AN ANALYSIS OF PUBLIC ATTITUDES TOWARD THE INSANITY DEFENSE*

Results from a public opinion survey of knowledge, attitudes, and support for the insanity defense indicate that people dislike the insanity defense for both retributive and utilitarian reasons: they want insane lawbreakers punished, and they believe that insanity defense procedures fail to protect the public. However, people vastly overestimate the use and success of the insanity plea. Several attitudinal and demographic variables that other researchers have found to be associated with people's support for the death penalty and perceptions of criminal sentencing are also related to support for the insanity defense. Implications for public policy are discussed.     

Myths of the insanity defense: Inherent and procedural obstacles

Often societies perceptions can be shaped by the media not only by what it reports but by how it is reported. This article discusses the impact that the American media has had on the social perception that the insanity defense is too often successfully used to avoid legal and criminal culpability. Many of the procedural obstacles associated with the assertion of an insanity defense are poorly understood or ignored. The article further address some of the less attractive characteristics associated with the assertion of the insanity defense that are not procedurally founded but nonetheless serve as an impediment the wide spread use of the defense. In conclusion the insanity defense is submitted as an unavoidable necessary evil in a civilized society that incarcerates its criminals.     

精神病辩护：历史、社会与现实

精神病辩护制度在普通法国家具有长久之历史,特别在美国,其不仅具有比较完善的刑事责任能力法则,而且其精神病辩护的案件也备受社会各界瞩目。而精神病辩护制度、相关立法或者司法实践活动并不是与世隔绝、生活在真空中的产物,其受到社会、政治、伦理道德等各种因素的影响。同时,即使在精神病辩护制度最为发达的美国,与人们印象中不同的是,实际上精神病辩护并未获得多大的成功,从而形成想象与现实的落差。对于我国而言,应从精神病辩护制度之历史、社会与现实多个视角或者因素考虑,从而确立一种渐进的或者改良的中国刑事责任能力法则或者辩护制度。     

Measuring the effects of the guilty but mentally Ill (GBMI) verdict

We studied effects of guilty but mentally ill (GBMI) legislation on use of the insanity defense in Georgia using data on all defendants entering an insanity plea before (1976–1981) and after (1982–1985) the introduction of the GBMI verdict. In contrast to earlier studies, our results indicated that GBMI did decrease the likelihood of an insanity verdict and affected the composition of those found not guilty by reason of insanity. Defendants pleading insanity and found GBMI were typically white males with a serious mental disorder, charged with murder or robbery in which an unrelated female victim was involved. The data also indicated that defendants who pleaded insanity and were found GBMI received harsher sentences than their guilty counterparts. We conclude that the GBMI verdict will make the insanity plea a less appealing option for mentally ill defendants.     

Not guilty by reason of insanity: a research note

The question of the insanity defense centers around the moralist-determinist debate. Insanity defense laws are premised on the assumption that individuals choose between right and wrong, and are responsible for that choice. Mental disease, however, can overpower, and thus, not of their own volition, insane persons become out-of-control. Hence, they cannot be held responsible for their behavior or subject to criminal punishment. It is the purpose of the insanity defense, of course, to distinguish between offenders in need of punitive disposition and ones where a medical-custodial disposition is best. The research presented here indicates that defendants who successfully raise the plea of NGRI do not beat the rap. In other words, they do not spend fewer days in confinement via an NGRI plea than had they been convicted and sentenced. Thus, for the reasons of justice, equity, and fairness the insanity defense should be kept intact. The wave of public fear and reaction to the decision in a few highly publicized cases is insufficient grounds for eliminating the plea. Not only is the use of the insanity defense infrequent, but defendants who select it give up important safeguards. Namely, they are unable to plea bargain, are stigmatized as "mad and bad," have no access to probation or parole, and are confined for an indeterminate amount of time. That some would call this leniency we find surprising. And, of course, we should not forget the findings reported here. NGRI acquittees spend more time being locked up. Defendants who successfully raise the NGRI plea are confined until professionals say they are no longer dangerous.(ABSTRACT TRUNCATED AT 250 WORDS)     

The military insanity defense

This article describes the military insanity defense. The success of the litigated insanity defense is explored through the number of insanity acquittals over a 28-month period. A questionnaire distributed to all United States Army psychiatrists provided information on the number of forensic evaluations performed, the number of not criminally responsible (NCR) opinions made, and the disposition of noncontested NCR opinions. The questionnaire also tested the Army psychiatrists' knowledge about recent changes in the military insanity defense. This pilot study raises interesting questions about the military insanity defense that further research can address.     

精神病辩护制度研究——基于美国精神病辩护制度的思考

由于刑事责任的承担要求行为人对自己行为的社会危害性有认识和控制能力,某些精神病人对自己行为的社会危害性没有认识或无法控制,因而无法对自己的行为承担刑事责任,精神病也就成了刑事辩护的重要事由。在美国刑事审判中,精神病是无罪辩护的重要理由,判例法与刑事立法共同形成了一套较为完善的精神病辩护制度。在美国,精神病辩护制度的存废问题一直备受争议;精神病法律标准处于变化之中,各法域标准不一;精神病辩护的提出、审理程序、证明责任分配与证明标准、裁定及专家证人的作用有其特点;因精神病而判无罪者的关押与释放形成了特定规则。我们可以借鉴其制度的某些合理因素,健全和完善我国的精神病辩护制度。     

The insanity defense in Shelby County,Tennessee

The purpose of this investigation was threefold: to document the number of cases in Shelby County, Tennessee where an insanity defense was possible: to follow cases through to disposition to determine what percentage of defendants use the defense successfully; and to examine the type of charges for insanity cases. Of the 25.000 individuals processed through the Criminal Courts. 685 (2.7%) were referred for insanity evaluations and 45 defendants (6.6%) were returned to the court with a recommendation from the Midtown Mental Health Center's Forensic Team that an insanity defense was possible. Of the 45 insanity defendants identified, 49% (n=22) pleaded guilty, 31% (n=14) went to trial, and 20% (n=9) were dismissed. Overall, 22% (n=10) of the insanity defendants were adjudicated not guilty by reason of insanity. Thus, of all defendants processed (25,000), 04% (n=11) were adjucated not guilty by reason of insanity. While no one type of offense predominated, two general categories were observed: murder and related offenses (33%) and property crimes (27%). The findings are discussed with reference to procedures for handling insanity cases in Tennessee and the position that extreme caution should be exercised before investing substantial resources to effect sweeping changes in laws that effect so few criminal defendants.     

Pathological gambling and criminal responsibility

There exists significant interdisciplinary support for eliminating the volitional component of the insanity defense. Somewhat in contrast to this trend is the presentation of pathological gambling as a potentially exculpatory condition in criminal trials. The authors discuss three federal appellate court decisions on this attempted inappropriate usage of psychiatric diagnostic nomenclature. All have upheld convictions, and thereby rejected contentions that such an impulse disorder can form the basis for a valid plea of lack of criminal responsibility. It is suggested that the public interest will be served by statutorily making disturbances of behavioral control insufficient to raise a defense of insanity.     

How the insanity acquittal retards treatment

In the continuing social debate about the insanity defense, little attention has been paid to the effects of the insanity acquittal on treatment. This article suggests that the insanity acquittal may retard treatment of mentally disordered and violent offenders. Failure to assign responsibility to a mentally disordered offender may lessen his/her initiative and emotional opportunity to make needed changes in perceptions and functioning. Three case studies illustrate the argument.     

Ideology as determinant of views on the insanity defense

This research explores the hypothesis that an individual's position on the insanity defense is a function of his/her underlying ideology. Fifty-seven clinical psychologists and fifty-five psychiatrists in the United States responded to a questionnaire that measured their beliefs about personal vs. social responsibility for crime, the frequency of their own experience as expert witnesses in insanity cases, and their attitudes toward the insanity defense. As predicted, locus of responsibility for crime was found to have a highly significant curvilinear relationship to attitude toward the insanity defense, with very liberal and very conservative subjects being most anti-insanity defense. Psychiatrists, and those with more expert witness experience, were also significantly more favorable toward the insanity defense.     

Post-Hinckley insanity reform in Oregon

The 1983 Oregon legislature responded to public pressure to narrow the application of the insanity defense by eliminating personality disordered individuals from consideration for an insanity verdict. This article examined the effects of the statutory change, and found no significant change in the frequency of insanity acquittals of personality disordered subjects between the three pre-reform years (n = 21) and the three post-reform years (n = 14). We also reviewed how the Psychiatric Security Review Board handled these patients once committed to their jurisdiction. We constructed a matched comparison group of psychotic acquittees and found that in the pre-reform years the personality disordered subjects spent less time in the system and less time in the hospital than the psychotic patients. However, in the post-reform years their time in the system and time in the hospital was the same as the psychotic controls. There were fewer decisions to discharge personality disordered patients from the system after the reform, although this difference may be due to factors other than the statutory reform itself. The conclusion is that narrowing the insanity defense is a worthy goal which may be difficult to achieve.     

Venirepersons’s Attitudes Toward the Insanity Defense: Developing,Refining, and Validating a Scale

Given the prevalence and predictive strength of negative attitudes toward the insanity defense, we conducted three studies with 426 venirepersons to develop an understanding and a measure of public attitudes toward the insanity defense. In these studies, we developed, iteratively refined, and cross-validated the insanity defense attitude-revised (IDA-R) scale. The results suggest that IDAs are underpinned by ones degree of (a) orientation toward strict liability, and (b) concern about perceived injustice and danger associated with the defense. The IDA-R assesses these two-dimensions with good internal consistency, convergent and divergent validity, and predictive utility. The IDA-Rs predictive utility generalizes across jurisdictions and manipulation of case facts. Theoretical and practical implications for research and for identifying impartial jurors at voir dire are discussed.     

The psychiatrist's guide to right and wrong: Part IV: The insanity defense and the Ultimate Issue Rule

In the wake of Hinckley, widespread public dissatisfaction with the role of psychiatrists in insanity defense litigation prompted Congress in 1984 to amend the Federal Rules of Evidence to prohibit psychiatric testimony on the ultimate legal issue of whether or not a defendant is insane. APA's Statement on the Insanity Defense served as the ably articulated premise for this evidentiary amendment. APA argued that in going beyond their psychiatric expertise by answering ultimate issue questions as to whether defendants are legally insane, experts are likely to confuse the jury and undermine public confidence in psychiatry. APA also asserted that there was an impermissible logical leap between scientific psychiatric inquiry and moral-legal conclusions on the ultimate issue of insanity. This article reviews the origins, history, and vicissitudes of the Ultimate Issue Rule and analyzes the Statement on the Insanity Defense from both a legal and psychiatric perspective on the issue of whether psychiatrists should answer the ultimate question in insanity cases. The analysis suggests that APA's conclusions are not supported on scientific or evidentiary grounds, but may be warranted as a policy consideration to safeguard the public image of psychiatry.     

Menstrual cycles and criminal responsibility

Since at least the turn of the century, there have been reports indicating that women have an increased tendency toward criminal behavior during certain phases of the menstrual cycle. Recently these reports have served as the basis for a proposal to expand the insanity defense to recognize the impact of menstrual cycles in diminishing criminal responsibility. This paper reviews the empirical literature on the link between menstruation and crime and raises several critical questions regarding interpretation of this data. In light of these questions it is suggested that at this time an insanity defense based on menstrual symptomology would be inappropriate.     

The insanity defense to suicide

The certification of suicide as the manner of death can result in either the complete loss or a significant reduction in life insurance benefits to the victim's survivors. It is, thus, not uncommon for these beneficiaries to contest suicide as the manner of death. Insanity is a recognized defense in law against suicide. It is recognized in law that, in some cases, an insane man cannot intentionally destroy himself. However, it is also recognized that life insurers can exclude suicide by an insane man from coverage. This article discusses the common law doctrines upon which the insanity defense to suicide is based, with references to judicial opinions from cases which involve contested suicides and the issue of insanity.     

The Impact of Insanity Acquittees on Missouri's Public Mental Health System

Even though state departments of mental health have primary responsibility for the care, custody, and treatment of insanity acquittees, the impact of insanity acquittees on the public mental health system is generally lacking in policy discussions and as a topic for policy research. This issue has received increased attention in Missouri, where insanity acquittees now occupy half of the long-term public psychiatric hospital beds. This article examines the presence of Missouri's insanity acquittees on the state's public mental health system and includes the impact on goals, fiscal costs, inpatient and community psychiatric services, and inpatient treatment staff. As states consider managed care and other cost containment measures, it remains to be seen if the high costs associated with extensive use of hospitalization of insanity acquittees to promote public safety will influence policy changes to more community-based insanity acquittee systems.