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Defendants pleading insanity: an analysis of outcome
J S Janofsky1, M B Vandewalle, J R Rappeport
1Johns Hopkins Hospital, Baltimore, MD 21205.
The Bulletin of the American Academy of Psychiatry and the Law
|January 1, 1989
Summary
In Baltimore, 1.2% of indicted defendants pleaded not criminally responsible. Physician
Area of Science:
- Forensic Psychiatry
- Criminal Law
- Psychiatric Diagnosis
Background:
- The insanity defense is a complex legal and psychiatric issue.
- Understanding factors influencing the success of the insanity defense is crucial for the legal and mental health systems.
Purpose of the Study:
- To examine the rate and outcomes of the insanity defense in Baltimore City.
- To identify factors that discriminate between defendants found not guilty by reason of insanity (NGRI) and those found guilty or not guilty.
Main Methods:
- Retrospective cohort study of defendants pleading not guilty by reason of insanity.
- Analysis of court records and physician evaluations over a 12-month period.
- Statistical comparison of demographic and clinical factors between NGRI and non-NGRI groups.
Main Results:
- 1.2% of indicted defendants pleaded not criminally responsible; 10% of those were found NGRI.
- High agreement between prosecution and defense, with few full trials on insanity.
- Physician's opinion on criminal responsibility, Axis I diagnosis, and charge severity predicted NGRI.
- Demographic factors and criminal background did not differentiate NGRI outcomes.
Conclusions:
- The insanity defense is rarely used but has a discernible outcome.
- Physician evaluations and charge severity are key predictors of NGRI findings.
- Further research into the interplay of clinical and legal factors in insanity defense cases is warranted.