ArticlePDF Available

The Volume and Characteristics of Insanity Defense Pleas: An Eight-State Study

Authors:

Abstract and Figures

The authors document the very complex process involved in identifying insanity defense pleas in eight states. Each state and each study county in each state required an individual approach. Most often, county court dockets were hand searched to identify those pleading insanity, although numerous other methodologies were used. The frequency and rate of insanity pleas and acquittals are presented for the study states as well as descriptive data on the characteristics of persons pleading and acquitted NGRI. Overall, the insanity defense was raised in one percent of all felony cases. Further, only 26 percent of those raising the insanity defense were actually acquitted NGRI. The necessity of obtaining data on insanity pleas to adequately understand and ultimately inform future directions of insanity defense research is discussed.
Content may be subject to copyright.
A preview of the PDF is not available
... Scholars have also pointed to psychosis as central to a common western idea of insanity (Moore, 2015;Wondemaghen, 2017, pp. 133-152), drawing attention to the fact that many of those acquitted due to insanity are diagnosed with schizophrenia (Callahan, Steadman, McGreevy, et al., 1991;Perlin, 2017b;Tsimploulis, 2018). Current psychiatric practices are at the same time increasingly criticized in light of advancing scientific theory and data that challenges the categorical diagnostic approach (see inter alia Jablensky, 2016;Scull, 2021). ...
... This is not surprising given that hallucinations and delusions are the core positive symptoms in impaired reality testing, and that schizophrenia is the disorder in which they most often occur. Studies from other countries show similar results (Callahan et al., 1991;Perlin, 2017b;Tsimploulis, 2018). The law is unclear, however, about why and how psychotic symptoms matter. ...
Article
This paper clarifies the conceptual space of discussion of legal insanity by considering the virtues of the ‘medical model’ model that has been used in Norway for almost a century. The medical model identifies insanity exclusively with mental disorder, and especially with psychosis, without any requirement that the disorder causally influenced the commission of the crime. We explore the medical model from a transdisciplinary perspective and show how it can be utilised to systematise and reconsider the central philosophical, legal and medical premises involved in the insanity debate. A key concern is how recent transdiagnostic and dimensional approaches to psychosis can illuminate the law's understanding of insanity and its relation to mental disorder. The authors eventually raise the question whether the medical model can be reconstructed into a unified insanity model that is valid across the related disciplinary perspectives, and that moves beyond current insanity models.
... States' different approaches to tracking CTP-related data (if they possessed such data at all) reflected their distinct public mental health systems and operations. In many ways, this study's challenges mirror those of L. A. Callahan et al. (1991), who also faced jurisdictional variability and incomplete data in their pursuit of the volume of insanity pleas across eight states; however, we had the benefit of today's technology. Differences in funding structures and processes have kept state systems siloed, each operating under its own idiosyncratic set of policies and procedures. ...
Article
Full-text available
Objective: Competence to proceed (CTP) is a constitutional protection intended to facilitate fairness and dignity of court proceedings. Researchers have estimated that between 60,000 and 94,000 defendants are evaluated for CTP each year. Yet no research has systematically identified the number of evaluations conducted each year, despite their critical role and many profound implications. We used large-scale, systematic data collection to address this knowledge gap. Hypotheses: Given the siloed nature of the judicial and forensic mental health systems, we anticipated incomplete data and that the number of evaluations would far exceed previous estimates. Method: In September 2019, we used public information requests to solicit CTP evaluation order data from the judiciaries of 50 U.S. states, the District of Columbia, and the Federal Bureau of Prisons. We accepted evaluation proxies, such as evaluations ordered or evaluations filed, from the 2018/2019 calendar/fiscal year. We used Uniform Crime Reporting data to estimate a nationwide evaluation-to-arrest ratio and annual evaluation volume. Results: Twenty-five states provided data. We deemed data from 18 states acceptable while acknowledging that data likely underrepresented actual evaluation volume. By extrapolating data from these 18 states, we estimated a conservative national evaluation-to-arrest ratio of 0.015 (95% confidence interval [−0.007, 0.037]), which suggested that 15 evaluations are conducted per 1,000 arrests each year. Consequently, it seems likely that at least 140,000 evaluations are ordered each year nationwide, with several hundred people referred for evaluations each day. Conclusions: Annual CTP evaluation volume likely far exceeds previous estimates. Transparent data are difficult, if not impossible, to obtain. As a result, researchers, legal and forensic mental health professionals, and policymakers lack the ability to implement informed, constitutionally protected CTP practices. Key implications, research directions, and detailed data infrastructure recommendations are provided.
... There are similar findings from other countries. Previous research from other countries indicatesthat a significant number of those acquitted by reason of insanity are diagnosed with schizophrenia (e.g., Callahan, Steadman, McGreevy, & Robbins, 1991;Tsimploulis, 2018). Scholars have even pointed to psychosis as centrally relevant to a common Western idea of insanity (Moore, 2015). ...
Article
Full-text available
This article raises the question of the prospect of a common approach to mentally ill offenders in Europe, through a comparative discussion of the criminal insanity rules and systems in Norway and Bulgaria. The underlying motivation is to fill a gap in current legal research where the insanity discourse is still to a certain extent nationally oriented. Bulgaria is to date not represented at all in the international discussion of criminal insanity. Starting out from recognizing the different history, rules, culture and welfare of Norway and Bulgaria, the authors argue that these countries have a similar practical understanding of insanity and how it is associated with mental disorders as well as common challenges in their forensic and legal systems. These insights can provide a basis for further comparative explorations concerning a possible harmonization of insanity law in Europe.
... Research, however, has consistently demonstrated that the insanity defense is rarely raised and, when it is, most defendants are ultimately convicted of the alleged offense. [44][45][46][47] Recent meta-analytic data indicate that experts opine a defendant is insane in about 14 percent of criminal responsibility evaluations. 47 When insanity is raised at trial, approximately 26 percent of defendants are acquitted. ...
Article
Full-text available
In 1995, the Kansas legislature adopted what is referred to as the "mens rea approach" and abolished the affirmative insanity defense. This approach allows a defendant to be acquitted who lacks the requisite mental state for the crime, without consideration of the defendant's understanding of wrongfulness. In Kahler v. Kansas, the U.S. Supreme Court recently held that this restrictive approach does not violate due process and that a state is not required to adopt an insanity test which considers a defendant's moral capacity at the time of the crime. Four other states currently follow the mens rea approach, or some form of it. In this article, we first discuss a brief history of insanity defense laws in the United States. We then outline relevant legislative history and precedent in Kansas and other states that have adopted the mens rea approach. We next discuss the Supreme Court's reasoning in Kahler The significance of this test is further discussed, including Eighth Amendment considerations. We advocate for continued education of the public, legislators, and the judiciary regarding the use, application, and necessity of an affirmative insanity defense.
... Among adults, the insanity plea is most often invoked only in cases of severe mental illness (e.g., schizophrenia and other psychotic disorders; Callahan, Steadman, McGreevy, & Robbins, 1991). Given that most psychotic disorders develop in the early 20s, fewer adolescents than adults would meet the standard for the insanity defense even if the legal option were available (Rogers & Myers, 2013). ...
Chapter
Full-text available
Adolescence is a unique time of change and challenge, when youths are set with accomplishing a multitude of developmental tasks necessary to transition to successful independent living and adult roles. Adolescents tend to be immature relative to adults in a variety of domains—biological, cognitive, emotional, social—and must undergo significant transformation in these domains before reaching maturity. One notable example (as detailed in Chapter 4, this handbook) concerns juveniles’ psychosocial immaturity—that is, deficiencies in youths’ social and emotional capacities relative to adults’. For example, adolescents are usually more impulsive, more likely to take risks, and more vulnerable to peer pressure than adults; they also tend to be more susceptible to stress and less able to weigh present benefits in the light of future consequences (Cauffman & Steinberg, 2000; Scott, Reppucci, & Woolard, 1995; Steinberg & Cauffman, 1996). These psychosocial deficiencies, compounded with still-developing cognitive faculties, contribute to adolescents’ often immature and short-sighted decision making in a variety of domains, such as engaging in risky sexual practices or reckless driving (Gardner & Steinberg, 2005).
Article
Full-text available
Alcohol and other substance use disorders share comorbidity with other RDS disorders, i.e. a reduction in dopamine signaling within the reward pathway. RDS is a term that connects addictive, obsessive, compulsive, and impulsive behavioral disorders. An estimated 2 million individuals in the United States have opioid use disorder related to prescription opioids. It is estimated that the overall cost of the illegal and legally prescribed opioid crisis exceeds one trillion dollars. Opioid Replacement Therapy is the most common treatment for addictions and other RDS disorders. Even after repeated relapses, patients are repeatedly prescribed the same opioid replacement treatments. A recent JAMA report indicates that non-opioid treatments fare better than chronic opioid treatments. Research demonstrates that over 50 percent of all suicides are related to alcohol or other drug use. In addition to effective fellowship programs and spirituality acceptance, nutrigenomic therapies (e.g., KB220Z) optimize gene expression, rebalance neurotransmitters, and restore neurotransmitter functional connectivity. KB220Z was shown to increase functional connectivity across specific brain regions involved in dopaminergic function. KB220/Z significantly reduces RDS behavioral disorders and relapse in human DUI offenders. Taking a Genetic Addiction Risk Severity (GARS) test combined with a the KB220Z semi-customized nutrigenomic supplement effectively restores dopamine homeostasis. (WC 199).
Article
Full-text available
Combined evaluations of competence to proceed (CTP) and mental state at the time of the offense (MSO) are commonplace, yet underexamined in the literature. Given the high stakes faced by defendants and substantial arguments that can be made for and against combined evaluations, it is imperative that we understand how practitioners navigate this process. In this exploratory practitioner study (N = 43), we surveyed professional practices and beliefs concerning combined evaluations as well as how, per practitioners’ self-reports, they were influenced by jurisdictional policy. As is recommended in nascent areas of research, we undertook both quantitative and qualitative methods. Many evaluators reported a disconnect between the spirit of adjudicative competence and the combined CTP/MSO evaluation process. On the whole, evaluators reported that combined evaluations accounted for 29% of their CTP and/or MSO referrals, but only 10 (23.3%) reported that their jurisdiction specifically addressed how to conduct them. They tended to endorse that seemingly incompetent defendants cannot consent to MSO evaluations, and so MSO reports should not be submitted for these defendants. They provided some consensus that seemingly incompetent defendants can provide useful information later integrated into MSO evaluations and that CTP and MSO opinions should be documented separately. We recommend that jurisdictions include statutory language directing evaluators to refrain from submitting MSO opinions when they believe defendants are incompetent, for jurisdictions to explicitly require separate CTP and MSO reports and to distinguish disclosure rules for each report type, and further professional discussion about the nature and process of combined evaluations.
Article
The criminal acts of offenders with a psychopathic disorder can be perpetrated without normal self‐control or moral appreciation. Thus, there is room for some jurisdictions to allow for consideration of psychopathic disorders. This chapter examines the evolution of insanity jurisprudence in the United States and Australia and variations in state jurisdictional law, especially as it pertains to psychopathic disorders. The frequency with which the insanity defense is raised and its success vary in different jurisdictions in the United States. In any event, the insanity defense is seldom used, and when used its likelihood of success is low. The chapter discusses the historical development of insanity defense and psychopathic disorder in Australia. Each jurisdiction in Australia has legislation that either partly or wholly provides for a mental illness or mental impairment defense. As a general rule, psychopathic disorders do not qualify for the insanity defense in either country, although ambiguities and exceptions exist.
Article
Full-text available
Thirty men acquitted not guilty by reason of insanity (NGRI) were matched on type of violent crime and compared to 30 men who unsuccessfully raised the insanity defense. Demographic, legal process, and psychological variables were compared. Eighty percent of successful acquittees previously had been found incompetent to stand trial, compared to only 33% of those found guilty and sentenced to prison. Ninety-six percent of NGRI acquittees opted for trial before a judge rather than a jury; 76% of cases raising an unsuccessful defense were heard in front of a jury. Unsuccessful attemptees also had significantly higher IQ scores and personality profiles characterized by acting-out potential and intact reality testing compared to profiles of NGRIs. The ability of the legal system to identify those meeting criteria for the insanity defense is discussed.
Article
Full-text available
The authors examined the cohort of all defendants pleading not guilty by reason of insanity over a 12-month period in Baltimore City's superior trial court. During that time, 143 of the 11,497 defendants indicted (1.2%) pled not criminally responsible. Fourteen of those defendants (10%) were subsequently found not guilty by reason of insanity. The authors found marked agreement between the prosecution and defense with only two cases leading to full trials where the issue of insanity was argued. The evaluating physician's opinion as to criminal responsibility and Axis I diagnosis, and the most serious underlying charge discriminated between those defendants found not guilty by reason of insanity and those defendants found guilty or not guilty by the court. Other demographic factors such as age, number of dependents, educational level, severity of illness, and criminal background did not discriminate between the two groups.
Article
Full-text available
Several states are changing legislation and treatment programs for mentally ill offenders without knowing how current laws and programs operate. To address this problem the authors linked data from police records, court reports, and clinical files for 2,735 psychiatric referrals from the criminal justice system of Alaska from 1977 through 1981. They found that only 0.2%-2.0% of all schizophrenic persons in the community were arrested for violent crimes each year, accounting for 1.1%-2.3% of all arrests for violent crimes; that psychiatrists agreed about competency and responsibility in 79% of the cases evaluated by more than one clinician; and that a successful insanity defense occurred in 0.1% or less of all criminal cases.
Article
Of 133 Colorado male defendants employing the insanity plea from 1980 to 1983, 36 were adjudicated insane and 97 found guilty. Considering all defendants, they were found to be primarily single, Caucasian, somewhat older and better educated than the usual defendant group, unemployed at the time of the insane offense, and with a history characterized by chronic unemployment, prior psychiatric treatment, drug abuse, alcohol abuse, and previous arrests. Acquittees differed significantly from convicted defendants in being older and better educated. They were more likely to have been diagnosed as schizophrenic and less likely to have had a history of drug abuse. No difference was found between the groups with respect to all other variables examined, including severity of instant offense, ethnicity, and number of prior arrests.
Article
The 50 states and the District of Columbia were surveyed for the operative insanity rule and frequency and success of the insanity plea and related alternate pleas. These data were compared with data collected for the year 1983. As in the earlier report, there seems to be a dearth of information about the use and success of the pleas. The information that is available is quite varied. There is a discussion of why basic data may not be available and what information is needed in order to have a basic understanding of the use of the insanity plea and alternate pleas.
Article
A sample of 50 homicide defendants acquitted by reason of insanity (NGRI) was compared with a group of 50 defendants who were evaluated for insanity and found to be criminally responsible (CR). Significant differences were found between the two groups in terms of prior psychiatric and criminal histories and nature of the homicide (i.e., relationship to victim). The dispositions of those found NGRI were also examined on the above variables.
Article
In 1979, Montana's insanity defense was replaced with the more restrictive mens rea defense, a change that has been described as an example of "abolition" of the insanity defense. The authors identified cases in which mental health was an issue in seven Montana counties for 3 years before and 3 years after the 1979 reform. They found that acquittals based on the insanity plea markedly declined, but that dismissals based on incompetence to stand trial increased substantially following the reform. They conclude that dismissal based on incompetence to stand trial became a substitute for acquittal based on the insanity plea under mens rea.
Article
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.
Article
Analysis of studies reporting upon defendants using the insanity defense suggests such defendants to be generally: male, of Caucasian ethnicity, older than the typical criminal defendant, single, unskilled vocationally, having previous psychiatric hospitalization, and having a prior arrest history.