THE HUMANITARIAN SIDE
But the delinquencies of the county are not wholly related in terms
of finance. Some good friend of the system is sure to come forward
with the remark that “county policies, like every other branch of
the business, may be expensive, but it has a good deal of wholesome
humanity about it.”
A view that is worth examining!
To the lot of the county, acting through the machinery and under the
influences which have been described, has fallen in large part, the
extensive and important governmental burden of looking after the poor
who are always with us, the sick in mind and those in prison. The
magnitude of this task in a populous center may be gathered from this
summary of the humanitarian functions of Cook County, by Dr. Graham
Taylor.
“It housed, fed and cared for about eleven thousand prisoners in the
county jail, nearly ten thousand of whom required medical treatment for
infectious diseases.
“It gathered in, temporarily cared for and committed to state asylums
or discharged, 2334 insane patients.
“It assumed and maintained care for 10,597 delinquent and dependent
children.
“It isolated and stamped out contagion.
“It housed, fed and furnished medical and surgical treatment for 34,000
sick people, 1000 tuberculosis patients, and 3000 aged, infirm or
irresponsible people.
“It supplied food, clothing and fuel to about 200,000 persons; buried
978 pauper and friendless dead, and granted $165,000 to 350 indigent
mothers for the support of 1126 children. To perform this service it
required the full time of 3000 employees and part time of about 10,000
others. The appropriations of Cook County for 1913 total $7,072,486.96.”
Such is the budget of what we may call the human problem of a great
metropolitan county. Between the services rendered in such a unit and
those of a sparsely settled, back-country county, almost anywhere in
the United States, the difference is one of degree rather than of kind.
This is the ancient heritage of the church, which it has gradually
transferred to the shoulders of the State, beginning at a time when
the treatment of unfortunates was yet mostly a matter of getting
undesirable citizens out of the way without actually assassinating
them. The recipients of relief in early times were all treated as just
so much of a public charge and all were obliged to wear the letter
“P.” There was no science of penology, and the insane were treated
as possessed of devils. Modern institutional care was practically
undreamed of.
But the care of unfortunates within the last half century has come
under the dominion of the scientific spirit. The old way was to
“bunch” all kinds of poor and all kinds of dependents and all classes
of criminals, regardless of all antecedent circumstances and all
hope of betterment. Science, on the other hand, has demanded first,
investigation into the causes and nature of crime and deficiency, then
classification of cases. New York led the way in the treatment of
these social relief problems by starting the process of segregation.
In the early part of the nineteenth century the almshouses in America
and the workhouse in England began to be built, as an expedient for
facilitating investigation of applicants and decreasing expense. These
institutions were soon used to house all sorts and conditions of men,
women and children. Says one authority[4]:
“If you went into an almshouse in any of the counties of this State
as recently as the ’70s of the last century, you would have found a
mixture of the aged, who were in the almshouse simply because they
were old and misfortune had come to them and they had lost their
money and were therefore obliged to spend their last days in the
almshouse. In addition, you would find children of all ages, beginning
with infants. A large number of infants, especially illegitimate
children, would be housed in the same building and would be cared
for promiscuously with the older groups. You would also find large
numbers of the insane, as there was no separate provision for them at
that time. So with the epileptic and feeble-minded and every class of
dependent vagrant and inebriate. It was a veritable dumping-ground for
all sorts and conditions of humanity.”
In the movement for segregation of cases the first step was to secure
a prohibition against the commitment of children to the almshouses.
Special provision was later made for the insane. From time to time
other classes of cases, including the feeble-minded, the epileptics and
vagrants, have been transferred for appropriate treatment elsewhere.
Later came the public health movement, the basic idea of which is
the segregation of the sick poor from those who are sound in body
but destitute. Even at the present time the almshouses are used for
inebriates.
In a later period the standards for the treatment of prisoners have
been advanced somewhat more slowly but along the same scientific
principle of classification and segregation, but less with reference to
psychological and sociological causes or the nature of crime than to
the conveniences of administration. But segregation has been prescribed
by law in generous measure according to certain crude principles of
decency and justice. Thus the New York Prison law provides at least ten
classifications, involving separation of men from women, men from boys,
persons awaiting trial from those under sentence, civil prisoners and
witnesses from criminal prisoners.
So much for the modern standards. Against such standards the success or
failure of the county as a humanitarian agency must be measured.
THE POOR
First as to the poor.
We can do no better than to recount the performances of certain typical
states. Certainly in New York the substantial improvement of this
class has come through no strong impulse within the county itself, but
rather as the result of the activities of unusually strong volunteer
organizations which forced the fact of the evil conditions upon the
attention of the officers and the people of the county and upon the
state in general. But lest it should be supposed that New York State
is a model in this field, let it be recorded that when by more or
less of an accident Mr. V. Everit Macy, a real friend of scientific
charity, was elected to the office of superintendent of the poor, he
found a system more ideally fitted to take care of “the boys” in the
“organization” than the poor themselves. In describing the system he
said:
“The law ingeniously divides responsibility so that the superintendent
has no power over the admissions to the almshouse or hospitals or of
children to institutions but only the negative power of discharge,
while the local committing officials have little control after the
adult or child is committed. This often results in setting up an
endless chain of commitments and discharges, for, as fast as the
superintendent discharges an adult or a child, the local official may
recommit.
“The superintendent is on a salary but practically all the overseers
are paid on a _per diem_ basis, and the justices of the peace are
paid a fee for each commitment. If an Overseer issues an order for
groceries or signs a commitment, he can collect his two dollars for a
day’s work.
“Could ingenuity devise a more absurd and wasteful method of relieving
suffering or one where responsibility and control could be more
disastrously divided to the injury of the taxpayer and the poor?”[5]
The same authority is responsible for the statement that “the
greatest injustice to the individual and injury to the state is now
done through the haphazard handling of the cases of delinquent and
destitute children.” Overseers of the poor, justices of the peace,
police magistrates and judges can all commit children and most of these
officials have a monetary interest in committing. Few of them have
any means of investigating cases before acting and fewer still have
any training to fit them to deal wisely with either the destitute or
delinquent child.
But what of other states?
In Missouri where poor relief is a function of the county court, a
county almshouse is maintained and a certain amount of outdoor relief
is dispensed. Professor Isador Loeb[6] of the University of Missouri
reports:
“While the county board is authorized to maintain a county hospital
for the sick poor, this has been done in only one county. Nine
counties still use the primitive system of sending the poor to board
with private families. Most of the counties in abandoning this system
have bought a farm and employed a superintendent to look after the
poor and use them as far as possible on the farm. As a result the
almshouse in the majority of the counties is a farmhouse, and the
county is apparently more interested in the successful management of
the farm than the welfare of the inmates. While a number of counties
have erected modern buildings, the physical conditions in most of the
almshouses are very bad.”
With respect to Pennsylvania, the special agent of the department of
public health and charities writes[7]:
“Twenty-seven counties have now accepted the Children’s Aid Society as
their agent for the care of dependent children. In the other counties
nearly every possible method of caring for children is represented
in the courses chosen. Where the township system is in use, the few
dependent children are placed out by adoption or indenture, by the
overseers themselves. Several counties have built homes for the
children, an expensive method, with no merit so far as the favorable
situation of the children is concerned. Some of the overseers place
the children in institutions, while others use private homes to some
extent, controlling and supervising the children themselves.”
THE INSANE
In no branch of humanitarian service is segregation, classification,
even to the point of individual treatment, more essential than in the
care of the insane. New Jersey puts no inconsiderable number of her
mentally afflicted on a par with offenders against the criminal law
for, according to the Commission on the Care of the Mental Defectives
for the year 1913, fifteen counties had confined insane persons in
penal institutions, in some cases for periods of from 85 to 223 days.
The State Charity Commission in Illinois recently reported that in
spite of a provision of the statutes forbidding such practices, only
eleven of the 102 counties did not so offend. Louisiana is reported to
have many lunatics in its parish jails.
In but few states are there no insane in the county almshouses, for
at least temporary confinement, and particularly is this true in the
South and Middle West. In such institutions a condition sometimes
prevails that staggers imagination. For the state of Pennsylvania, Dr.
C. Floyd Haviland has summed up the situation in these words:
“As a result of the existing system, in these institutions, custodial
care is generally substituted for active remedial treatment directed
to the improvement or the recovery of the insane as such. As a
rule, medical treatment for physical ills is satisfactory, although
such is not invariably the case. With but few exceptions, the
county institutions have no special medical facilities, nor can
it be expected that such facilities can be provided under present
conditions, for, with the comparatively small number of patients
treated in the respective institutions, such provisions would require
a prohibitive _per capita_ expense; but as a result of such
lack of facilities, mechanical means of restraint and confinement
are substituted for proper personal treatment and attention. With
but a limited number of attendants, enclosed exercise yards and
personal restraint and seclusion must inevitably result. Under
existing conditions, one cannot blame the caretakers of the insane for
resorting to such means, for while restraint and seclusion can and
should be abolished, they cannot be successfully abolished without
the substitution of other means of dealing with the disturbed insane,
such as hydrotherapy, occupational training, and close personal
supervision. In this connection it is agreeable to note that little
evidence was obtained of actual physical abuse, but that gross neglect
exists is indisputable.
“That the theory of county hospitals for the chronic insane only
does not obtain in actual practice is but a necessary result of the
prevailing custom of determining the question as to whether a patient
shall be committed to a state hospital, regardless of prognosis or
medical issues, in many instances the decision being made by local
lay authorities without medical advice. It is certain that many acute
cases have lapsed into chronicity in the county hospitals simply for
lack of proper treatment. Dreary, desolate wards, lack of recreation,
or other means of exciting or maintaining active interest are alone
sufficient not only to hinder improvement or recovery, but must
necessarily result in actually hastening the terminal process of
deterioration.”[8]
Writing concerning the treatment of the insane in Texas, Dr. Thomas
W. Salmon, of the National Committee for Mental Hygiene calls county
almshouse care of the insane the “saddest and most sordid spectacle
in American community life.” For a graphic picture of the practical
significance of the system in one of the almshouses in that state the
reader is urged to read the extracts from Dr. Salmon’s address in the
Appendix of this volume.
COUNTY PRISONS
But what of the treatment of the prisoner?
The county theoretically has very little to do with persons convicted
of serious offenses. By far the greater number of the inmates of the
prison are persons awaiting trial and therefore presumably innocent of
wrongdoing. The minimum standard of justice demands that such persons
be kept apart from hardened criminals. We shall see how this and other
standards are observed in the county.
To begin with, it should be noted that the head of the jail,
universally, is the sheriff. Bear in mind that this officer in
forty-seven states is elective, that his term is usually very short,
that he is usually ineligible to succeed himself and that he has
numerous special duties to perform. It is therefore obvious that
nothing but an exceptional piece of good luck can bring to the head of
the jail an expert penologist. Often, too, he will be under contract
with the board of supervisors to supply the prisoners with food at as
good a profit to himself as may be.
In this atmosphere it is certainly not to be expected that the finest
flowers of penology should grow. Massachusetts has so far fallen
below standard as to call forth this stinging description from the
Massachusetts Prison Association:
“In fact, in the county prisons nothing is done but to give the
inmates custodial care. The man who goes to the reformatory is dealt
with with a definite purpose to reform him. Another man goes to a
county prison and comes out unchanged.
“Even worse is the indiscriminate association of all sorts of
criminals in the county prisons. Beginners in crime are forced into
close contact with hardened criminals. Men who are committed for
being too poor to pay their fines for petty offenses, are compelled
to associate with men who have spent their lives in crime. The county
prison is, inevitably a school of crime.”[9]
The Prison Association in New York State is scarcely more complimentary
concerning the prison conditions in that state. According to Mr.
O. F. Lewis,[10], its secretary, the requirements of the statutes
respecting the classification of prisoners appear to be systematically
violated. Jails are frightfully overcrowded. The buildings are faultily
constructed and unsanitary. For a prisoner to make a six-months’ stay
in one of them is to undergo “the most serious possible contamination.”
The condition of the jails in Illinois is apparently no better, for
the State Charities Commission reported recently,[11], there had been
little improvement since the first examination of the former State
Charities Board in 1870. A large majority of the jails were reported to
be old and unsanitary. In seventy-two of one hundred and two counties,
the law requiring the segregation of minors from adults was violated
and in eleven counties there was no provision for women.
And so it goes. The county as a truly humanitarian agency has most
lamentably failed. As to the underlying cause of the failure, this is
suggested in a remark of the state prison inspector of Alabama in his
report for 1914: “Publicity is not only a political antiseptic, but
is the sure antidote for most, if not all, our governmental ills.” A
justifiable inference from this declaration would be that counties
are suffering from the lack of publicity. In the immunity from the
restraint which such a purifying influence would supply the elementary
human instincts of county officials has full sway--such instincts as
the inspector had in mind when he said:
“The vile, pernicious, perverting, fee system beggars description, and
my vocabulary is inadequate to describe its deleterious and baneful
effects. It inculcates into the management of our jails greed for the
Almighty Dollar; persons are arrested because of the dollar and shame
to say, are frequently kept in captivity for months, in steel cages,
for no other reason than the Almighty Dollar.”
The organization of the county for political purposes to secure
the utmost obscurity and irresponsibility breaks the force of any
humanitarian public opinion that might be developed for the betterment
of the lot of the unfortunate. The same influences render the county
practically uninhabitable for the expert administrator, who would
be likely to direct popular attention to the evil conditions which
we have described. His place has been preëmpted by the hanger-on and
the wire-puller to whom charity means the dispensing of favors to
“deserving” workers of all political faiths. In _this_ sense the
county is a very humane institution, and a very open-handed one. It
serves well such local officials as the overseer of the poor in an
up-state New York county who presented this remarkable annual report to
his superior:
“I am a little late with my report. I hope you will excuse me and
overlook the matter. Like last year, there are no county poor here;
but if you will allow me $5.00 _for keeping them off_, you will
oblige,
“Yours respectfully,
“----.”
This claim was paid and the poor were presumably “kept off”
indefinitely.
There is not a little evidence to support the statement that many
county officers believe that they have satisfied the requirements of
humanity when they have taken care of their own personal wants. Such
officers, and the system of which they are part, are very good--to
themselves.
[4] Bailey B. Burritt, in _Proceedings of the Second Conference for
the Study and Reform of County Government_, pp. 6, 7.
[5] _First Conference for Better County Government_, p. 22.
[6] _Annals of the American Academy of Political and Social
Science_, May, 1913, p. 56.
[7] _Op. cit._, p. 168.
[8] _The Treatment and Care of the Insane in Pennsylvania_, pp.
68-69. Philadelphia, 1915.
[9] _Leaflet._ 1911.
[10] _Proceedings of the Third Conference for the Study and Reform of
County Government_, pp. 6-7.
[11] _Annals of the American Academy of Political and Social
Science_, May, 1913, p. 70.