The Psychiatrist as a Conservative Agent of Social Control

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Abstract
Examining the role of psychiatrists in criminal proceedings to commit or detain individuals as mentally ill demonstrates their conservative use of the state's police power more clearly than previous research on involuntary civil commitments. Comparing a group of criminally insane patients transferred against psychiatric advice because of a U.S. Supreme Court decision with a group of patients whose transfers were approved from the same two institutions, we found the unduly conservative psychiatric criteria were associated with patients' race, age, length of hospitalization, and length of criminal record. Our data show that the group transferred against psychiatric advice fared considerably better in civil hospitals and in the community than had been expected, was released at a rate higher than the approved transfers, and had only slightly more criminal activity after release. The level of success of both patient groups highlights the psychiatrists' ascendance into an expert role for which they have unproven skills.