Genuine 'not guilty by reason insanity' case - Do you accept "He's cured?"

Our sanity is such a fragile thing anyway – more fragile than many of you might think.

Suppose you are given the wrong medication and it makes you delusional. You aren’t going to know that you are delusional. It is possible that you might mistakenly think that someone is trying to kidnap a neighbor’s child. In order to save the life of the child, you swing a baseball bat and club to death a perfectly innocent by-stander. You think you have done the right thing.

A court finds you not guilty by reason of temporary insanity. Your mind is now perfectly clear and the cause of your delusional state is known. You are not a danger to society. Your actions were the result of a terrible mistake either at the doctor’s office or at the pharmacy.

Mental illness can happen to anyone. The mentally ill aren’t “broken” things to be thrown away.

Thanks for everyone’s responses.

Mernieth, and Lissa - your point about a halfway house is a good one. Certainly that’s what’s being discussed in the the case I linked in my OP. But, the implication is that if his time in the group home is as good as the professionals are predicting, that is only a temporary step.

Which is why I was talking about release to the community, since that is the ultimate goal.

rainy, I have to say that your position is one that scares me. Like Doc Cathode, I suffer from mental illness. Your position, and to a lesser extent, the position espoused by Tevildo, scares me. And frustrates me. I can’t even get a job because of my history of mental illness, no matter that I’ve never hurt anyone while too depressed to work. (Physically, that is. My actions caused great pain to my family - but that’s not exactly something that the law has any role in.)

To take examples from the headlines: Mark Hacking - the Arizona man who’s accused to killing his pregnant wife because his fabricated life was about to blow up in his face. So, in his illness, he decided that to spare her the disappointment of learning the truth, he’d kill her, instead. While I don’t doubt that Mark Hacking has serious mental health problems, his behavior - hiding the body, disposing of evidences, and so on - was that of a man who could still think rationally, and consider that what he did was wrong. So, while he may even be insane, he’s not a candidate for being found not guilty because of his insanity.

Then we’ve got James Yang, from my OP. Who did nothing to hide the body - was not capable of planning anything, it appears from the article. Who believed, apparantly, that his mother was a threat to his life, and soul. That the reasons for that belief are insane doesn’t change that he was acting at the time within the normal bounds of behavior: killing in self-defense is allowed, and there have been enough cases that remove even the need for an immediate threat to support this. (IIRC, the “Burning Bed” murder case was one such.) That, generally, the courts and the law frown on that doesn’t mean that it’s an unreasonable conclusion for someone to draw. It is often a wrong one, but not unreasonable.

(BTW, Mernieth, how is my hypothetical too unrealistic? The only things changed from the article about James Yang was the assumption that all of us here on the Dope could be assured that the medical types have evidence to back up their claim that my hypothetical killer is responding well to treatment, and his illness can be kept in remission with medications.)

I read, several years ago, a book by a psychiartrist - who’d often been involved in insanity cases before the courts. He listed case histories of some six or seven cases. And in that whole book there was only one case of a person being found not guilty be reason of insanity. If I could remember the book’s title, or author, or even anything but the vaguest details of the one case I’d recommend it. He made it very clear that the legal defition for being found not guilty by reason of insanity is no simple standard to meet. For that matter, Susan Smith didn’t meet it. For all that anyone looking at her case has to realize she was a very ill woman.

Let me take a moment, now, to talk about schizophrenia - the specific diagnosis that James Yang has. This is not, actually, that the patient has seperate personalities, like Sybel. Rather, it usually manifests as the patient hearing voices. For really bad cases they’ll be hearing these voices all the time. The voices can be benign, or vile. Or simply mundane. There’s no way to guess without talking to the patient. But, can you imagine having someone in your head, always talking to you, whom you can’t shut up? That’s the best description I’ve gotten from someone who’d had a problem with schizophrenia. Onset is usually associated with puberty, but anything can trigger it: stress, especially.

So, it becomes quite possible for someone who was fine last week, to start suffering from this disease. And, in part because of the stigma attached to seeking psychiatric care, it is not unusual for people to simply hope it will go away. Rather than getting help, while they’re still sane enough to recognize that something’s wrong. What’s worse is that family and friends can re-inforce that thinking, especially for those with late onset mental illness: “You never needed a shrink before this, why see one now? You’ve just got to be strong.” This attitude is one that I’ve seen is especially common in people with minimal education. I have to admit that I wonder whether James Yang’s mother had been one of those sorts.

If you’ve ever experience hypnagogic hallucinations, that is a pretty good measuring stick for what schizophrenia can feel like from the inside. Except that’s all the time. (The wikipedia article I’ve linked isn’t innaccurate, I don’t think - just not complete. It focuses on the benefits of hypnogogia, rather than how unsettling it is to be “awake” and hearing a voice calling your name, or seeing bugs that aren’t there.)

What I’m trying to say is that it is completely credible for me to hear about a person falling completely into the miasma of schizophrenia, listening to the advice and direction of the voices, without ever quite realizing that they’re sick, and could be treated.

But, and this is the key point to all my words, with modern medications such attacks can be controlled. It’s often a matter of trial and error to find the medication that will treat a specific person’s disorder, and even after medication has been found, it’s not a silver bullet, making everything well. Even after the initial cause is found and treated, the habits of thought that are insane still have to be dealt with.

So, all in all, we’re talking about a years long process to fight for one’s sanity. And it is a fight. Many people who end up that far gone don’t make it back. Others kill themselves, finding that the medications rob them of pleasure in life. But, in my hypothetical, we’ve got a man who’s come back about 90% of the way. (I don’t say 100%, because he’ll never be the person he had been before the crime occured.) The people familiar with his case feel he is no longer a threat to himself or others. If “Not guilty by reason of insanity” is to mean anything other than a means of committing someone to a mental institution for life, without chance of parole, then for the rare ones who do win back their sanity - we have to accept that we made a bargain, and they can come back out again.

I don’t suggest leaving them to go unmonitored. Rights that belong to the normal person can be restricted when dealing with someone who has shown such behavioral problems. So, keeping them on medications as a condition of release, and blood/urine testing to make sure that he continues don’t seem out of line to me. Nor does requiring regular sessions with a therapist.

Now, D_Odds and Doc Cathode, I don’t think that the government has a right to treat persons who’ve not committed any wrong as someone on parole just because they have a mental illness. Regardless of how it would affect my own liberties, I don’t like it because it will raise the percieved costs to the patient who looks for help. Anything that increases the real stigma associated with mental illness, making it seem more of a burden to seek help will, in the long run, be counter-productive, in my opinion.

And avoiding help, isolating, and just hoping it will all get better is part of what happened with Andrea Yates.

I’m a simple guy, I always think that ‘not guilty by reaons of insanity’ should really be ‘guilty but not punishable by reason of insanity.’

John Douglas, ex FBI serial killer profiler, had many observations. One that true psychopaths were quite easy to catch.

Second is that majority of juries will not buy the insanity defense. In his opinion, that was because most juries recognized these were really bad people even if they were insane, and wanted to get them in a place where they would not be eligible for re-entry to society.

A good example is John Hinckley, and how he is being dealt with is a good example of what I think the process should be.

Firstly, I do think we have to accept the possibility that someone who is “not guilty by reason of insanity” could eventually be treated to a degree that he is no longer a threat to society. At that point, he would deserve some degree of freedom.

However, I don’t think it should be instantaneous or without condition. His rights are of importance, but protecting society is also important. And we aren’t dealing with what the person may do but with what they have already done to a large degree, the person in question (your hypothetical person) has indeed killed before. Fears about him and monitoring of him is justified due to his prior actions.

Hinckley was described by medical professionals as being effectively sane, and that his mental illness is more or less in what they described as “full remission.” Currently he is permitted to go on furloughs out of the hospital where he has lived for over two decades, these furloughs are restricted in that he must stay with his parents when he is out.

I think this is a good path to follow. No two patients are alike, obviously. But a generally “structured release” is preferable. It allows oversight and observation, so we can tell if the released is actually going to function acceptably. Eventually we could move to the point where the patient is fully released, but must come in at given times to receive medication. And he must also continue to meet with doctors on a regular basis. Failure to do so would result in his being involuntarily readmitted to the hospital on a full-time basis.

It is unfortunate that that person would have to live under these draconian regulations, through no real fault of their own. However it’s basically necessary. And if it was not done properly society would become even more reluctant to accept the insanity defense in the first place, and it may even disappear from society (in response to Hinckley’s acquittal several states removed the insanity defense altogether.)

I do not know if someone who is mentally ill to the degree that they’ve been homicidal in the past can ever exist without medications. If it is possible, then that too would have to be done in a structured manner. First doctors would have to testify that the patient can exist and exist safely without the meds. Then they would have to have an observationary period where his behavior and movements are tightly monitored to insure that he really is going to remain well without the medications.

Just to clarify, in case there was any confusion, I do not agree with the position stated in the article. My nod to Ben Franklin was in regards to his statement about trading away liberty for security and deserving neither. Mandated, enforced care for the non-violent mentally disabled is not the right solution. Violent offenders are a different story, IMO. Where I waffle is in the mentally ill who display violent tendencies or a violent disconnect, yet haven’t committed any violent act.

No problem, D_Odds. I’d meant only to speak to an issue you and Doc Cathode had brought up, nothing more.

Under the right circumstances, I think it is possible to make reasonable diagnoses as to the patient’s ability to operate in the real world. Each case is different and each person responds differently to medication and other types of treatment.

Sure, some people will slip through the cracks and a dangerous person may commit another crime. But through due diligence, I think these cases will be minimal. It’s the price we pay for living in a free society.

Right and just to be clear, I think complete release into the community is a bad idea for the criminally insane, even if their illness is currently under control.

The guy in the article killed his mother, sawed off her face and ate her eyeballs. It’s in everyone’s (his own, the guards’, the other prisoners’) best interests that he stay on his treatment. Putting him in a halfway house or supervised furloughs like with Hinkley will probably help with the treatment in terms of relieving some of the stress and problems of a prison setting.

But I don’t think he should be released on his own recognizance. I think the magnitude of his crime plus the nature of his illness would be giving him too much responsibility. In fairness to everyone, I think he should be required to pursue his treatment (or not, if he chooses) in an unsupervised manner.

On a side note, I do think he should have the right to refuse treatment. I just don’t think he should be free to do it with noone the wiser.

Apologies for my lack of clarity. I meant the situation was unrealistic, not your hypothetical per se.

Mental illness is too ephemeral in nature to be able to say for sure that a patient has it licked and is no future danger to anyone. It’s possible that the treatment is successful currently but there’s no gaurantee that the treatment will lose effectiveness. Perhaps the meds he’s taking will be pulled off the market or maybe he’ll develop a physical condition that requires conflicting medication. Sometimes a drug’s effectiveness can wear off on a patient.

And that doesn’t even address the way different stresses in life might affect him. In a way, I’d say that if he’s found a situation where he’s (relatively) healthy, he should just stick with it!

But what I was trying say upthread was that I think it’s unrealistic to assume that Yang’s current state is anything more than a hill in the road. It’s unrealistic to assume that his condition will stay in “remission” - especially in new circumstances such as freedom. And I think it’s unrealistic to expect his neighbors to take the unwitting chance.

Maybe in another 25 years we’ll have a better handle on schizophrenia & treatments. For now though I think a criminally insane person should stay within supervision.

What do psychopaths (I prefer the term sociopaths) have to do with legal insanity? A sociopath does not have the capacity for empathy, or guilt. However, they can distinguish between right and wrong. They just don’t care. A sociopath evaluates their actions only in light of possible consequences to themselves. A sociopath may decide that mugging is easier and more lucrative than a standard job. But, they realise that mugging is wrong, illegal, and are fully aware of what will happen to them if they are arrested and convicted.

I think you already answered your own questions: DocCathode quote: We can know whether or not the person is a danger to society by the same means, and with pretty much the same degree of accuracy, that we decided they were legally insane- A bunch of pyschologists, pyschiatrists, etc sit down and have long talks with the person, administer many tests, hold conferences with each other and testify in court.

If PPD is temporary then its treated as such. Otherwise, the person becomes a ward of the state either through incarceration or continuos monitoring. The state is obligated to intervene in cases involving people who require a primary caregiver (children, the infirm, the elderly etc…).

I was responding to different points.

‘How do we decide who is crazy and dangerous?’

‘With a system that is flawed and subject to abuse.’

then

‘How do we know this crazy person is safe to release?’

‘If you accepted the shrink’s word that they were crazy, why won’t you accept the shrink’s word that they are no longer dangerous’

Temporary but likely to recurr if the woman becomes pregnant again. If a woman with PPD is a danger to others, she’ll be a danger the next time she has a kid too. Do you suggest we prevent a recurrence of PPD by forcibly sterilizing her?

Well I can see I’m in the minority here. As a last comment, just let me say that my hardline attitude here is in the context of criminals, who may or may not have a legit claim to some definition of insanity – not just to someone who is diagnosed with mental illness. I don’t want anyone to get that impression.

If it matters, I’m pretty hardline about criminals in general, believing we are too forgiving of them.

Oh well, carry on.

-rainy