NGRI Revisited: Venirepersons' Attitudes Toward the Insanity Defense1

Three hundred venirepersons from the 12^th Judicial Circuit in Sarasota, Florida completed the following booklet of stimulus materials: one question measuring participants' level of support for insanity defense; a 16‐item measure assessing participants' attitudes toward the myths associated with the insanity defense, the legal definitions of insanity, and mental illness; a case scenario; verdict preference; and standard demographic questions. Level of support for the insanity defense was significantly related to participants' attitudes toward legal standards of insanity, mental illness, and the myths associated with the insanity defense. In addition, results indicated that level of support for the insanity defense, age, educational level, occupation, type of prior jury service, and political views were significantly related to verdict preference. Notably, three factors that have been found to impact verdict preference in previous research failed to do so in the current study: participants' experience with psychological disorders; participants' exposure to psychotropic medications; and participants' experience with psychologists or psychiatrists. The findings both replicate and extend earlier findings by suggesting that attitudes toward the insanity defense are more complex than previously imagined.     

The insanity defense: Historical development and present status

This article provides an overview of the historical development of the insanity defense, including a discussion of the standards which have been used to excuse someone from criminal responsibility. The legal issues raised pre-trial and at trial are presented, along with a discussion of current proposals to modify or abolish the insanity defense. The article also focuses on the disposition of insanity acquittees, including both the case and statutory law in this area. Constitutional bases for challenges to differential procedures for insanity acquittees, along with proposals to change the law relating to them are included.     

Mental health criminal defenses in persons with neuropsychiatric disorders

Persons with neuropsychiatric disorders present specific and unique challenges for forensic experts and defense attorneys in the criminal justice system. This article reviews two potential criminal defenses: legal insanity and the various legal standards or tests of criminal responsibility that are used in jurisdictions throughout the United States (i.e., the M’Naghten standard and the American Law Institute's Model Penal Code), and the partial legal defense of diminished capacity (lacking the mental state necessary to be found guilty of a specific intent crime). The process of evaluating criminal responsibility or diminished capacity is also presented with a specific emphasis on common issues that arise in evaluating defendants with Intellectual Developmental Disorder (Intellectual Disability), Parasomnias, Seizure Disorders, and Neurocognitive Disorders.     

Characteristics and outcomes of insanity acquittees in Oklahoma

The insanity defense is perhaps the most vigorously debated topic at the interface of the legal and mental health systems. This article addresses the need for empirical evidence by providing data on insanity acquittees and their later outcomes in Oklahoma, a jurisdiction not previously studied. Information was obtained on the demographic, legal, psychiatric, hospitalization, and post-hospitalization characteristics of all 61 defendants acquitted not guilty by reason of insanity (NGRI) and treated on the state forensic unit during a 5-year period. Insanity acquittees had few resources, significant psychopathology, and extensive involvement with the legal and mental health systems prior to the NGRI offense. Follow-up of three groups of discharged patients--those released at an initial court review, those who completed the NGRI treatment program, and those who absconded from the forensic unit--revealed that those who escaped from the unit had significantly more arrests and subsequent legal charges than regularly discharged patients.     

Neuroscience, Ethics and Legal Responsibility: The Problem of the Insanity Defense

The insanity defense presents many difficult questions for the legal system. It attracts attention beyond its practical significance (it is seldom used successfully) because it goes to the heart of the concept of legal responsibility. ??Not guilty by reason of insanity?? generally requires that as a result of mental illness the defendant was unable to distinguish right from wrong at the time of the crime. The many difficult and complex questions presented by the insanity defense have led some in the legal community to hope that neuroscience might help resolve some of these problems, but that hope is not likely to be realized.     

The mental disability requirement in the insanity defense.

This paper offers a discussion of some of the nuances of mental disease or defect as required for the insanity defense in criminal law. It also compares and contrasts the mental disease or defect definitions of criminal law with those definitions used in clinical practice. It points out a general pattern of vagueness and dispute regarding the proper interpretation of the mental disability requirement in the insanity defense and in other legal provisions. It reports a variety of interpretations by courts and commentators regarding the meaning of these phrases, and it reports attempts by state legislatures to narrow the range of applicable conditions by excluding various mental or emotional states.     

The insanity plea: Szaszian ethics and epistemology

The traditional legal verdict of ‘not guilty by reason of insanity’ as well as the more recent verdict of ‘guilty but mentally ill’ rest on often unquestioned epistemological assumptions about human behavior and its causes, unjustified reliance on forensic psychiatrists, and questionable, if not deplorable ethical standards. This paper offers a critique of legal perspectives on insanity, historical and current, based on the altermative epistemological and ethical assumptions of Thomas S. Szasz. In addition, we examine Szasz's unique rhetorical analysis of ‘mental illness’ and its implications for forensic psychiatry.     

Insanity defense research and treatment of insanity acquittees

This article is a comprehensive review of issues relevant to the insanity defense and the disposition of insanity acquittees. The characteristics of persons found Not Guilty by Reason of Insanity (NGRI) are described. Although the locus of treatment of the NGRI acquittee varies by jurisdiction, at this time, care and detention of insanity acquittees fall mainly to state mental health agencies. Recent reforms, as they relate to locus of treatment, are reviewed and public policy issues are discussed. The author concludes that more clinical research on the insanity acquittee is necessary for the development of more informed public policy on the insanity defense.     

Posttraumatic stress disorder and criminal violence: Basic concepts and clinical-forensic applications

In a small number of felony murder cases, posttraumatic stress disorder (PTSD) has been used as an affirmative defense to plead not guilty by reason of insanity or to argue for diminished capacity as a mitigating factor at sentencing. This article traces the history of PTSD as a legal defense; describes the clinical criteria for diagnosing and assessing PTSD; outlines the legal criteria for the affirmative defense of not guilty by reason of insanity (NGRI) and mitigation on the grounds of diminished capacity; and discusses the applications and pitfalls of using PTSD as an exculpatory factor in crimes of violence, including murder.     

Constructing insanity: jurors' prototypes, attitudes, and legal decision-making

Research consistently indicates that jurors' intuitive prototypes of insanity and case-relevant attitudes shape their verdicts more strongly than legal definitions of insanity. Based on a sample of 113 prospective jurors, this study was designed to (a) assess the extent to which three prototypes of insanity held by jurors in a past study generalize to a sample of jurors in another state and (b) determine the relative influence of attitudes toward the insanity defense and prototypes of insanity on jurors' case judgments across four insanity case vignettes. Results suggest that jurors' attitudes toward the insanity defense affected case judgments so strongly (r = .41-.61) that they swamped efforts to assess jurors' prototypes of insanity. Further, jurors' prototypes of insanity offered little incremental utility beyond that of insanity defense attitudes. Implications for identifying biased jurors and potential interventions for bringing jurors' decisions into greater accord with the law are discussed.     

Pathological gambling as an insanity defense

Recognition of pathological gambling as a diagnostic and clinical entity has been paralleled by its use as an insanity defense by gamblers engaged in criminal behavior. The societal ramifications of exculpation for crimes committed by volitionally impaired defendants require a critical analysis of the relationship between mental illness and criminal acts. Following a summary of current knowledge about pathological gambling as a clinical disorder, case law relevant to its use as an insanity defense is reviewed. It is argued that pathological gambling is not a serious mental illness for the purposes of the criminal law and that it bears no causal relationship to criminal activity. Legal and societal interests dictate that pathological gambling be excluded as a potential insanity defense.     

Psychological evaluations in the criminal justice system: Basic principles and best practices

Forensic psychologists are frequently called upon to conduct evaluations for competency to stand trial, insanity defense, or prediction of future dangerousness. Psychological evaluations for the court typically include record review, clinical examination of the defendant, interview of collaterals, psychological testing, and preparation of a written report. Psychological forensic examiners may also be called upon to testify in court. In rendering their conclusions, forensic examiners should conduct a careful analysis of each individual case, not rely on the mere presence, absence, or severity of any mental disorder to make a legal determination.     

Measuring knowledge of the insanity defense: scale construction and validation

Given the influence of social conformity and prejudice, defendants pleading not guilty by reason of insanity face the significant challenges of securing fair and impartial juries. Attitudes and knowledge of the insanity defense are factors that may influence levels of impartiality. In the light of this, we set out to develop a scale to examine knowledge levels of the insanity defense and their influence on decision-making. Two studies were conducted to construct a scale designed to assess laypersons' knowledge of the insanity defense. Items measuring knowledge of the insanity defense were based on Perlin's (1995) insanity defense myths. The first study identified particular items in need of revision and subscales that required the development of additional items in order to improve reliability and construct validity in the second study. The second study used the revised scale, demonstrating improved validity and reliability. The scale also had acceptable predictive validity with reference to insanity defense verdicts.     

The competency of criminal defendants to refuse,for delusional reasons,a viable insanity defense recommended by counsel

This article addresses the issues of whether mentally ill defendants charged with serious crimes who refuse to plead a viable and counsel-recommended insanity defense for delusional reasons (but who are otherwise competent to stand trial) should be considered to be competent, or incompetent, to stand trial; whether such defendants should be allowed to represent themselves with a delusional defense; and whether an insanity defense may properly be imposed upon such defendants. Based on an analysis of relevant Supreme Court decisions and other relevant cases, it is concluded that such defendants should not be allowed to go forward with a delusional defense (at least until reasonable efforts to treat the defendants' delusions are made). It is also argued, however, that unless an insanity defense would be viable (as well as recommended by counsel) delusional defendants who are otherwise competent to stand trial should be permitted to go forward, and represent themselves, with the defense of their choosing.     

Use of the insanity defense: A survey of attorneys in wyoming

Attorneys in the State of Wyoming were surveyed to determine their reported use of the insanity defense during the preceding 5 years. They were asked about the success, defined as “benefit to the defendant,” of the insanity defense at various stages that occur before trial. The attorneys reported that the insanity defense is used throughout the various stages preceding trial, with more use and benefit to the defendant being reported than previously suggested. This was particularly true for the earlier stages in the criminal justice process. The attorneys were also asked various attitude questions related to the insanity defense. Defense lawyers were more in from of the insanity defense and expressed attitudes that supported the insanity defense while prosecuting attorneys were relatively more opposed to the insanity defense and expressed attitudes consistent with this view.     

The Impact of Culture and Religion in the United States and Saudi Arabia on the Concept of Justice and its Treatment of Insanity Defense

In this paper I examine convergent and divergent perspectives on justice and their relation to culpability. Two culturally distinct judicial systems serve as the focus, the American rule of law, and Saudi Arabian legal procedures. I studied cultural and legal differences by examining the insanity defense and how it is perceived and practiced in both American and Saudi Arabian societies, according to the prevailing contemporary legal systems.     

The mental illness defense in the capital penalty hearing

Several defense strategies are available to the capital defendant who is arguing for life in the penalty phase, including a mental illness (MI) defense. An MI defense presents psychiatric testimony to the effect that the defendant was mentally disturbed at the time of the offense and, therefore, should not be held completely responsible. The few studies available suggest that an MI defense will be ineffective because (1) death-qualified jurors do not respond favorably to purely psychological explanations of criminal behavior and (2) an MI defense may erroneously mislead the jury regarding the defendant's unpredictability and dangerousness. Analagous studies of insanity acquittals suggest certain factors that may be associated with a succesful MI defense.     

Insanity and responsibility

This paper attempts to set forth, in the context of Anglo‐U.S. criminal law, the meaning of the concept of insanity, its necessary relation to absence of responsibility, and its bearing on some relevant psychiatric concepts and legal controversies. Irrationality is a distinctive and necessary (but not sufficient) condition for insanity. Irrationality consists in failure even to grasp the relevance of what is ‘essentially’ relevant. To that extent there obviously can be no responsibility. A mental makeup which renders one (who would not normally be so) substantially incapable of rational conduct constitutes insanity, and in that respect renders the person non‐responsible. Much more broadly and roughly speaking, the mind that is ill is the mind that is irrational (and hence in that respect non‐responsible).     

Craziness and criminal responsibility.

This article addresses why mental disorder is relevant to criminal responsibility. It begins by considering the meaning of criminal responsibility because it is impossible to understand the relevance of mental disorder unless one understands responsibility clearly. The next section provides a theoretical account of responsibility and excuse in general and addresses common misconceptions about these topics. The third section examines in detail why mental disorder can sometimes produce either a complete or partial excusing condition, such as legal insanity or "partial responsibility," and whether the U.S. Constitution requires the provision of an excuse based on mental disorder. The section proposes that mental disorder should produce an excusing condition in appropriate cases. The next section considers the relation of mental disorder to mens rea, the mental state "element" that is a definitional criterion of most crimes, and whether the U.S. Constitution requires that defendants be permitted to use evidence of mental disorder to negate mental state elements of the crime charged. This section argues that mental disorder rarely negates mens rea, but in those cases in which a plausible claim for negation could be made, defendants should be allowed to make this claim.