Dr. Jonas Rappeport, first President and first Medical Director of the American Academy of Psychiatry and the Law (AAPL), retired from forensic practice in 1999. Even during his retirement, he remains active in AAPL and teaches forensic psychiatry at the University of Maryland Fellowship in Forensic Psychiatry. Dr. Rappeport continues as a resource and mentor for us, two of his former fellows, as well as for his colleagues throughout the United States. Recently, we sat down with him over the course of several days and asked him to review his life's story. He was happy to oblige us.
Jonas Rappeport grew up in Baltimore. As a teenager, he babysat for Manfred Guttmacher, a noted forensic psychiatrist and chief medical officer at the Court Clinic for Baltimore City's Supreme Bench.1 He recalled leafing through Dr. Guttmacher's medical library while babysitting, including a copy of Krafft-Ebbings' Psychopathia Sexualis. Much later, Dr. Guttmacher invited him, then a newly minted psychiatrist, to sit in on discussions at the legal psychiatry section of the annual meeting of the American Psychiatric Association (APA). Dr. Rappeport recalled being with Colonel Albert Glass, Henry Davidson, Manfred Guttmacher, Karl Menninger, Herbert Modlin, John Ordway, John Torrens, and several others at those meetings. As he recalled the experience, “They'd ask what I thought and I shot my mouth off.” After President Kennedy's assassination, Dr. Guttmacher evaluated Jack Ruby, who had killed the assassin Lee Harvey Oswald. Dr. Rappeport recalled Dr. Guttmacher's discussion of Mr. Ruby at those meetings.
Dr. Rappeport graduated from the University of Maryland School of Medicine in 1952. He first became interested in forensic psychiatry when he conducted research on inpatient psychiatric patient violence, after a patient assaulted a staff member. He interned at the Michael Reese Hospital in Chicago and then returned to Maryland for his residency in psychiatry at the University of Maryland Medical School and the Sheppard Pratt Hospital. He remained an extra year at Sheppard Pratt as assistant chief of service (chief resident) in 1956. While a resident at Sheppard, he was asked to testify at civil commitment hearings and worked with psychoanalyst Dr. Samuel Novey, evaluating juveniles for the Baltimore County Circuit Court.
After completing his residency, Dr. Rappeport joined the staff at Maryland's Spring Grove State Hospital. Spring Grove housed Maryland's only forensic psychiatry unit at the time. He recalled that the forensic unit was a primitive place by today's standards, with literally a hole in the floor in which violent patients were housed. Spring Grove Hospital Superintendent Isadore Tuerk, who was interested in forensic psychiatry, supervised Dr. Rappeport's evaluation and treatment of forensic patients. Dr. Rappeport also began psychiatric consulting at the Hagerstown Maryland Reformatory. While at Spring Grove, he worked and socialized with Dr. Saleem Shah, then a psychology intern, who later became branch chief for the Center for Studies of Crime and Delinquency at the National Institute of Mental Health (NIMH).2
In 1959, Dr. Rappeport opened a private practice in clinical psychiatry in Baltimore. He continued his outpatient clinical practice until his retirement. He consulted Dr. Novey for supervision in his practice. Dr. Novey recommended him for the new part-time position as court psychiatrist for the Baltimore County Circuit Court. Dr. Rappeport established the office of Court Psychiatrist for Baltimore County.
After Dr. Guttmacher's death, Dr. Rappeport left Baltimore County and was invited to succeed Dr. Guttmacher as Chief Medical Officer for the Supreme Bench in Baltimore City in 1967. Dr. Shah had obtained funding for teaching fellowships in forensic psychiatry through the NIMH for eight university forensic psychiatry teaching programs across the United States.3 Dr. Rappeport applied for and obtained funding for his first forensic fellow at the University of Maryland in 1968.
He remained interested in teaching and advancing knowledge of forensic psychiatry and began correspondence to locate other training program directors. This resulted in an initial meeting during the APA Annual Meeting in Boston in May 1968, and a subsequent meeting of forensic psychiatry program directors at the Miami APA in May 1969, which he chaired. At that meeting, a new organization was formed to
advance the body of knowledge in the area of psychiatry and law, to act as an agency of exchange of information, knowledge and ideas between members and at the interface between psychiatry and the law, and to indicate and study where contribution to the legal and penal system could be made by the behavioral sciences. (Ref. 4, p I)
The organization, which became AAPL, had its first meeting in Baltimore in November 1969. Dr. Rappeport became the first President that year and the first executive director in 1980. He recalled that AAPL was originally a “mom and pop organization.” Administrative support was initially provided by staff at the Baltimore City Court Medical office, then through the Baltimore City Medical Society and the Maryland Medical Society (MedChi). During its early years, members' wives provided all administrative support at meetings (all of the original members were men). Along with Herbert Thomas, Winn Perr, and Robert Sadoff, Dr. Rappeport wrote AAPL's first ethics code. The writers concentrated on forensic psychiatrists' relationships with the people they examined and how much information should be shared when writing a report or testifying. Dr. Sadoff recalled that the initial draft was written by a group seated at his kitchen table in Philadelphia during 1980 or 1981 (Sadoff R, personal communication, April 2007). That draft became the basis for AAPL's “Ethics Guidelines for the Practice of Forensic Psychiatry.”5
Dr. Rappeport became very active in the Maryland Psychiatric Society (MPS), Maryland's APA district branch. He recalled, “I'd go to meetings, and I'd sound off in committees. If you sound off enough they either kick you out or make you President.” Indeed, Dr. Rappeport served as MPS President from 1965 to 1966. Before his presidency, he wrote and advocated the passage of a psychiatrist-patient privileged-communications statute in Maryland.6 An initial attempt to pass the statute failed. The legislature then passed a privileged-communications statute for psychiatrists in 1965, only to have it vetoed by the governor after lobbying by the state bar association and the state psychological association (who claimed they were discriminated against). Thus began the "territorial rift" between psychologists and psychiatrists. During Dr. Rappeport's MPS presidency, a new bill was signed into law only when psychiatrists and psychologists joined to obtain the privilege for both professions.7 He said, "I can still see myself on the telephone getting people to call their legislators [to gain support for the bill]."
Dr. Rappeport remained active in advocacy and public policy matters, both in Maryland and nationally. After the Hinckley verdict, he was appointed in 1983 to the Maryland Governor's Task Force to Review the Insanity Defense. He strongly advocated retaining Maryland's American Law Institute (ALI) insanity test. The Task Force subsequently recommended retaining the ALI Test but changed the burden of proof and the form of the verdict. The Task Force specifically rejected any proposal to restrict expert testimony by mental health professionals in cases involving the insanity defense based on "the general excellence the task force found in Maryland's forensic psychiatric examination and evaluation process" (Ref. 8, p 37). In 1984, the Maryland legislature passed parallel bills that retained the ALI Insanity Test based on the recommendations of the Task Force. Dr. Rappeport advocated for the same position when he testified before the U.S. Congress in hearings after the Hinckley verdict.9
In the early 1980s, along with Nicholas Conti, LCSW-C, his long-time colleague and the administrator of the Supreme Bench of Baltimore Medical Office (the name of the court was changed in 1983 to the Circuit Court for Baltimore City), Dr. Rappeport developed Maryland's pretrial screening program for all defendants who raised questions about their competency to stand trial or about their criminal responsibility.10 Before the initiation of the program, such defendants were always sent to the hospital. The pretrial screening program reduced unnecessary hospitalizations, saved money, and resulted in more rapid submission of reports to the court. In addition, the program led to quicker hospitalization for those who were found to be acutely mentally ill. As Mr. Conti recalled, "Jonas has a good understanding of people. He looked for people who thought outside the box." Dr. Rappeport and Mr. Conti received strong support from Maryland's chief judge and then visited all 23 Maryland counties to explain the program and to obtain the support of county judges and sheriffs.
As Baltimore City's Chief Medical Officer, Dr. Rappeport consulted on virtually all major forensic psychiatry cases in Baltimore City during his career. Nationally, he consulted on the Arthur Bremer (attempted assassination of presidential candidate George Wallace), Sarah Jane Moore (attempted assassination of President Ford), John Hinckley (attempted assassination of President Reagan), and John DuPont (murder of wrestler David Schultz) cases.
Dr. Rappeport met his wife Joan during his internship at Michael Reese Hospital, where she served as head nurse on the psychiatric unit. Recalling her professionalism, he stated, "“she wouldn't date me while I was working on her service.”" They quickly fell in love and married when both were 29 years of age. In Baltimore, Mrs. Rappeport taught psychiatric nursing and worked as a psychiatric nurse, an outpatient therapist, and then a visiting nurse until 1985 when she retired. She staffed the registration booth at almost every AAPL meeting through October 2006, only a few months before her death in June 2007. The Rappeports have three children and four grandchildren.
By the time he retired, Jonas Rappeport had trained 39 fellows. Twenty of those fellows, along with 130 AAPL members, celebrated Dr. Rappeport's contributions to American forensic psychiatry during a dinner at AAPL's 30th Annual Meeting in Baltimore in 1999.11 AAPL created the Rappeport Fellowship in 1985 to offer outstanding residents with interests in forensic psychiatry the opportunity to attend AAPL's Annual Meeting to develop their knowledge and skills in forensic psychiatry. Dr. Rappeport received the Isaac Ray Award, sponsored by the APA and AAPL, in 1984 and the MPS Lifetime of Service Award in 2002.
Phillip Resnick, MD, another Past President of AAPL, views Dr. Rappeport as his "primary mentor." When Dr. Resnick began running the court clinic in Cleveland, there were no local forensic psychiatrists to turn to for guidance. He said Dr. Rappeport was “warm, open, and supportive.” Over the years, he found that Dr. Rappeport's “most remarkable qualities were his inclusiveness and graciousness to young people.” In summing up Dr. Rappeport's contributions to AAPL, Dr. Resnick recalled a famous quote of Ralph Waldo Emerson that “every institution is the lengthened shadow of one man.” Dr. Rappeport has cast a long shadow indeed.
Footnotes
This article is reprinted from J Am Acad Psychiatry Law 35(3):290–3, 2007.
Disclosures of financial or other potential conflicts of interest: None.
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