Evaluating insanity

In place of the individualistic-subjective approaches to insanity evaluations, a specific criterion-based construct of insanity is proposed and examined. This construct entails the presence of a severe mental disorder which has substantially impaired the individual's cognitive and/or behavioral control. The construct was tested through the utilization of a specifically designed protocol (RCRAS) on 73 insanity evaluations from three forensic settings. Estimates of inter-rater reliability were obtained by indepedent rating of 25 cases, and yielded satisfactory to exceptionally high reliability coefficients (mean kappar=0.77). Results of a discriminant analysis and MANOVA generally confirmed the validity of the construct, demonstrating that insane patients were evaluated as having more severe psycho-pathology and a greater loss of cognitive and behavioral control.     

Schizotypal personality disorder and the insanity defense

What constitutes a "mental disorder" for purposes of the insanity defense? Does mental disorder denote any diagnosable condition listed in the third edition of the Diagnostic and Statistical Manual of Mental Disorders? Is a mental disorder a disturbance wherein the functional criteria of the appropriate insanity law appear to be met? Or does insanity law define mental disorder apart from functional criteria of insanity? The answer to the last question is that some insanity laws attempt to define or qualify mental disorder, but many do not. Unclarities in the law leave room for unnecessary disagreements between expert witnesses even before the functional criteria for insanity are to be addressed. The potential for confusion is compounded when the defendant's disturbance is ambiguous, amphibious, or both. Schizotypal personality disorder is offered as an example of such a disturbance, and inferences are discussed.     

The insanity defense

Changing thelegal test definition of insanity remains the remedy of choice when insanity outcomes appear problematic, despite empirical studies showing no significant differences among tests. An alternative strategy suggests changing theverdict schema, although critics contend that jurors will reach compromise verdicts that are unconscionable and incoherent. Undergraduate subjects (N=179) rendered insanity verdicts and ratings for four insanity cases using one of four different verdict schemas: a traditional two-choice schema, a three-choice schema (DR) without instructions, a threechoice schema (GBMI) with instructions, and a sequential schema proposed by Finkel (1988) that separately assesses different types of culpability. When internal consistency measures between verdicts and broad ratings and specific construct ratings of the defendant were examined, the sequential schema produced the highest internal consistency, reducing the most error variance and yielding the highest prediction criterion of any of the schemas.     

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.     

Factors associated with the insanity adjudication

Journal of Police and Criminal Psychology -     

The death-qualified jury and the defense of insanity

We predicted that people who are excluded from serving on juries in capital cases due to their opposition to the death penalty (excludable subjects) tend to place a greater value on the preservation of due process guarantees than on efficient crime control, and therefore are more likely to accept an insanity defense in criminal cases than are people who are permitted to serve on capital juries (death-qualified subjects). Subjects who had previously been classified as death-qualified or excludable read four summaries of cases in which the defendant entered a plea of insanity, and made judgments of guilt or innocence. In the two cases involving nonorganic disorders (schizophrenia), death-qualified subjects were significantly more likely than excludable subjects to vote guilty; in the two cases involving organic disorders (mental retardation and psychomotor epilepsy), there were no differences between the two groups. In addition, excludable subjects gave significantly higher estimates than death-qualified subjects of the proportion of defendants pleading insanity who really are insane.     

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.     

Evaluation and treatment of insanity acquittees in the community

This paper describes the monitored outpatient treatment program for Psychiatry Security Review Board (PSRB) clients in the largest single community treatment agency in the Oregon system. We describe 161 persons referred to this agency for evaluation and treatment. Ninety-one PSRB clients received treatment and of this group 51% had their conditional release revoked by the PSRB. The most frequent cause of revocation was noncompliance with treatment. There were only 11 crimes committed during the study period, four of which were in the felony range. The majority of PSRB clients are chronically mentally ill persons. We discuss both the treatment approach and our results in light of a recently published research agenda for insanity acquittees.     

Demythologizing inaccurate perceptions of the insanity defense

Public opinion data show that the most prevalent concern expressed regarding the insanity defense is that it is a loophole through which would-be criminals escape punishment for illegal acts. This article examines the extent to which the public's perceptions of the insanity defense are consistent with newly collected empirical data. Specifically, it compares perceptions of the use, success, and outcomes associated with the insanity defense to data derived from a large-scale study of insanity pleas in eight states. The analysis reveals that the public overestimates the use and success of an insanity defense and underestimates the extent to which insanity acquittees are confined upon acquittal. The role of selective media reporting in the formation of public perceptions is discussed.An earlier version of this paper was presented at the 1992 meetings of the Society for the Study of Social Problems. Special thanks go to John Monahan and Joel Dvoskin for reviewing an earlier draft and to Sharon Steadman for providing editorial comments.     

Community standards of criminal liability and the insanity defense

Two experiments (N=71) compare lay standards of insanity to standards incorporated in American legal codes. In Experiment 1, case vignettes provided only legally relevant information about defendants' degrees of impairment in cognition or in behavioral control. Respondents' judgments of criminal liability ornot guilty by reason of insanity (NGRI) reflected an exculpatory standard of substantial impairment in both cognition and control. In Experiment 2, case vignettes provided realistic information about defendants' psychiatric diagnoses; respondents had to infer levels of cognitive and control impairment. Results showed that respondents made highly idiosyncratic inferences based on diagnostic categories, but once made, these inferences predicted NGRI judgments. Implications of the concordance between laypeople's rules for assigning NGRI verdicts and the rules used in American legal codes are discussed.Daniel Bailis gratefully acknowledges the support of Public Health Service grant No. 5T32 MH18021-07 for Research Training in Social Psychology during the time in which the present research was conducted. John Darley wished to acknowledge the generous support of the John Simon Guggenheim Foundation and Princeton University. Study 2 presents work done for the Princeton University undergraduate thesis of Tracy Waxman. The authors are grateful to Norman J. Finkel, Valerie Hans, and three anonymous reviewers for comments on an earlier draft on this article.Northwestern University.     

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.     

Civil commitment and the criminal insanity plea in Israeli law

In Israeli jurisprudence there is a substantial difference towards mentally ill patients between the civil and penal law systems that goes well beyond differences required by their separate objectives. Mentally ill people dangerous to others due to their illness belong in the hospital, not in the community or in jail. The data gathered especially for this paper make it hard to escape the conclusion that contemporary practice in Israel does not accord with this objective. On the civil front, inaccuracy in predicting who is dangerous may lead to involuntary commitment of people who are not dangerous. On the criminal side, too few people are sent to the hospital in Israel and correspondingly too many to jail. Comparison with US data and practice shows that on the civil side prediction has been improved by using actuarial methods, while on the penal side more up to date definitions of mental illness have been adopted. Whatever the appropriate solution for Israel, surely the first requirement is recognition of the problem.     

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.