Insanity defence
Encyclopedia
In criminal trials, the insanity defense is where the defendant
claims that he or she was not responsible for his or her actions due to mental health problems (psychiatric illness or mental handicap). The exemption of the insane from full criminal punishment dates back to at least the Code of Hammurabi
. There are different views of the insanity defense, each of which has its merits. Some view it as a status defense; some see it as relating to lack of mens rea
; others see it as an excuse. There are different definitions of legal insanity, which is a legal term of art, not a medical term. There are the M'Naghten Rules
, the Durham Rule, the Americal Legal Institute definition, and various miscellaneous provisions (e.g. relating to lack of mens rea). The chief distinction of the M'Naghten Rules is that there is no volitional limb - that is to say that irresistible impulse
is not part of the M'Naghten Rules definition of insanity.
In the United Kingdom
, Ireland
, and the United States
, use of the defense is rare; since the Criminal Procedure (Insanity and Fitness to Plead) Act of 1991 , insanity pleas have steadily increased in the UK, but it is more common to rely upon a state of temporary mental impairment. In the United States, this is not a legal defense, but a mitigating factor
referred to as diminished responsibility
(or diminished capacity). Mitigating factors, including things not eligible for the insanity defense like intoxication, may lead to reduced charges or reduced sentences. Lesser degrees of mental impairment may be reflected in sentencing or the partial defence of diminished responsibility, which results in a manslaughter rather than murder conviction.
The insanity defense is based on evaluations by forensic mental health professionals that the defendant was incapable of distinguishing between (legal) right and wrong or appreciating the nature of his or her actions at the time of the offense. Some jurisdictions require the evaluation to address the defendant's ability to control his or her behavior at the time of the offense (the volitional limb). A defendant claiming insanity is pleading "not guilty by reason of insanity" (NGRI) or "guilty but insane/mentally ill" in some jurisdictions which, if successful, may result in the defendant being committed to a psychiatric facility for an indeterminate period.
Diminished responsibility or diminished capacity can be employed as a mitigating factor
or partial defence to murder and, in the United States, is applicable to more circumstances than the insanity defense. For example, some jurisdictions accept inebriation or other drug intoxication as mitigating factors, but do not accept intoxication as an insanity defense on its own. If diminished responsibility or capacity is presented convincingly, the charges may be reduced to the lesser offense of manslaughter or the sentence may be more lenient.
) and the United States Court of Appeals for the Fifth Circuit
(in Bigby v. Dretke
) have been clear in their decisions that jury instructions
in death penalty cases that do not ask about mitigating factor
s regarding the defendant's mental health
violate the defendant's Eighth Amendment
rights, saying that the jury is to be instructed to consider mitigating factors when answering unrelated questions. This ruling suggests specific explanations to the jury are necessary to weigh mitigating factors.
and the court vacated his insanity acquittal. He was granted a new trial and found guilty of the original charges, receiving a prison sentence of 40 years.
, the court ruled that the insanity defense cannot be imposed upon an unwilling defendant if an intelligent defendant voluntarily wishes to forego the defense. This is not the case in England and Wales, where the prosecution can argue for an insanity defence. This is a tactic used when the defendant is presenting a defence of sane automatism
, when the prosecution believes that the condition amounts to insane automatism (usually on the grounds of an internal cause).
treatment, except in the case of temporary insanity (see below). Defendants found not guilty by reason of insanity are generally placed in a mental institution. This is not the case in England and Wales, where under the Criminal Procedure (Insanity and Unfitness to Plead) Act of 1991 (amended by the Domestic Violence, Crime and Victims Act, 2004 to remove the option of a guardianship order), the court can mandate a hospital order, a restriction order (where release from hospital requires the permission of the Home Secretary), a "supervision and treatment" order, or an absolute discharge. Unlike defendants who are found guilty of a crime, they are not institutionalized for a fixed period, but rather held in the institution until they are determined not to be a threat. Authorities making this decision tend to be cautious, and as a result, defendants can often be institutionalized for longer than they would have been incarcerated in prison.
In Foucha v. Louisiana
(1992) the Supreme Court of the United States
ruled that a person could not be held "indefinitely".
So far, in the United States, those acquitted of a federal offense by reason of insanity have not been able to challenge their psychiatric confinement through a writ of habeas corpus or other remedies. In Archuleta v. Hedrick
, 365 F.3d 644 (8th Cir. 2004), the U.S. Court of Appeals for the Eighth Circuit the court ruled persons found not guilty by reason of insanity and later want to challenge their confinement may not attack their initial successful insanity defense:
and criminal responsibility.
Competency largely deals with the defendant's present condition, while criminal responsibility addresses the condition at the time the crime was committed.
In the United States
, a trial in which the insanity defense is invoked typically involves the testimony of psychiatrist
s or psychologist
s who will, as expert witnesses
, present opinions on the defendant's state of mind at the time of the offense. Mental health practitioners are restrained from making a judgment on the issue of whether the defendant is or is not insane or what is known as the "ultimate issue".
As a legal defense, insanity is a legal concept, not a psychiatric concept. Whether a person has a diagnosed mental disorder is not sufficient reason, from the court's point of view, to relieve him or her from all responsibility for illegal acts he or she may commit - nor does the person have to have a psychiatric disorder to be considered insane. In English, a 'disease of mind' is required, which is any disease that affects the capacity of the person - thus diabetes, cerebrovascular disease, or a brain tumour can be considered 'diseases of mind'. A person may have a mental disorder and be a competent person in many other ways: able to write checks, handle personal affairs, hold a job, and carry on a variety of behaviors despite the mental disorder. Likewise, a person may commit a criminal act, independent of the fact that he or she has a mental disorder. Depending on the jurisdiction, other elements need to be proven for the court to accept that the mental disorder was responsible for the criminal act; that is, it must be shown that the defendant committed the crime because of the mental disorder - for example, the mental disorder interfered with his or her ability to determine right from wrong at the time the offense was committed.
It would unduly stigmatize a person with a diagnosed mental illness to say that because of the mental illness he is not responsible for his behavior. Therefore, a person whose mental disorder is not in dispute is determined to be sane if the court decides that despite a "mental illness" the defendant was responsible for the acts he or she committed and that he or she will be treated in court as a normal defendant. If the person has a mental illness and it is determined that the mental illness interfered with the person's ability to determine right from wrong (and other associated criteria a jurisdiction may have) and if the person is willing to plead guilty or is proven guilty in a court of law, some jurisdictions have an alternative option known as either a Guilty but Mentally Ill (GBMI) or a Guilty but Insane verdict. The GBMI verdict is available as an alternative to, rather than in lieu of, a "not guilty by reason of insanity" verdict. Michigan
(1975) was the first state to create a GBMI verdict, after two prisoners released after being found NGRI committed violent crimes within a year of release, one raping two women and the other killing his wife.
Sometimes a person without mental illness can be found to be insane; for example, a person who was in a medical state of delirium
at the time of the crime, or a person who is acting under the influence of a drug that was involuntarily administered (though voluntary intoxication has been rejected by most jurisdictions as a defense to crime).
Greece
and Rome
. However, in colonial America
a delusion
al Dorothy Talbye
was hanged in 1638 for murder
ing her daughter, as at the time Massachusetts
's common law
made no distinction between insanity
(or mental illness
) and criminal behavior. Edward II
, under English Common law, declared that a person was insane if his or her mental capacity was no more than that of a "wild beast" (in the sense of a dumb animal, rather than being frenzied). The first complete transcript of an insanity trial dates to 1724. It is likely that the insane, like those under 14, were spared ordeal by trial. When trial by jury replaced this, the jury members were expected to find the insane guilty but then refer the case to the King for a Royal Pardon. From 1500 onwards, juries could acquit the insane, and detention required a separate civil procedure (Walker, 1985) . The Criminal Lunatics Act 1800
, passed with retrospective effect following the acquittal of James Hadfield
, mandated detention at his or her majesty's pleasure (indefinitely) even for those who although insane at the time of the offence were now sane.
The M'Naghten Rules
of 1843 were not a codification or definition of insanity but rather the responses of a panel of judges to hypothetical questions posed by Parliament in the wake of M'Naghten's acquittal for the homicide of Edward Drummond, who he mistook for British
Prime Minister
Robert Peel
. The rules define the defense as "at the time of the commission of the acts constituting the offense, the defendant as a result of a severe mental disease or defect, was unable to appreciate the nature and quality of the wrongfulness of his acts." The key is that the defendant could not appreciate the nature of his actions during the commission of the crime.
In Ford v. Wainwright
477 U.S. 399 (1986), the US Supreme Court
upheld the common law
rule that the insane cannot be executed
. It further stated that a person under the death penalty is entitled to a competency evaluation
and to an evidentiary hearing in court on the question of his competency to be executed.
In Wainwright v. Greenfield
, the Court ruled that it was fundamentally unfair for the prosecutor
to comment during the court proceedings on the petitioner's silence invoked as a result of a Miranda warning
. The prosecutor had argued that the respondent's silence after receiving Miranda warnings was evidence of his sanity.
cases. Much information is unknown about the criminal justice system and the mentally ill:
Some U.S. states have begun to ban the use of the insanity defense, and a 1994 Supreme Court ruling upheld the right of Montana
to do so. Idaho
, Kansas
, and Utah
have also banned the defense. In 2006, the Supreme Court decided Clark v. Arizona
upheld Arizona's limitations on the insanity defense.
jurisdiction with respect to insanity defenses are discussed.
(1843) 10 C & F 200, state, inter alia, and evaluating the criminal responsibility for defendants claiming to be insane were settled in the British courts in the case of Daniel M'Naughten in 1843. M'Naughten was a Scottish woodcutter who murdered the secretary to the prime minister, Edward Drummond, in a botched attempt to assassinate the prime minister himself. M'Naughten apparently believed that the prime minister was the architect of the myriad of personal and financial misfortunes that had befallen him. During his trial, nine witnesses testified to the fact that he was insane, and the jury acquitted him, finding him "not guilty by reason of insanity."
The House of Lords
asked the judges of the common law courts to answer five questions on insanity as a criminal defence, and the formulation that emerged from their review—that a defendant should not be held responsible for his actions only if, as a result of his mental disease or defect, he (i) did not know that his act would be wrong; or (ii) did not understand the nature and quality of his actions—became the basis of the law governing legal responsibility in cases of insanity in England. Under the rules, loss of control because of mental illness was no defense. The M'Naughten rule was embraced with almost no modification by American courts and legislatures for more than 100 years, until the mid-20th century. In 1998, 25 states plus the District of Columbia still used versions of the M'Naughten rule to test for legal insanity.
". Psychiatrists agree that it is possible to understand that one's behavior is wrong, but still be unable to stop oneself. To address this, some states have modified the M'Naughten test with an "irresistible impulse" provision, which absolves a defendant who can distinguish right and wrong but is nonetheless unable to stop himself from committing an act he knows to be wrong. (This test is also known as the "policeman at the elbow" test: Would the defendant have committed the crime even if there were a policeman standing at his elbow?).
, set aside the Durham ruling arguing the ruling’s requirement that a crime must be a “product of mental disease or defect” placed the question of guilt on expert witnesses and diminished the jury’s role in determining guilt. Under this proposal, juries are allowed to decide the "insanity question" as they see fit. Basing its ruling on the American Law Institute
’s (ALI) Model Penal Code
, the court ruled that for a defendant not to be criminally guilty for a crime the defendant, “(i) lacks substantial capacity to appreciate that his conduct is wrongful, or (ii) lacks substantial capacity to conform his conduct to the law.”
It is noteworthy that this case was (1) decided by the U.S. Court of Appeals for the District of Columbia circuit and not the United States Supreme Court, and is thus not a national precedent, and (2) not based on constitutional arguments and was thus superseded by Congress in 1984 with the Insanity Defense Reform Act of 1984.
of President Reagan's assassination attempt
was found not guilty by reason of insanity, Congress passed the Insanity Defense Reform Act of 1984. Under this act, the burden of proof was shifted from the prosecution to the defense and the standard of evidence was increased from a preponderance of evidence to clear and convincing evidence. The ALI test was discarded in favor of a new test that more closely resembled M'Naughten's. Under this new test only perpetrators suffering from severe mental illnesses at the time of the crime could successfully employ the insanity defense. The defendant's ability to control himself or herself was no longer a consideration.
The Act also curbed the scope of expert psychiatric testimony and adopted stricter procedures regarding the hospitalization and release of those who found not guilty by reason of insanity.
Daniel Sickles
of New York
in 1859 after he had killed his wife's lover, Philip Barton Key, but was most used during the 1940s and 1950s. Another case around that time was that of Charles J. Guiteau
, who assassinated President James Garfield
in 1881.
The phrase "absolute alienation of reason" is still regarded as at the core of the defense in the modern law (see HM Advocate v Kidd (1960) JC 61 and Brennan v HM Advocate (1977) JC 38).
is unusual in that it has no provisions for insanity defense. Instead, courts can sentence mentally ill defendants to involuntary commitment
.
Defendant
A defendant or defender is any party who is required to answer the complaint of a plaintiff or pursuer in a civil lawsuit before a court, or any party who has been formally charged or accused of violating a criminal statute...
claims that he or she was not responsible for his or her actions due to mental health problems (psychiatric illness or mental handicap). The exemption of the insane from full criminal punishment dates back to at least the Code of Hammurabi
Code of Hammurabi
The Code of Hammurabi is a well-preserved Babylonian law code, dating to ca. 1780 BC . It is one of the oldest deciphered writings of significant length in the world. The sixth Babylonian king, Hammurabi, enacted the code, and partial copies exist on a human-sized stone stele and various clay...
. There are different views of the insanity defense, each of which has its merits. Some view it as a status defense; some see it as relating to lack of mens rea
Mens rea
Mens rea is Latin for "guilty mind". In criminal law, it is viewed as one of the necessary elements of a crime. The standard common law test of criminal liability is usually expressed in the Latin phrase, actus non facit reum nisi mens sit rea, which means "the act does not make a person guilty...
; others see it as an excuse. There are different definitions of legal insanity, which is a legal term of art, not a medical term. There are the M'Naghten Rules
M'Naghten Rules
The M'Naghten rules were a reaction to the acquittal of Daniel McNaughton. They arise from the attempted assassination of the British Prime Minister, Robert Peel, in 1843 by Daniel M'Naghten. In fact, M'Naghten fired a pistol at the back of Peel's secretary, Edward Drummond, who died five days later...
, the Durham Rule, the Americal Legal Institute definition, and various miscellaneous provisions (e.g. relating to lack of mens rea). The chief distinction of the M'Naghten Rules is that there is no volitional limb - that is to say that irresistible impulse
Irresistible impulse
In criminal law, irresistible impulse is a defense by excuse, in this case some sort of insanity, in which the defendant argues that they should not be held criminally liable for their actions that broke the law, because they could not control those actions....
is not part of the M'Naghten Rules definition of insanity.
In the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, Ireland
Ireland
Ireland is an island to the northwest of continental Europe. It is the third-largest island in Europe and the twentieth-largest island on Earth...
, and the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, use of the defense is rare; since the Criminal Procedure (Insanity and Fitness to Plead) Act of 1991 , insanity pleas have steadily increased in the UK, but it is more common to rely upon a state of temporary mental impairment. In the United States, this is not a legal defense, but a mitigating factor
Mitigating factor
A mitigating factor, in law, is any information or evidence presented to the court regarding the defendant or the circumstances of the crime that might result in reduced charges or a lesser sentence.-Death penalty in the United States:...
referred to as diminished responsibility
Diminished responsibility
In criminal law, diminished responsibility is a potential defense by excuse by which defendants argue that although they broke the law, they should not be held fully criminally liable for doing so, as their mental functions were "diminished" or impaired. The defense's acceptance in American...
(or diminished capacity). Mitigating factors, including things not eligible for the insanity defense like intoxication, may lead to reduced charges or reduced sentences. Lesser degrees of mental impairment may be reflected in sentencing or the partial defence of diminished responsibility, which results in a manslaughter rather than murder conviction.
The insanity defense is based on evaluations by forensic mental health professionals that the defendant was incapable of distinguishing between (legal) right and wrong or appreciating the nature of his or her actions at the time of the offense. Some jurisdictions require the evaluation to address the defendant's ability to control his or her behavior at the time of the offense (the volitional limb). A defendant claiming insanity is pleading "not guilty by reason of insanity" (NGRI) or "guilty but insane/mentally ill" in some jurisdictions which, if successful, may result in the defendant being committed to a psychiatric facility for an indeterminate period.
Diminished responsibility or diminished capacity can be employed as a mitigating factor
Mitigating factor
A mitigating factor, in law, is any information or evidence presented to the court regarding the defendant or the circumstances of the crime that might result in reduced charges or a lesser sentence.-Death penalty in the United States:...
or partial defence to murder and, in the United States, is applicable to more circumstances than the insanity defense. For example, some jurisdictions accept inebriation or other drug intoxication as mitigating factors, but do not accept intoxication as an insanity defense on its own. If diminished responsibility or capacity is presented convincingly, the charges may be reduced to the lesser offense of manslaughter or the sentence may be more lenient.
Mitigating factor
The United States Supreme Court (in Penry v. LynaughPenry v. Lynaugh
Penry v. Lynaugh, , sanctioned the death penalty for mentally retarded offenders because the Court determined executing the mentally retarded was not "cruel and unusual punishment" under the Eighth Amendment...
) and the United States Court of Appeals for the Fifth Circuit
United States Court of Appeals for the Fifth Circuit
The United States Court of Appeals for the Fifth Circuit is a federal court with appellate jurisdiction over the district courts in the following districts:* Eastern District of Louisiana* Middle District of Louisiana...
(in Bigby v. Dretke
Bigby v. Dretke
Bigby v. Dretke 402 F.3d 551 , the U.S. Court of Appeals for the Fifth Circuit heard a case appealed from the United States District Court for the Northern District of Texas on the issue of the instructions given to a jury in death penalty sentencing...
) have been clear in their decisions that jury instructions
Jury instructions
Jury instructions are the set of legal rules that jurors should follow when the jury is deciding a civil or criminal case. Jury instructions are given to the jury by the jury instructor, who usually reads them aloud to the jury...
in death penalty cases that do not ask about mitigating factor
Mitigating factor
A mitigating factor, in law, is any information or evidence presented to the court regarding the defendant or the circumstances of the crime that might result in reduced charges or a lesser sentence.-Death penalty in the United States:...
s regarding the defendant's mental health
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...
violate the defendant's Eighth Amendment
Eighth Amendment to the United States Constitution
The Eighth Amendment to the United States Constitution is the part of the United States Bill of Rights which prohibits the federal government from imposing excessive bail, excessive fines or cruel and unusual punishments. The U.S. Supreme Court has ruled that this amendment's Cruel and Unusual...
rights, saying that the jury is to be instructed to consider mitigating factors when answering unrelated questions. This ruling suggests specific explanations to the jury are necessary to weigh mitigating factors.
Withdrawal of successful insanity defense
Several cases have ruled that persons found not guilty by reason of insanity may not withdraw the defense in a habeas petition to pursue an alternative. However, other rulings have allowed it. In State v. Connelly, 700 A.2d 694 (Conn. App. Ct. 1997), for example, the petitioner who had originally been found not guilty by reason of insanity and committed for ten years to the jurisdiction of a Psychiatric Security Review Board filed a pro se writ of habeas corpusHabeas corpus
is a writ, or legal action, through which a prisoner can be released from unlawful detention. The remedy can be sought by the prisoner or by another person coming to his aid. Habeas corpus originated in the English legal system, but it is now available in many nations...
and the court vacated his insanity acquittal. He was granted a new trial and found guilty of the original charges, receiving a prison sentence of 40 years.
Refusal of insanity defense
In the landmark case of Frendak v. United StatesFrendak v. United States
Frendak v. United States, 408 A.2d 364 is a landmark case in which United States Court of Appeals for the District of Columbia Circuit decided that a judge could not impose an insanity defense over the defendant's objections.-Circumstances:...
, the court ruled that the insanity defense cannot be imposed upon an unwilling defendant if an intelligent defendant voluntarily wishes to forego the defense. This is not the case in England and Wales, where the prosecution can argue for an insanity defence. This is a tactic used when the defendant is presenting a defence of sane automatism
Automatism
Automatism may refer to:*Automatic behavior, spontaneous verbal or motor behavior; an act performed unconsciously. Defendants have been found not guilty due to an automatism defense ....
, when the prosecution believes that the condition amounts to insane automatism (usually on the grounds of an internal cause).
Psychiatric treatments
Those found to have been not guilty by reason of insanity are generally then required to undergo psychiatricPsychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
treatment, except in the case of temporary insanity (see below). Defendants found not guilty by reason of insanity are generally placed in a mental institution. This is not the case in England and Wales, where under the Criminal Procedure (Insanity and Unfitness to Plead) Act of 1991 (amended by the Domestic Violence, Crime and Victims Act, 2004 to remove the option of a guardianship order), the court can mandate a hospital order, a restriction order (where release from hospital requires the permission of the Home Secretary), a "supervision and treatment" order, or an absolute discharge. Unlike defendants who are found guilty of a crime, they are not institutionalized for a fixed period, but rather held in the institution until they are determined not to be a threat. Authorities making this decision tend to be cautious, and as a result, defendants can often be institutionalized for longer than they would have been incarcerated in prison.
In Foucha v. Louisiana
Foucha v. Louisiana
Foucha v. Louisiana, 504 U.S. 71 , was a U.S. Supreme Court case in which the court addressed the criteria for the continued commitment of an individual who had been found not guilty by reason of insanity...
(1992) the Supreme Court of the United States
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
ruled that a person could not be held "indefinitely".
So far, in the United States, those acquitted of a federal offense by reason of insanity have not been able to challenge their psychiatric confinement through a writ of habeas corpus or other remedies. In Archuleta v. Hedrick
Archuleta v. Hedrick
Archuleta v. Hedrick, 365 F.3d 644 was a pro se petition for a writ of habeas corpus filed in the U.S. Court of Appeals for the Eighth Circuit in October 2002, appealing the dismissal of a case brought by defendant Benjamin Archuleta...
, 365 F.3d 644 (8th Cir. 2004), the U.S. Court of Appeals for the Eighth Circuit the court ruled persons found not guilty by reason of insanity and later want to challenge their confinement may not attack their initial successful insanity defense:
Incompetency and Mental Illness
An important distinction to be made is the difference between competencyCompetency evaluation (law)
In the United States criminal justice system, a competency evaluation is an assessment of the ability of a defendant to understand and rationally participate in a court process....
and criminal responsibility.
- The issue of competency is whether a defendant is able to adequately assist his attorney in preparing a defense, make informed decisions about trial strategy and whether or not to plead guilty or accept a plea agreement. This issue is dealt with in UK law as "fitness to plead".
- Criminal responsibility, however, deals with whether a defendant can be held legally responsible for his criminal behavior.
Competency largely deals with the defendant's present condition, while criminal responsibility addresses the condition at the time the crime was committed.
In the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, a trial in which the insanity defense is invoked typically involves the testimony of psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
s or psychologist
Psychologist
Psychologist is a professional or academic title used by individuals who are either:* Clinical professionals who work with patients in a variety of therapeutic contexts .* Scientists conducting psychological research or teaching psychology in a college...
s who will, as expert witnesses
Expert witness
An expert witness, professional witness or judicial expert is a witness, who by virtue of education, training, skill, or experience, is believed to have expertise and specialised knowledge in a particular subject beyond that of the average person, sufficient that others may officially and legally...
, present opinions on the defendant's state of mind at the time of the offense. Mental health practitioners are restrained from making a judgment on the issue of whether the defendant is or is not insane or what is known as the "ultimate issue".
As a legal defense, insanity is a legal concept, not a psychiatric concept. Whether a person has a diagnosed mental disorder is not sufficient reason, from the court's point of view, to relieve him or her from all responsibility for illegal acts he or she may commit - nor does the person have to have a psychiatric disorder to be considered insane. In English, a 'disease of mind' is required, which is any disease that affects the capacity of the person - thus diabetes, cerebrovascular disease, or a brain tumour can be considered 'diseases of mind'. A person may have a mental disorder and be a competent person in many other ways: able to write checks, handle personal affairs, hold a job, and carry on a variety of behaviors despite the mental disorder. Likewise, a person may commit a criminal act, independent of the fact that he or she has a mental disorder. Depending on the jurisdiction, other elements need to be proven for the court to accept that the mental disorder was responsible for the criminal act; that is, it must be shown that the defendant committed the crime because of the mental disorder - for example, the mental disorder interfered with his or her ability to determine right from wrong at the time the offense was committed.
It would unduly stigmatize a person with a diagnosed mental illness to say that because of the mental illness he is not responsible for his behavior. Therefore, a person whose mental disorder is not in dispute is determined to be sane if the court decides that despite a "mental illness" the defendant was responsible for the acts he or she committed and that he or she will be treated in court as a normal defendant. If the person has a mental illness and it is determined that the mental illness interfered with the person's ability to determine right from wrong (and other associated criteria a jurisdiction may have) and if the person is willing to plead guilty or is proven guilty in a court of law, some jurisdictions have an alternative option known as either a Guilty but Mentally Ill (GBMI) or a Guilty but Insane verdict. The GBMI verdict is available as an alternative to, rather than in lieu of, a "not guilty by reason of insanity" verdict. Michigan
Michigan
Michigan is a U.S. state located in the Great Lakes Region of the United States of America. The name Michigan is the French form of the Ojibwa word mishigamaa, meaning "large water" or "large lake"....
(1975) was the first state to create a GBMI verdict, after two prisoners released after being found NGRI committed violent crimes within a year of release, one raping two women and the other killing his wife.
Sometimes a person without mental illness can be found to be insane; for example, a person who was in a medical state of delirium
Delirium
Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior...
at the time of the crime, or a person who is acting under the influence of a drug that was involuntarily administered (though voluntary intoxication has been rejected by most jurisdictions as a defense to crime).
History of the insanity defense
The concept of defense by insanity has existed since ancientAncient history
Ancient history is the study of the written past from the beginning of recorded human history to the Early Middle Ages. The span of recorded history is roughly 5,000 years, with Cuneiform script, the oldest discovered form of coherent writing, from the protoliterate period around the 30th century BC...
Greece
Ancient Greece
Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...
and Rome
Roman Empire
The Roman Empire was the post-Republican period of the ancient Roman civilization, characterised by an autocratic form of government and large territorial holdings in Europe and around the Mediterranean....
. However, in colonial America
Colonial America
The colonial history of the United States covers the history from the start of European settlement and especially the history of the thirteen colonies of Britain until they declared independence in 1776. In the late 16th century, England, France, Spain and the Netherlands launched major...
a delusion
Delusion
A delusion is a false belief held with absolute conviction despite superior evidence. Unlike hallucinations, delusions are always pathological...
al Dorothy Talbye
Dorothy Talbye trial
The Dorothy Talbye Trial is an early American example of a trial of an insane woman at a time when the insane were treated no differently than ordinary criminals...
was hanged in 1638 for murder
Murder
Murder is the unlawful killing, with malice aforethought, of another human being, and generally this state of mind distinguishes murder from other forms of unlawful homicide...
ing her daughter, as at the time Massachusetts
Massachusetts
The Commonwealth of Massachusetts is a state in the New England region of the northeastern United States of America. It is bordered by Rhode Island and Connecticut to the south, New York to the west, and Vermont and New Hampshire to the north; at its east lies the Atlantic Ocean. As of the 2010...
's common law
Common law
Common law is law developed by judges through decisions of courts and similar tribunals rather than through legislative statutes or executive branch action...
made no distinction between insanity
Insanity
Insanity, craziness or madness is a spectrum of behaviors characterized by certain abnormal mental or behavioral patterns. Insanity may manifest as violations of societal norms, including becoming a danger to themselves and others, though not all such acts are considered insanity...
(or mental illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
) and criminal behavior. Edward II
Edward II of England
Edward II , called Edward of Caernarfon, was King of England from 1307 until he was deposed by his wife Isabella in January 1327. He was the sixth Plantagenet king, in a line that began with the reign of Henry II...
, under English Common law, declared that a person was insane if his or her mental capacity was no more than that of a "wild beast" (in the sense of a dumb animal, rather than being frenzied). The first complete transcript of an insanity trial dates to 1724. It is likely that the insane, like those under 14, were spared ordeal by trial. When trial by jury replaced this, the jury members were expected to find the insane guilty but then refer the case to the King for a Royal Pardon. From 1500 onwards, juries could acquit the insane, and detention required a separate civil procedure (Walker, 1985) . The Criminal Lunatics Act 1800
Criminal Lunatics Act 1800
The Criminal Lunatics Act 1800 was a British Act of Parliament that required and established a set procedure for the indefinite detention of mentally ill offenders...
, passed with retrospective effect following the acquittal of James Hadfield
James Hadfield
James Hadfield or Hatfield attempted to assassinate George III of the United Kingdom in 1800 but was acquitted of attempted murder by reason of insanity....
, mandated detention at his or her majesty's pleasure (indefinitely) even for those who although insane at the time of the offence were now sane.
The M'Naghten Rules
M'Naghten Rules
The M'Naghten rules were a reaction to the acquittal of Daniel McNaughton. They arise from the attempted assassination of the British Prime Minister, Robert Peel, in 1843 by Daniel M'Naghten. In fact, M'Naghten fired a pistol at the back of Peel's secretary, Edward Drummond, who died five days later...
of 1843 were not a codification or definition of insanity but rather the responses of a panel of judges to hypothetical questions posed by Parliament in the wake of M'Naghten's acquittal for the homicide of Edward Drummond, who he mistook for British
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
Prime Minister
Prime minister
A prime minister is the most senior minister of cabinet in the executive branch of government in a parliamentary system. In many systems, the prime minister selects and may dismiss other members of the cabinet, and allocates posts to members within the government. In most systems, the prime...
Robert Peel
Robert Peel
Sir Robert Peel, 2nd Baronet was a British Conservative statesman who served as Prime Minister of the United Kingdom from 10 December 1834 to 8 April 1835, and again from 30 August 1841 to 29 June 1846...
. The rules define the defense as "at the time of the commission of the acts constituting the offense, the defendant as a result of a severe mental disease or defect, was unable to appreciate the nature and quality of the wrongfulness of his acts." The key is that the defendant could not appreciate the nature of his actions during the commission of the crime.
In Ford v. Wainwright
Ford v. Wainwright
Ford v. Wainwright, ', was the case in which the United States Supreme Court upheld the common law rule that the insane cannot be executed; therefore the petitioner is entitled to a competency evaluation and to an evidentiary hearing in court on the question of his competency to be...
477 U.S. 399 (1986), the US Supreme Court
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
upheld the common law
Common law
Common law is law developed by judges through decisions of courts and similar tribunals rather than through legislative statutes or executive branch action...
rule that the insane cannot be executed
Capital punishment in the United States
Capital punishment in the United States, in practice, applies only for aggravated murder and more rarely for felony murder. Capital punishment was a penalty at common law, for many felonies, and was enforced in all of the American colonies prior to the Declaration of Independence...
. It further stated that a person under the death penalty is entitled to a competency evaluation
Competency evaluation (law)
In the United States criminal justice system, a competency evaluation is an assessment of the ability of a defendant to understand and rationally participate in a court process....
and to an evidentiary hearing in court on the question of his competency to be executed.
In Wainwright v. Greenfield
Wainwright v. Greenfield
Wainwright v. Greenfield, 474 U.S. 284 , is a case in which the United States Supreme Court reversed the lower court's finding and overturned the petitioner's conviction, on the grounds that it was fundamentally unfair for the prosecutor to comment during the court proceedings on the petitioner's...
, the Court ruled that it was fundamentally unfair for the prosecutor
Prosecutor
The prosecutor is the chief legal representative of the prosecution in countries with either the common law adversarial system, or the civil law inquisitorial system...
to comment during the court proceedings on the petitioner's silence invoked as a result of a Miranda warning
Miranda warning
The Miranda warning is a warning given by police in the United States to criminal suspects in police custody before they are interrogated to preserve the admissibility of their statements against them in criminal proceedings. In Miranda v...
. The prosecutor had argued that the respondent's silence after receiving Miranda warnings was evidence of his sanity.
Controversy over the insanity defense
The public tends to believe that the insanity defense is used more often than it actually is, possibly because insanity defense cases tend to be of a high-profile nature and the evidence in those cases tends to overwhelmingly implicate the defendant, giving the perception of the insanity defense being used as a last resort. The insanity plea is used in the U.S Criminal Justice System in less than 1% of all criminalCriminal law
Criminal law, is the body of law that relates to crime. It might be defined as the body of rules that defines conduct that is not allowed because it is held to threaten, harm or endanger the safety and welfare of people, and that sets out the punishment to be imposed on people who do not obey...
cases. Much information is unknown about the criminal justice system and the mentally ill:
Some U.S. states have begun to ban the use of the insanity defense, and a 1994 Supreme Court ruling upheld the right of Montana
Montana
Montana is a state in the Western United States. The western third of Montana contains numerous mountain ranges. Smaller, "island ranges" are found in the central third of the state, for a total of 77 named ranges of the Rocky Mountains. This geographical fact is reflected in the state's name,...
to do so. Idaho
Idaho
Idaho is a state in the Rocky Mountain area of the United States. The state's largest city and capital is Boise. Residents are called "Idahoans". Idaho was admitted to the Union on July 3, 1890, as the 43rd state....
, Kansas
Kansas
Kansas is a US state located in the Midwestern United States. It is named after the Kansas River which flows through it, which in turn was named after the Kansa Native American tribe, which inhabited the area. The tribe's name is often said to mean "people of the wind" or "people of the south...
, and Utah
Utah
Utah is a state in the Western United States. It was the 45th state to join the Union, on January 4, 1896. Approximately 80% of Utah's 2,763,885 people live along the Wasatch Front, centering on Salt Lake City. This leaves vast expanses of the state nearly uninhabited, making the population the...
have also banned the defense. In 2006, the Supreme Court decided Clark v. Arizona
Clark v. Arizona
Clark v. Arizona, 548 U.S. 735 , was a case decided by the Supreme Court of the United States, in which the Court upheld the constitutionality of the insanity defense used by the State of Arizona. The ruling affirmed the murder conviction of a man with paranoid schizophrenia, for the killing of a...
upheld Arizona's limitations on the insanity defense.
Rules of appreciation
In this section, various rules applied in United StatesUnited States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
jurisdiction with respect to insanity defenses are discussed.
The M'Naghten Rules
The guidelines for the M'Naghten RulesM'Naghten Rules
The M'Naghten rules were a reaction to the acquittal of Daniel McNaughton. They arise from the attempted assassination of the British Prime Minister, Robert Peel, in 1843 by Daniel M'Naghten. In fact, M'Naghten fired a pistol at the back of Peel's secretary, Edward Drummond, who died five days later...
(1843) 10 C & F 200, state, inter alia, and evaluating the criminal responsibility for defendants claiming to be insane were settled in the British courts in the case of Daniel M'Naughten in 1843. M'Naughten was a Scottish woodcutter who murdered the secretary to the prime minister, Edward Drummond, in a botched attempt to assassinate the prime minister himself. M'Naughten apparently believed that the prime minister was the architect of the myriad of personal and financial misfortunes that had befallen him. During his trial, nine witnesses testified to the fact that he was insane, and the jury acquitted him, finding him "not guilty by reason of insanity."
The House of Lords
House of Lords
The House of Lords is the upper house of the Parliament of the United Kingdom. Like the House of Commons, it meets in the Palace of Westminster....
asked the judges of the common law courts to answer five questions on insanity as a criminal defence, and the formulation that emerged from their review—that a defendant should not be held responsible for his actions only if, as a result of his mental disease or defect, he (i) did not know that his act would be wrong; or (ii) did not understand the nature and quality of his actions—became the basis of the law governing legal responsibility in cases of insanity in England. Under the rules, loss of control because of mental illness was no defense. The M'Naughten rule was embraced with almost no modification by American courts and legislatures for more than 100 years, until the mid-20th century. In 1998, 25 states plus the District of Columbia still used versions of the M'Naughten rule to test for legal insanity.
Irresistible Impulse
One of the major criticisms of the M'Naughten rule is that, in its focus on the cognitive ability to know right from wrong, it fails to take into consideration the issue of control "irresistible impulseIrresistible impulse
In criminal law, irresistible impulse is a defense by excuse, in this case some sort of insanity, in which the defendant argues that they should not be held criminally liable for their actions that broke the law, because they could not control those actions....
". Psychiatrists agree that it is possible to understand that one's behavior is wrong, but still be unable to stop oneself. To address this, some states have modified the M'Naughten test with an "irresistible impulse" provision, which absolves a defendant who can distinguish right and wrong but is nonetheless unable to stop himself from committing an act he knows to be wrong. (This test is also known as the "policeman at the elbow" test: Would the defendant have committed the crime even if there were a policeman standing at his elbow?).
The Durham/New Hampshire Test
The strict M'Naghten standard for the insanity defense was used until the 1950s and the Durham v. United States case. In the Durham case, the court ruled that a defendant is entitled to acquittal if the crime was the product of his mental illness (i.e., crime would not have been committed but for the disease). The test, also called the Product Test, is broader than either the M'Naghten test or the irresistible impulse test. The test has much more lenient guideline for the insanity defense, but it addressed the issue of convicting mentally ill defendants, which was allowed under the M'Naghten Rule. However, the Durham standard drew much criticism because of its expansive definition of legal insanity.American Law Institute Model
The Model Penal Code, published by the American Law Institute, provided a "substantial capacity" standard for legal insanity that was a compromise between the strict M'Naghten Rule, the lenient Durham ruling, and the irresistible impulse test. Under the MPC standard, which represents the modern trend, a defendant is not responsible for criminal conduct "if at the time of such conduct as a result of mental disease or defect he lacks substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law." The test thus takes into account both the cognitive and volitional capacity of insanity.The Brawner rule
The Brawner Rule, from the case of United States v. Brawner, 471 F.2d 969 (1972) by the United States Court of Appeals for the District of Columbia CircuitUnited States Court of Appeals for the District of Columbia Circuit
The United States Court of Appeals for the District of Columbia Circuit known informally as the D.C. Circuit, is the federal appellate court for the U.S. District Court for the District of Columbia. Appeals from the D.C. Circuit, as with all the U.S. Courts of Appeals, are heard on a...
, set aside the Durham ruling arguing the ruling’s requirement that a crime must be a “product of mental disease or defect” placed the question of guilt on expert witnesses and diminished the jury’s role in determining guilt. Under this proposal, juries are allowed to decide the "insanity question" as they see fit. Basing its ruling on the American Law Institute
American Law Institute
The American Law Institute was established in 1923 to promote the clarification and simplification of American common law and its adaptation to changing social needs. The ALI drafts, approves, and publishes Restatements of the Law, Principles of the Law, model codes, and other proposals for law...
’s (ALI) Model Penal Code
Model Penal Code
The Model Penal Code is a statutory text which was developed by the American Law Institute in 1962. The Chief Reporter on the project was Herbert Wechsler. The current form of the MPC was last updated in 1981. The purpose of the MPC was to stimulate and assist legislatures in making an effort to...
, the court ruled that for a defendant not to be criminally guilty for a crime the defendant, “(i) lacks substantial capacity to appreciate that his conduct is wrongful, or (ii) lacks substantial capacity to conform his conduct to the law.”
It is noteworthy that this case was (1) decided by the U.S. Court of Appeals for the District of Columbia circuit and not the United States Supreme Court, and is thus not a national precedent, and (2) not based on constitutional arguments and was thus superseded by Congress in 1984 with the Insanity Defense Reform Act of 1984.
The Insanity Defense Reform Act of 1984
After the perpetratorJohn Hinckley, Jr.
John Warnock Hinckley, Jr., attempted to assassinate U.S. President Ronald Reagan in Washington, D.C., on March 30, 1981, as the culmination of an effort to impress teen actress Jodie Foster. He was found not guilty by reason of insanity and has remained under institutional psychiatric care since...
of President Reagan's assassination attempt
Reagan assassination attempt
The Reagan assassination attempt occurred on Monday, March 30, 1981, just 69 days into the presidency of Ronald Reagan. While leaving a speaking engagement at the Washington Hilton Hotel in Washington, D.C., President Reagan and three others were shot and wounded by John Hinckley, Jr...
was found not guilty by reason of insanity, Congress passed the Insanity Defense Reform Act of 1984. Under this act, the burden of proof was shifted from the prosecution to the defense and the standard of evidence was increased from a preponderance of evidence to clear and convincing evidence. The ALI test was discarded in favor of a new test that more closely resembled M'Naughten's. Under this new test only perpetrators suffering from severe mental illnesses at the time of the crime could successfully employ the insanity defense. The defendant's ability to control himself or herself was no longer a consideration.
The Act also curbed the scope of expert psychiatric testimony and adopted stricter procedures regarding the hospitalization and release of those who found not guilty by reason of insanity.
Temporary insanity
The notion of temporary insanity argues that a defendant was insane, but is now sane. A defendant found to have been temporarily insane will often be released without any requirements of psychiatric treatment. This defense was first used by U.S. CongressmanUnited States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
Daniel Sickles
Daniel Sickles
Daniel Edgar Sickles was a colorful and controversial American politician, Union general in the American Civil War, and diplomat....
of New York
New York
New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...
in 1859 after he had killed his wife's lover, Philip Barton Key, but was most used during the 1940s and 1950s. Another case around that time was that of Charles J. Guiteau
Charles J. Guiteau
Charles Julius Guiteau was an American lawyer who assassinated U.S. President James A. Garfield. He was executed by hanging.- Background :...
, who assassinated President James Garfield
James Garfield
James Abram Garfield served as the 20th President of the United States, after completing nine consecutive terms in the U.S. House of Representatives. Garfield's accomplishments as President included a controversial resurgence of Presidential authority above Senatorial courtesy in executive...
in 1881.
Scottish law
The Scottish Law Commission, in its Discussion Paper No 122 on Insanity and Diminished Responsibility (2003), http://www.scotlawcom.gov.uk/downloads/dp122_insanity.pdf pp. 16/18 confirms that the law has not substantially changed from the position stated in Hume's Commentaries:- We may next attend to the case of those unfortunate persons, who have plead the miserable defense of idiocy or insanity. Which condition, if it is not an assumed or imperfect, but a genuine and thorough insanity, and is proved by the testimony of intelligent witnesses, makes the act like that of an infant, and equally bestows the privilege of an entire exemption from any manner of pain; Cum alterum innocentia concilii tuetur, alterum fati infelicitas excusat. I say, where the insanity is absolute, and is duly proved: For if reason and humanity enforce the plea in these circumstances, it is no less necessary to observe a caution and reserve in applying the law, as shall hinder it from being understood, that there is any privilege in a case of mere weakness of intellect, or a strange and moody humor, or a crazy and capricious or irritable temper. In none of these situations does or can the law excuse the offender. Because such constitutions are not exclusive of a competent understanding of the true state of the circumstances in which the deed is done, nor of the subsistence of some steady and evil passion, grounded in those circumstances, and directed to a certain object. To serve the purpose of a defense in law, the disorder must therefore amount to an absolute alienation of reason, ut continua mentis alienatione, omni intellectu careat - such a disease as deprives the patient of the knowledge of the true aspect and position of things about him - hinders him from distinguishing friend from foe - and gives him up to the impulse of his own distempered fancy.
The phrase "absolute alienation of reason" is still regarded as at the core of the defense in the modern law (see HM Advocate v Kidd (1960) JC 61 and Brennan v HM Advocate (1977) JC 38).
Sweden
The judicial system of SwedenJudicial system of Sweden
The judicial system of Sweden consists of the law of Sweden and a number of government agencies tasked with upholding security and rule of law within the country...
is unusual in that it has no provisions for insanity defense. Instead, courts can sentence mentally ill defendants to involuntary commitment
Involuntary commitment
Involuntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a hospital or in the community ....
.
Usage and success rate
Media coverage in the United States tends to dictate how situations are perceived by the public. A case using the insanity defense usually receives increased media attention because it is considered unusual or dramatic. This increased coverage gives the impression that the defense is widely used, but this is not the case. According to an eight-state study, the insanity defense is used in less than 1% of all court cases and, when used, has only a 26% success rate. Of those cases that were successful, 90% of the defendants had been previously diagnosed with mental illness.See also
- Settled insanitySettled insanitySettled insanity is defined as a permanent or "settled" condition caused by long-term substance abuse and differs from the temporary state of intoxication...
- Frendak v. United StatesFrendak v. United StatesFrendak v. United States, 408 A.2d 364 is a landmark case in which United States Court of Appeals for the District of Columbia Circuit decided that a judge could not impose an insanity defense over the defendant's objections.-Circumstances:...
- Archuleta v. HedrickArchuleta v. HedrickArchuleta v. Hedrick, 365 F.3d 644 was a pro se petition for a writ of habeas corpus filed in the U.S. Court of Appeals for the Eighth Circuit in October 2002, appealing the dismissal of a case brought by defendant Benjamin Archuleta...
- Diminished responsibilityDiminished responsibilityIn criminal law, diminished responsibility is a potential defense by excuse by which defendants argue that although they broke the law, they should not be held fully criminally liable for doing so, as their mental functions were "diminished" or impaired. The defense's acceptance in American...
- Mental disorder defenceMental disorder defenceIn the criminal laws of Australia and Canada, the defence of mental disorder is a legal defence by excuse, by which a defendant may argue they should not be held criminally liable for breaking the law because they were mentally ill at the time of the alleged criminal actions.These are a statutory...
- Intoxication defence
- SanitySanitySanity refers to the soundness, rationality and healthiness of the human mind, as opposed to insanity. A person is sane if they are rational...
- Twinkie defenseTwinkie defense"Twinkie defense" is a derisive label for an improbable legal defense. It is not a recognized legal defense in jurisprudence, but a catchall term coined by reporters during their coverage of the trial of defendant Dan White for the murders of San Francisco city supervisor Harvey Milk and mayor...
- United States federal laws governing offenders with mental diseases or defects
Further reading
- Boland, F. (1996). "Insanity, the Irish Constitution and the European Convention on Human Rights". 47 Northern Ireland Legal Quarterly 260.
- Brown, M. (2007). "The John Hinckley Trial & Its Effect on the Insanity Defense".
- Butler Committee. (1975). The Butler Committee on Mentally Abnormal Offenders, London: HMSO, Cmnd 6244
- Ellis, J. W. (1986). "The Consequences of the Insanity Defense: Proposals to reform post-acquittal commitment laws". 35 Catholic University Law Review 961.
- Gostin, L. (1982). "Human Rights, Judicial Review and the Mentally Disordered Offender". (1982) Crim. LR 779.
- The Law Reform Commission of Western Australia. The Criminal Process and Persons Suffering from Mental Disorder, Project No. 69, August 1991. http://www.austlii.edu.au/au/other/walrc/69/P69-R.pdf
- Mackay, RD (1995) Mental Condition Defences in the Criminal Law, Oxford: Clarendon Press.
External links
- Camarillo State Mental Hospital history (largest mental asylum west of Mississippi and home to many criminals who used the insanity defense, open 1936 - 1997, housing 7,000 patients at a time
- Frontline—From Daniel M'Naughten to John Hinckley: A Brief History of the Insanity Defense
- Evolution of the Insanity Plea
- http://www.pbs.org/wgbh/pages/frontline/shows/crime/trial/history.html