (U.S. Government Printing Office, Washington, 1973); p. 351. b. U.S. Department of Health, Education, and Welfare, State and County Mental Hospitals, United States, 1 9 7 3 - 4 (U.S. Government Printing Office, Washington, 1976), p. 43. c. U.S. Department of Commerce, Bureau of the Census, 1970 Census o f Population: Persons in Institutions and Other Group Quarters, pp. 7 4 - 7 7 . d. U.S. Department of Justice, Law Enforcement Assistance Administration, Census o f Prisoners in State Correctional Facilities, 1973 (U.S. Government Printing Office, Washington, 1976). e. U.S. Department of Commerce, Bureau of the Census, Historical Statistics o f the United States: Colonial Times to 1970 (U.S. Government Printing Office, Washington, 1975).

RESEARCH NOTE

67

use of imprisonment rate as an indicator of penal policy (Wilkins, 1967; Waller and Chan, 1974; Blumstein, e t a l . , 1976; Jasinski, 1976). The extent to which rates of imprisonment can be employed safely without explicit controls for rates of psychiatric hospitalization was tested with two regression models shown in Table II. Separate models explaining variations in rates of imprisonment were specified with cross-state and time series data. The models were fairly strong in explanatory power, explaining 73 and 89 percent of the variance respectively. The analysis were then repeated, exactly as before, with one exception - the measure of mental hospital residency was forced into the equation prior to any of the other independent variables. 2 As the beta weights and R 2 values in Table II suggest, the impact of hospitalization was negligible. The relative influence of the other independent variables remained unchanged, and the explanatory power of the model as a whole was not significantly enhanced.

400

r

Rate (per 100,000 civilian resident populationl

~

,

3oo

i

ill,fir

t

i

. . . . . . . .

,

i 2JL~

I

,

.

t

\

:

,

I

E

,

i

.L__i" . _.ii Patients in Federal, S t a t e , County, and Private Mental Hospitals

\ ~oo

_t . . . . . . . .

-_.

, 9 . , ,

Prisoners in State and Federal I n s t i t u t i o n s for Adult Offenders

lO0

! !I!!i

1930

1940

!i i !ii" ~ ::i ~TT

195(7

1960

1970

Fig. 1. Rates of imprisonment and mental hospital residency, United States, 1930-1970.

68

R E S E A R C H NOTE TABLE II

Determinants of rates of imprisonment (standardized regression coefficients)

Equation 1:

Equation la:

Inmates of state prisons and local jails, U.S. States, 1970 (N = 50) 0.48 0.40 0.55 -0.33 -0.21 -0.16 -0.14

Inmates of state prisons and local jails, U.S. States, 1970 (Hospitalization rates forced in) (N = 50) Mental hospital residents -0.06 0.51 0.39 0.55 -0.28 -0.20 -0.16 -0.19

0.73

0.73

Minority population Population increase, 1960-70 Crime Income State expenditures Population 1 5 - 4 4 Urbanization R2

Equation 2:

Equation 2a:

Prisoners in state and federal institutions for adult offenders, U.S. annual totals, 1930-70 (N = 41)

Prisoners in state and federal institutions for adult offenders, U.S. annual offenders, U.S. annual totals, 1930-70 (hospitalization rates forced in) (N= 41) Mental hospital residents

War Crime Unemployment Unemployment 2 Welfare expenditures Age Debt R2 D.W.

0.28 -1.18 2.68 -1.62 0.84 -0.31 -0.14

0.05 0.28 -1.11 2.71 -1.67 0.83 -0.34 -0.16

0.89 1.61

0.89 1.60

The measures employed and their sources are as follows:

Equations 1 and la: Minority population: Percent of population Black or of Spanish origin. (Statistical Abstract of the United States, 1971; U.S. Bureau of the Census, 1970 Census of Population, Persons of Spanish Origin.) Population increase, 1960-70; Percentage population change, 1 9 6 0 - 7 0 (Statistical Abstract of the United States, 1971). Crime: Mean rate of burglaries, robberies, and murder and non-negligent manslaughters known to the police per 100 000 population, 1969. (Federal Bureau of Investigation, Uniform Crime Reports, 1969.) Income: Per capita personal income, Calendar 1969. State Expenditures: Total general expenditures per capita, 1970. Population 15-44: Percent of population aged 15-44, 1970. Urbanization: Percent of population residing in urban places (2500+) 1970. (Statistical Abstract of the United States, 1971.)

R E S E A R C H NOTE

69

Mental patients: Mental hospital patients per 100 000 population, 1970 (1970 Census o f Population, Persons in Institutions and Other Group Quarters.) 9 Equations 2 and 2a: War: Dummy variable, years 1940-45 = 1. Crime: Mean standard score, homicides, burglaries, armed robberies per 100000 population. Unemployment: Percent of civilian labor force unemployed. Unemployment 2 : Unemployment variable squared. Welfare expenditures: Total federal, state and local governmental expenditures on welfare (odd years, 1931-51, interpolated). Age: Percent of population aged 15 - 3 4 . Debt: Total federal, state and local governmental debt outstanding, in millions (odd years, 1931-51, interpolated). Mental hospital population: Persons in federal, state, county, and private mental hospitals at year's end, per 100 000 civilian resident population. Prison population: Persons in state and federal institutions for adult offenders at year's end, per 100 000 civilian resident population (Historical Statistics o f the United States." Colonial Times to 1970).

II. C O N C L U S I O N S

The findings reported above cast considerable doubt on the conventional 'zero-sum' notion of the two custodial systems. Not only are respective rates of incarceration apparently unrelated across jurisdictions, but they tend to manifest independent behavior over time as well. These findings have important implications for general theories of social control, as well as for narrower issues of measurement. With regard to the former, it would seem that in the contemporary American setting, agencies of control have attained a substantial state of differentiation, and in general, may be seen to operate independently of each other. Those similarities in behavior which are occasionally visible appear to be a function of general fiscal pressures rather than a reflection of any significant interdependence between the two systems. Since scholars have employed rates of imprisonment in developing indices of the certainty and severity of a jurisdictions penal sanctions, the above findings bear importantly on the question of measurement. Simply stated, the operations of contemporary American penal systems appear generally uninfluenced by the use of custodial alternatives. Rates of imprisonment when employed as social indicators need not be adjusted statistically to account for contemporaneous variation in mental hospitalization rates. To be sure, there remain considerable limitations on the generalizability of these findings. Strictly speaking, they apply only to United States

70

R E S E A R C H NOTE

jurisdictions during the years u n d e r investigation. By no means should developing societies be e x p e c t e d to manifest similar patterns, and o t h e r western industrial

societies may themselves exhibit different relationships. More

i m p o r t a n t l y , however, the techniques and findings r e p o r t e d here should guide comparative analysts in the future developments o f t h e o r y and m e t h o d .

University o f Vermont

P. N. GRABOSKY

NOTES * This study was conducted while the author was a Russell Sage Fellow in Law and Social Science at Yale Law School. He is grateful to numerous colleagues for comments on earlier versions of the manuscript, to Russell Sage Foundation for its support during the preparation of this study, to Fred Puddester and Heather Munro for their assistance with the data analysis, and to The University of Vermont for the use of its computing facilities. Any errors of fact or interpretation remain the author's responsibility. 1 With the exception of 1970 Census data, the totals reflect persons is residence at year's end. The census data report persons in residence at mid-April, 1970. 2 For a discussion of the stepwise regression procedures employed, see Nie et al. (1975, pp. 344-6). BIBLIOGRAPHY Biles, D. and G. Mulligan: 1973, 'Mad or bad? The enduring dilemma', British Journal of Criminology 13, pp. 275-279. Black, D. J.: 1976, The Behavior of Law (Academic Press, New York). Blumstein, A., J. Cohen, and D. Nagin: 1976, 'The dynamics of a homeostatic punishment process', Journal of Criminal Law and Criminology 67, pp. 317-334. ENKI Research Institute: 1972, A Study of California's New Mental Health Law (ENKI Corp., Chatsworth, California). Griinhut, M.: 1948, Penal Reform (Oxford University Press, London). Jasinski, J.: 1976, 'The punitiveness of criminal justice systems', The Polish Sociological Bulletin, No. 1, pp. 43-51. Kittrie, N.: 1973, The Right to be Different: Deviance and Enforced Therapy (Penguin Books, Baltimore). Nie. N., C. Hull, J. Jenkins, K. Steinbrenner, and D. Bent: 1975, Statistical Package for the Social Sciences (McGraw Hill, New York). Penrose, L.: 1939, 'Mental disease and crime: Outline of a comparative study of European statistics', British Journal of Medical Psychology 28, pp. 1-15. Rusche, G. and O. Kirchheimer: 1939, Punishment and Social Structure (Columbia University Press, New York). Scull, A.: 1977, Decarceration (Prentice Hall, Englewood Cliffs). Waller, 1. and J. Chan: 1974, 'Prison use: A Canadian and international comparison', Criminal Law Quarterly 17, pp. 47-71.