The impact of system design on the characteristics of Missouri's insanity acquittees

This study describes the characteristics of Missouri insanity acquittees, which numbered 797 on July 1, 1992. Unlike reports of characterization data from other states, the study endeavors to link the characteristics to the design of Missouri's insanity acquittee system. This is accomplished by analyzing Missouri's insanity acquittee system and comparing it with the system designs and characteristics of insanity acquittees from other states. Overall, Missouri has a high number of annual insanity acquittals, inpatient hospitalization is used as the primary residential setting for insanity acquittees, most insanity acquittees have severe mental illnesses, the majority of insanity acquittees committed serious crimes, most insanity acquittees are hospitalized for extended periods of time, and insanity acquittees now occupy over 50 percent of Missouri's long-term public psychiatric hospital beds. Evidence did not exist for a linkage between the design of Missouri's insanity acquittee system and most of the insanity acquittee characteristics. Further research is needed to identify system designs that can shape insanity acquittee characteristics in intended ways, to assess the degree to which policy implementors may influence the policy implementation process, and to explore the role of symbolic politics in shaping insanity acquittee systems.