CREATED BY LAW IN 1951 AND OPENED IN 1955, PATUXENT PROVIDED PSYCHIATRIC AND OTHER SERVICES FOR MARYLAND OFFENDERS WHO, HAVING BEEN DESIGNATED 'DEFECTIVE DELINQUENTS' UNDER STATE LAW, WERE COMMITTED TO THE FACILITY TO SERVE INDETERMINATE SENTENCES. THE EVALUATION, UNDERTAKEN TO HELP THE STATE LEGISLATURE DECIDE WHETHER TO CONTINUE, TERMINATE, OR MODIFY THE PATUXENT PROGRAM, COVERED DECISIONMAKING, RECIDIVISM, COST-EFFECTIVENESS, AND DIAGNOSIS AND TREATMENT. THE DIAGNOSIS AND TREATMENT TEAM STUDIED THE FOLLOWING FACTORS: THE STAFFING AND ADMINISTRATION OF PATUXENT; DETERMINATION OF DEFECTIVE DELINQUENCY; MAJOR TREATMENT COMPONENTS INCLUDING A GRADED TIER SYSTEM OF POSITIVE AND NEGATIVE REINFORCEMENTS INTENDED TO ENCOURAGE INMATES TO DEVELOP BEHAVIOR CONTROLS, INDIVIDUAL AND GROUP PSYCHOTHERAPY, EDUCATIONAL AND VOCATIONAL TRAINING PROGRAMS, AND A UNIT TREATMENT TEAM SYSTEM; TREATMENT MODALITIES WITHIN THE MAJOR COMPONENTS SUCH AS BEHAVIOR MODIFICATION, PEER COUNSELING, PSYCHOTROPIC AND ANTICONVULSANT MEDICATION, COUNSELING WITHIN PATUXENT'S PRERELEASE CENTER AND A HALFWAY HOUSE PRIOR TO RELEASE; THE INSTITUTIONAL BOARD OF REVIEW, THE BODY RESPONSIBLE FOR REVIEWING THE PROGRESS OF PATUXENT INMATES AND FOR GRANTING LEAVES OF ABSENCE, WORK RELEASE ASSIGNMENTS, AND PAROLE. THE EVALUATION FOUND THAT A DUAL MODEL OF OPERATION EXISTED AT PATUXENT, WITH REHABILITATIVE TREATMENT AND CUSTODIAL COMPONENTS SIMULTANEOUSLY PRODUCING EXPECTATIONS OF STAFF AND INMATES ALIKE. NO CRITERIA THAT THEORETICALLY OR OPERATIONALLY DISTINGUISHED DEFECTIVE DELINQUENTS FROM NONDEFECTIVE DELINQUENTS WERE FOUND. DATA PRODUCED BY THE DIAGNOSIS AND TREATMENT STUDY TEAM FAILED TO DEMONSTRATE THE OVERALL EFFECTIVENESS OF THE PATUXENT TREATMENT PROGRAM AND POINTED TO SPECIFIC PROBLEMS WITH TREATMENT MODALITIES (LACK OF TREATMENT PLANS, FAILURE TO APPLY AND APPRAISE PSYCHOTHERAPY RIGOROUSLY, INCONSISTENTLY ADMINISTERED BEHAVIOR MODIFICATION TECHNIQUES, AND MARKED DEFICIENCIES IN VOCATIONAL TRAINING). TOGETHER WITH THE FINDINGS OF THE OTHER STUDY TEAMS, THE DIAGNOSIS AND TREATMENT TEAM'S DATA LED TO RECOMMENDATIONS TO ELIMINATE INDETERMINATE SENTENCES AT PATUXENT, TO ABOLISH THE DESIGNATION 'DEFECTIVE DELINQUENT,' TO MODIFY AND UPDATE PATUXENT'S TREATMENT PROGRAM, TO EVALUATE PATUXENT'S OPERATIONS ON AN ONGOING BASIS, AND TO MAKE ADMISSION TO PATUXENT VOLUNTARY. (LKM)