The legislative structuring of insanity acquittee policies

Using Missouri's insanity acquittee system as a case study, this analysis explores the extent to which legislation can structure the implementation of mental health policy. It found that Missouri's insanity acquittee legislation substantially structured policy implementation toward its primary goal of public safety. It did so (a) by including actors from both the criminal justice and mental health systems in the insanity acquittee release process, (b) by specifying procedures and criteria for the commitment and release of insanity acquittees, and (c) by requiring monthly monitoring of insanity acquittees released into the community and funding the staff positions to conduct the monitoring. The ability of legislation to structure policy implementation highlights the need for active involvement by mental health policy makers in the legislative process to shape policy goals and to structure implementation to support the interests of the mental health community. Without this involvement, implementation options available to mental health administrators may be severely limited.