Insanity in bar of trial in Scotland: a State Hospital study

Legal findings of unfitness to stand trial are returned ten times more frequently in Scotland than in England and Wales. Sixty-five patients in the State Hospital who had been found insane in bar of trial were compared with a control group of 64 offender patients. They showed a significantly greater incidence of homicidal crimes and diagnoses of psychotic disorders, 19 per cent of which later proved to be unstable. They had also been detained longer at the State Hospital. These findings are discussed and particular reference is made to the tendency for psychotic offenders to be almost automatically regarded as unfit to plead. A brief comparison is made with the situation in England, and some modifications in forensic psychiatric procedure are suggested.