Insanity plea: predicting not guilty by reason of insanity adjudications

Using 35 variables and discriminant analysis procedures, it was found that, of 133 male defendants entering the insanity plea in Colorado, 87 percent were classified correctly into the disposition groups "adjudicated insane" and "convicted." Most positively related to an insanity adjudication were a psychiatric evaluation of insanity and a diagnosis of schizophrenia. Negatively related to the insanity verdict were diagnoses of substance use and personality disorders.     

Part II: Sex differences in persons found not guilty by reason of insanity: analysis of data from the Connecticut NGRI Registry

Thirty-one female insanity acquittess from Connecticut were matched to a group of 31 male NGRIs. The samples were compared with regard to demographic, criminal, and clinical characteristics. Logistic regression analyses were used to determine predictors of criminal recidivism for the sample. Results indicated that women NGRIs were older, more likely to be married, less likely to be substance abusers, had less extensive criminal records, and were released from hospitals sooner than the men. A significant racial difference was noted: white women had less extensive criminal records and were hospitalized for shorter periods than minority women. Results of the logistic regression analyses showed that the strongest independent predictors of criminal recidivism were race and having a diagnosis other than psychosis (schizophrenia, affective or organic disorders). Findings support recent APA policy guidelines on the insanity defense.     

Judicial oversight of release of patients committed after being found not competent to stand trial or not guilty by reason of insanity in violent crimes

In 1981, North Carolina joined a growing number of states in passing legislation requiring judicial concurrence with discharge decisions for civilly committed patients who had been found either not competent to proceed to trial or not guilty by reason of insanity. The authors studied all such patients at one of North Carolina's four state mental hospitals during the first year of the new law's operation, and found that there were only 16 of them. These patients were compared to a control sample of civilly committed patients without criminal charges; it was found that the forensic patients spent longer in the hospital than the controls, but still significantly less time than reported in studies from other states. The authors discuss possible reasons for these differences and comment on the effectiveness of such legislation.     

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)     

Applications for release by Australians in Victoria found not guilty of offences of violence by reason of mental impairment

Much research in relation to mental illness and the law has concentrated upon when accused persons are entitled to avail themselves of the defence of not guilty by reason of insanity or mental impairment. However, the decision as to when persons found not guilty by such pleas should be released step by step back into the community involves difficult analyses of the risk of recidivism by persons who have committed serious acts of violence whilst mentally ill. This article analyses some 70 cases heard by the Supreme Court of Victoria in Australia since the jurisdiction to make such decisions has been transferred from the executive arm of government to the judiciary. The jurisprudence generated by the Victorian Supreme Court constitutes Australia's most developed law in relation to prediction of dangerousness. This article evaluates the different and subtle dynamics that have influenced the judges in an increasingly sophisticated way to grapple with the phenomenon of mental illness in deciding when persons who have already killed can safely be released from involuntary detention status within the confines of a forensic psychiatric institution back into the general community.     

Decision making and examiner bias in forensic expert recommendations for not guilty by reason of insanity

Source of nomination (prosecution, defense, judge) was varied in a fictional not guilty by reason of insanity (NGRI) case distributed to 180 community forensic evaluators in a state employing theM'Naghten rule. Differences among examiners by appointment for the final NGRI judgment was not significant; interrater reliability for psychopathological symptomatology was .73. Discriminant analysis revealed significant differences in the decision-making process between evaluators recommending sanity and those endorsing insanity, as well as between psychiatrists and psychologists.     

Returning the not guilty by reason of insanity to the community: a new scale to determine readiness

The very difficult and very important decision on the readiness of an insanity acquittee for community treatment is often based on informal, invalidated criteria. A more standardized approach is needed. The bases for decisions can then be more clearly articulated and the adequacy of recommendations evaluated. This article describes the development of a scale designed to help guide decisions on readiness for community treatment.     

Not guilty by reason of insanity: clinical and judicial profile of medium and high security patients in Belgium

Under Belgian law, offenders deemed to lack criminal responsibility because of insanity receive mandated treatment under the internment law. Population profiles of these forensic patients (‘internees’) are, however, very scarce. In this study, we analysed the demographic, clinical and judicial profile of a large sample of Belgian internees admitted to a secure setting. In addition, differences between internees admitted to a medium versus a high security setting were investigated. Belgian internees were characterised by a large number of personality disorders and a low number of first offenders. Comparative analyses showed substantial differences between the high and medium security settings, with a marked proportion of the forensic patients in high security having committed a sexual offence. Contrary to expectations, more predictors for length of stay were found in the medium security subsample, while admission periods were significantly longer in the high security subsample.     

Child murder committed by severely mentally III mothers: an examination of mothers found not guilty by reason of insanity. 2005 Honorable Mention/Richard Rosner Award for the best paper by a fellow in forensic psychiatry or forensic psychology

Forensic hospital records of 39 severely mentally ill mothers adjudicated Not Guilty by Reason of Insanity for filicide (child murder by parents) were analyzed to describe characteristics preceding this tragedy and to suggest prevention strategies. Almost three-quarters of the mothers (72%) had previous mental health treatment. Over two thirds (69%) of the mothers were experiencing auditory hallucinations, most frequently command hallucinations, and half (49%) were depressed at the time of the offense. Over one third (38%) of the filicides occurred during pregnancy or the postpartum period, and many had a history of postpartum psychosis. Almost three-quarters (72%) of the mothers had experienced considerable developmental stressors, such as death of their own mother or incest. Maternal motives for filicide were predominantly "altruistic" (meaning murder out of love) or "acutely psychotic" (occurring in the throes of psychosis, without rational motive). Psychiatrists should perform careful risk assessments for filicide in mothers with mental illnesses.     

South Africa: airline found guilty of employment discrimination

On 28 September 2000, the Constitutional Court of South Africa ruled that South African Airways (SAA) violated the constitutional rights of Jacques Hoffmann in September 1996 by refusing to employ him as a cabin attendant on the ground that he is HIV-positive.     

Comparing females acquitted by reason of insanity,convicted, and civilly committed in Florida 1977–1984

Females who had been acquitted by reason of insanity (N=41), convicted of comparable offenses (N=41), and involuntarily hospitalized without criminal involvement (N=41) were matched for age and race. The psychiatric histories of the acquitted and civilly committed women were similar, and significantly more extensive than the convicted group. The acquitted women had been arrested significantly more often than the civilly committed women but less frequently than the convicted women. Total length of stay (hospitalization or imprisonment) reflected a similar pattern, with civilly commited women hospitalized for the shortest period, acauitted women an intermediate period, and convicted women the longest. Regression-based prediction of length of stay reflected a number of common predictors for the acquitted and convicted women, with offense type one of the most powerful for both groups.     

Comparing persons found not criminally responsible on account of mental disorder for sexual offences versus nonsexual violent offences

Using data from the National Trajectory Project, we compared 50 individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) for sexual offences with 50 age- and gender-matched individuals found NCRMD for nonsexually violent offences. We also described the concurrent offenses, the symptoms at the time of the offense and the characteristics of the victims of offenders found NCRMD for sexual offences. Persons found NCRMD for sexual offences were less likely to be employed and were significantly younger at time of first psychiatric contact, but did not differ in other sociodemographic characteristics, other aspects of their psychiatric histories or in criminal history. Despite no differences in recidivism and no differences in behaviours between Review Board hearings when adjusting for unequal time at risk, persons found NCRMD for sexual offences had longer tenures under a Review Board mandate than persons found NCRMD for nonsexually violent offences. Given the many similarities between the two groups, this finding suggests that Review Boards may be unnecessarily conservative in how they manage sexual offenders.     

After Oregon's insanity defense: : A comparison of conditional release and hospitalization

This paper is one in a series of reports on the characteristics of persons committed to the Oregon Psychiatric Security Review Board (PSRB) and their treatment and disposition while subject to its jurisdiction. For the purpose of this discussion, we have focused on conditional release and attempt to answer a number of questions. How do the individuals who are placed in the community differ from those who remain hospitalized? Do the two mechanisms of conditional release in this system, by judges or the PSRB, differ in terms of the kinds of people that they are likely to release? Lastly, what features distinguish those individuals who manage to succeed in their release plans from those who do not?     

The review panel process: an algorithm for the conditional release of insanity acquittees

The release of insanity acquittees requires making informed decisions regarding both the presence and severity of an individuals' mental illness and the dangerousness of these individuals. This study evaluated the usefulness of employing structured assessments of mental health and violence risk factors in the conditional release decision-making process. All persons found Not Guilty by Reason of Insanity at East Louisiana Mental Health System, Forensic Division who underwent a review panel between July 1, 1997 and July 1, 1999 were included in this study. The Classification and Regression Tree analysis was utilized to arrive at cutpoints that would optimize the predictive ability of the decision tree analysis. The results indicated that the Community Outpatient Treatment Readiness Profile score was the strongest predictor -- all patients receiving a score of 62 or greater on this scale were recommended to remain at the facility. When women were recommended for release, it was to civil facilities and with moderate levels of symptoms. For males with moderate symptoms, low PCL-R scores were associated with recommendations for release, whereas high scores were associated with recommendations for continued commitment. Our data suggests that algorithms may be useful to governing bodies when making release decisions.     

Follow-up after release of insanity acquittees, mentally disordered offenders, and convicted felons

The authors compared 127 insanity acquittees in the state of Maryland with a matched prisoner control group of 127 convicted felons and a comparison group of 135 mentally disordered prisoners transferred for hospital treatment. Subjects were followed from five to 17 years after discharge from hospital or release from prison. Subsequent arrests, hospitalizations, employment, and functioning of these large cohorts were studied and compared. The study focused on outcome data at five years after release. The authors found that, at five years postrelease, 54.3 percent of the insanity acquittees, 65.4 percent of the prisoner control group, and 73.3 percent of the mentally disordered prison transfers were rearrested. At 17 years postrelease, rearrest rates increased to 65.8 percent of the insanity acquittees, 75.4 percent of the prisoner controls, and 78.4 percent of the prison transfers. Significantly more mentally disordered prison transfers than NGRIs were rehospitalized during the follow-up period. Overall, the prison transfers had significantly poorer outcomes on nearly all variables studied compared with the other two groups. The authors conclude that although there were a substantial number of rearrests among insanity acquittees, that group had a statistically significantly lower rate of criminal activity compared with the other two groups of offenders.