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.
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.”
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.
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.