insanity defense


Summary: A legal concept that an accused is not criminally responsible if, at the time of committing the act, the person was laboring under such a defect of reason from disease of the mind as not to know the nature and quality of the act done or if the act was known, to not have known that what was done was wrong. (From Black's Law Dictionary, 6th ed)

Top Publications

  1. Schweitzer N, Saks M. Neuroimage evidence and the insanity defense. Behav Sci Law. 2011;29:592-607 pubmed publisher
    ..Despite the non-influence of neuroimagery, however, jurors who were not provided with a neuroimage indicated that they believed neuroimagery would have been the most helpful kind of evidence in their evaluations of the defendant. ..
  2. Rutman I. Interested in a new challenge? The not guilty by reason of insanity plea. Part II: Fifteen questions. Psychiatr Rehabil J. 2002;26:109-11 pubmed
  3. Sparr L. Personality disorders and criminal law: an international perspective. J Am Acad Psychiatry Law. 2009;37:168-81 pubmed
    ..Mental incapacity defenses based on personality disorders are more often used in The Netherlands, England, Germany and Belgium, but seldom in Canada and rarely in the United States and Sweden. ..
  4. Schopp R. Treating criminal offenders in correctional contexts: identifying interests and distributing responsibilities. Behav Sci Law. 2009;27:833-55 pubmed publisher
    ..Rather, it is intended to promote rigorous ongoing inquiry by clarifying the relevant interests at stake and the responsibilities of various participants in the complex interaction of health care and corrections. ..
  5. Kogstad R. Protecting mental health clients' dignity - the importance of legal control. Int J Law Psychiatry. 2009;32:383-91 pubmed publisher
    ..Under this convention, the European Court of Human Rights has support for the application of the ECHR without exemptions for special groups of people. ..
  6. Carson D, Felthous A. Mens rea. Behav Sci Law. 2003;21:559-62 pubmed
  7. Collins P, White T. Depression, homicide and diminished responsibility: new Scottish directions. Med Sci Law. 2003;43:195-202 pubmed
    ..The psychiatric literature regarding depression and homicide is reviewed. ..
  8. Heitzman J, Opio M, Waszkiewicz Białek E. [Disease--defence--manipulation: the difficulties in providing forensic-psychiatry opinions]. Psychiatr Pol. 2008;42:609-22 pubmed
  9. Wortzel H, Metzner J. Clark v. Arizona: diminishing the right of mentally ill individuals to a full and fair defense. J Am Acad Psychiatry Law. 2006;34:545-8 pubmed
    In Clark v. Arizona, the U.S. Supreme Court was faced with two main questions: Does Arizona's insanity defense statute, with its abridged M'Naughten standard, violate the Fourteenth Amendment? And does Arizona case law, with its complete ..

More Information


  1. Price M, Norris D. National Instant Criminal Background Check Improvement Act: implications for persons with mental illness. J Am Acad Psychiatry Law. 2008;36:123-30 pubmed
    ..The legislation was introduced following the Virginia Tech tragedy, when public opinion favored tightening control over access to firearms of persons with mental illness. ..
  2. Swaminath R, Mendonca J, Vidal C, Chapman P. Experiments in change: pretrial diversion of offenders with mental illness. Can J Psychiatry. 2002;47:450-8 pubmed
  3. Weiss K, WATSON C. NGRI and Megan's Law: no exit?. J Am Acad Psychiatry Law. 2008;36:117-22 pubmed
    ..Thus, insanity acquittees run the risk of interminable supervision. We discuss a recent challenge to the Arkansas registration law and the decision's implications for planning forensic mental health testimony. ..
  4. Everington C, Notario Smull H, Horton M. Can defendants with mental retardation successfully fake their performance on a test of competence to stand trial?. Behav Sci Law. 2007;25:545-60 pubmed
    ..The results suggest that defendants with mental retardation may be able to successfully fake their performance in certain circumstances. Implications of these findings are discussed. ..
  5. Newman S, Buckley M, Newman S, Bloom J. Oregon's Juvenile Psychiatric Security Review Board. J Am Acad Psychiatry Law. 2007;35:247-52 pubmed
    ..They go on to discuss potential problems foreseen with implementation of the JPSRB system and to recommend possible solutions. ..
  6. Bledsoe W. Criminal offenders residing in long-term care facilities. J Forensic Nurs. 2006;2:142-6 pubmed
    ..Additional awareness and investigation is urgently needed to facilitate policy changes at all levels. Such action will help ensure the safety of facility residents who are currently at ongoing risk. ..
  7. Stone A. The ethical boundaries of forensic psychiatry: a view from the ivory tower. Bull Am Acad Psychiatry Law 12:209-19, 1984. J Am Acad Psychiatry Law. 2008;36:167-74 pubmed
  8. Melamed Y, Ganot N, Mester R, Bleich A. The civil liability for damages of the criminally insane. Isr J Psychiatry Relat Sci. 2008;45:285-90 pubmed
    ..The Court related to the issue of justice according to which an innocent person's damages should not remain uncompensated, and the assailant was required to pay damages to the victim. ..
  9. Weiss K. Confessions and expert testimony. J Am Acad Psychiatry Law. 2003;31:451-8 pubmed
    ..The conditions are: Mental illness, Intoxication, Retardation, Acquiescence, Narcotic withdrawal, Deception, and Abuse. These are discussed, supported by examples from the author's practice. ..
  10. Higashi T. [Criminal responsibility in schizophrenia with special attention to the mental state during the criminal act--a study based upon the activation-recurrence phenomenon]. Seishin Shinkeigaku Zasshi. 2009;111:762-88 pubmed
  11. Madea B, Schmidt P, Preuss J, Dietmar E. [Unusual questions of evidence in a case of offensive post-mortem dismemberment]. Arch Kriminol. 2010;225:46-60 pubmed
    ..In addition, some issues to be answered such as the detection of bloodstains on nonporous surfaces by means of leucocrystalviolet and the time of heat exposure of burned body parts are dealt with. ..
  12. Akinkunmi A. The MacArthur Competence Assessment Tool-Fitness to Plead: a preliminary evaluation of a research instrument for assessing fitness to plead in England and Wales. J Am Acad Psychiatry Law. 2002;30:476-82 pubmed
    ..The instrument was able to detect significant differences in scores over time. It is suggested that once the instrument has been further validated for research purposes, it may be developed for clinical application. ..
  13. Perlin M. "Too stubborn to ever be governed by enforced insanity": Some therapeutic jurisprudence dilemmas in the representation of criminal defendants in incompetency and insanity cases. Int J Law Psychiatry. 2010;33:475-81 pubmed publisher
    ..This gambit would also allow us to address-in a more successful way than has ever yet been done-the problems raised by the omnipresence of ineffective counsel in cases involving defendants with mental disabilities. ..
  14. Manes F, Torralva T, Ibanez A, Roca M, Bekinschtein T, Gleichgerrcht E. Decision-making in frontotemporal dementia: clinical, theoretical and legal implications. Dement Geriatr Cogn Disord. 2011;32:11-7 pubmed publisher
    ..This represents a unique legal and ethical dilemma. Our findings have important implications for medicolegal decisions relating to capacity and culpability, and regarding the philosophical concept of 'free will'. ..
  15. Andrews J. From stack-firing to pyromania: medico-legal concepts of insane arson in British, US and European contexts, c. 1800-1913. Part I. Hist Psychiatry. 2010;21:243-60 pubmed
    ..Additionally, this article compares and contrasts contemporary debates about other special manias, especially kleptomania. Part 2 will be published in the next issue, History of Psychiatry 21 (4). ..
  16. Hempel A, Meloy J, Stern R, Ozone S, Gray B. Fiery tongues and mystical motivations: glossolalia in a forensic population is associated with mania and sexual/religious delusions. J Forensic Sci. 2002;47:305-12 pubmed
    ..Glossolalist perpetrators tended to be female. We review the extant research on glossolalia in both normal and clinical samples. and integrate our findings, the first study of glossolalia in a forensic setting. ..
  17. Folino J, Abait P. Pathological gambling and criminality. Curr Opin Psychiatry. 2009;22:477-81 pubmed publisher
  18. Gray J, O Reilly R. Supreme court of Canada's "Beautiful Mind" case. Int J Law Psychiatry. 2009;32:315-22 pubmed publisher
  19. Dike C. Commentary: Is ethical forensic psychiatry an oxymoron?. J Am Acad Psychiatry Law. 2008;36:181-4 pubmed
    ..Alan Stone's critique of forensic psychiatry 25 years ago is probably the most pointed. In this article, a summary of four different responses to Alan Stone's critique will be presented and analyzed. ..
  20. Reisner A, Piel J, Makey M. Competency to stand trial and defendants who lack insight into their mental illness. J Am Acad Psychiatry Law. 2013;41:85-91 pubmed
    ..Such evaluations may have the effect of negating the necessity of a Frendak inquiry in those jurisdictions that can impose the insanity defense on defendants.
  21. Allnutt S, Samuels A, O driscoll C. The insanity defence: from wild beasts to M'Naghten. Australas Psychiatry. 2007;15:292-8 pubmed
    ..Principles are offered to guide psychiatrists who are called to give evidence in cases where the mental illness defence has been raised. ..
  22. Young G. Causality in criminal forensic and in civil disability cases: Legal and psychological comparison. Int J Law Psychiatry. 2015;42-43:114-20 pubmed publisher
    ..perpetrator of the criminal act at issue in terms of the person's mental state (mens rea), and whether the insanity defense applies...
  23. McSherry B. Epilepsy, automatism and culpable driving. Med Law. 2002;21:133-53 pubmed
  24. Skipworth J, Brinded P, Chaplow D, Frampton C. Insanity acquittee outcomes in New Zealand. Aust N Z J Psychiatry. 2006;40:1003-9 pubmed
    ..It may be that insanity acquittees are initially detained in hospital longer than is clinically indicated, and that safe forensic community treatment can occur at an earlier stage of recovery without compromising public safety. ..
  25. Salize H, Dressing H. [Placement and treatment of mentally ill offenders--basic concepts and service provision in European Union Member States]. Psychiatr Prax. 2007;34:388-94 pubmed
    ..National and cross-boundary research should be intensified. Defining European quality and training standards in forensic psychiatry seems to be an activity to be started on a short term basis. ..
  26. Steger F. [From the person to an isolated case: Frank Schmökel in the discourses of power and stigmatization]. Psychiatr Prax. 2003;30:389-94 pubmed
    ..Such conveyance of opinion is amazingly influential in terms of societal politics and health politics, and has repercussions in law and politics. ..
  27. Wheatman S, Shaffer D. On finding for defendants who plead insanity: the crucial impact of dispositional instructions and opportunity to deliberate. Law Hum Behav. 2001;25:167-83 pubmed
    ..Implications of these results for both legal policy and the conduct of mock-trial research are discussed. ..
  28. Meynen G. An ethical framework for assessments of criminal responsibility: applying Susan Wolf's account of sanity to forensic psychiatry. Int J Law Psychiatry. 2012;35:298-304 pubmed publisher
    ..I argue that after some substantial revisions her account can be helpful in order to arrive at an ethics-based conceptual framework for forensic psychiatric assessments within the context of an insanity defense.
  29. Advokat C, Guidry D, Burnett D, Manguno Mire G, Thompson J. Competency restoration treatment: differences between defendants declared competent or incompetent to stand trial. J Am Acad Psychiatry Law. 2012;40:89-97 pubmed
    ..9 ± 7.0 months). While consistent with prior research, this is the first study to compare both psycholegal comprehension and specific clinical symptoms in defendants before and after competency restoration treatment. ..
  30. Crocker A, Braithwaite E, Côté G, Nicholls T, Seto M. To detain or to release? Correlates of dispositions for individuals declared not criminally responsible on account of mental disorder. Can J Psychiatry. 2011;56:293-302 pubmed
    ..Further, dynamic variables provide direction for titration of treatment and supervision. Results are discussed regarding enhancing evidence-informed RB dispositions. ..
  31. Appelbaum P. Treating incompetent defendants: the Supreme Court's decision is a tough Sell. Psychiatr Serv. 2003;54:1335-6,1341 pubmed
  32. Habermeyer E, Herpertz S. [Dis-social personality disorder]. Nervenarzt. 2006;77:605-15; quiz 616 pubmed
    ..In addition to psychiatric diagnostics, considerations on the severity of the disorder and its effects on the ability to inhibit actions are necessary. ..
  33. Ross C. Paraphilia from a dissociative perspective. Psychiatr Clin North Am. 2008;31:613-22 pubmed publisher
    ..The model could be tested first in epidemiological studies and later in treatment outcome studies. ..
  34. Santry C. Mental health. Call to action as killings continue to fail service users and public. Health Serv J. 2007;117:12-3 pubmed
  35. Weiss K. Isaac Ray's bibliography: some addenda and Ray's evidence-based thinking. J Am Acad Psychiatry Law. 2007;35:109-11 pubmed
    ..Among them is an 1870 review of a book, illustrating Ray's critical thinking. Search aids for finding additional Ray publications, as well as those of his son, B. Lincoln Ray, are included. ..
  36. Caruso K, Benedek D, Auble P, Bernet W. Concealment of psychopathology in forensic evaluations: a pilot study of intentional and uninsightful dissimulators. J Am Acad Psychiatry Law. 2003;31:444-50 pubmed
    ..Although further study is indicated, it appears that dissimulators are a heterogeneous group. ..
  37. Nau M, McNiel D, Binder R. Postpartum psychosis and the courts. J Am Acad Psychiatry Law. 2012;40:318-25 pubmed
    ..This case series suggests that states that use the stricter M'Naughten standard have not been less likely than states with an MPC standard to adjudicate women who have committed infanticide as not guilty by reason of insanity. ..
  38. Halpern A. Psychiatric advance directives. J Am Acad Psychiatry Law. 2006;34:571-2 pubmed
  39. Gutheil T. Reflections on coaching by attorneys. J Am Acad Psychiatry Law. 2003;31:6-9 pubmed
  40. Côté G, Crocker A, Nicholls T, Seto M. Risk assessment instruments in clinical practice. Can J Psychiatry. 2012;57:238-44 pubmed
    ..The findings confirm that there remains a significant gap between research evidence and risk assessment practice. ..
  41. Yeo S. Clarifying automatism. Int J Law Psychiatry. 2002;25:445-58 pubmed
  42. Cantor J. Of pills and needs: involuntarily medicating the psychotic inmate when execution looms. Indiana Health Law Rev. 2005;2:117-70 pubmed
  43. Toib J. Civil commitment and the criminal insanity plea in Israeli law. Int J Law Psychiatry. 2008;31:308-18 pubmed publisher
    ..Whatever the appropriate solution for Israel, surely the first requirement is recognition of the problem. ..
  44. Nishiyama A. [Malingered prison psychosis as a reactive type of pseudologia phantastica]. Seishin Shinkeigaku Zasshi. 2011;113:961-76 pubmed
    ..Therefore, from another point of view, it could be said that narratives of defendants can be classified as a reactive type of pseudologia phantastica. ..
  45. Seifert D, Jahn K, Bolten S, Wirtz M. Prediction of dangerousness in mentally disordered offenders in Germany. Int J Law Psychiatry. 2002;25:51-66 pubmed
  46. Rutman I. Interested in a new challenge?. Psychiatr Rehabil J. 2002;26:1-2 pubmed
  47. Wolff N. (New) public management of mentally disordered offenders. Part II: A vision with promise. Int J Law Psychiatry. 2002;25:427-44 pubmed
  48. Garland B, Glimcher P. Cognitive neuroscience and the law. Curr Opin Neurobiol. 2006;16:130-4 pubmed
  49. Liettu A, Mikkola L, Säävälä H, Räsänen P, Joukamaa M, Hakko H. Mortality rates of males who commit parricide or other violent offense against a parent. J Am Acad Psychiatry Law. 2010;38:212-20 pubmed
    ..The results of the present study are compared with the previous study findings on parricidal offenders and offenders in general. ..
  50. Gaebel W, Haessler F. [The problem of infanticide]. Nervenarzt. 2008;79:856-7 pubmed publisher
  51. Schwartz Watts D, Rowell C. Commentary: Update on assessing risk for violence among stalkers. J Am Acad Psychiatry Law. 2003;31:440-3 pubmed
  52. Gold L. AAPL and the death penalty: a historical perspective on the debate. J Am Acad Psychiatry Law. 2005;33:6-7 pubmed