insanity on trial
ralph tortorici
mentally ill inmates

readings and links
The Insanity Defense
Insanity Defense: Overviews

Two overviews of the insanity defense, from the American Psychiatric Association and The Washington Post
"Crazed and Confused"

Using the case of Russell Weston, the gunman who shot his way into the U.S. Capitol in 1998, as the context, reporter Sally Satel offers this review of the insanity defense, its relevancy, and it limitations. "Insanity defenses have become increasingly difficult to mount since John Hinckley's successful plea in the Ronald Reagan shooting. Many states changed their insanity defense laws to shift the burden of proof: In the old regime, the prosecution had to prove the defendant was sane beyond a reasonable doubt. Now in many states and in the District of Columbia, the defense must establish the defendant's insanity with a standard of clear and convincing evidence." (Slate.com, Aug. 30, 2001)
"Insanity, Guilty but Mentally Ill: The Role of the Forensic Psychiatrist"

"There is a difference between medical insanity and legal insanity. Medical insanity is simply the presence of a major mental illness but the threshold for legal insanity is much higher. It is the presence of the major mental illness plus a lack of appreciation of wrong. The legal threshold is much more difficult to overcome." (Juris, Spring 2001)
"Does the Insanity Defense Have a Legitimate Role?"

"Insanity is a well-established defense in this country. Although efforts to eliminate this way of escaping punishment will continue to generate attention, it is unlikely that our laws will eliminate the essential difference between those who choose to break the law and those who cannot choose." (Psychiatric Times, April 2002)
"The Insanity Defense: Bad or Mad or Both?" (PDF)

By William Reid, psychiatrist and past president of the American Academy of Psychiatry and the Law. Reid writes that "the insanity defense is one of the most misunderstood aspects of forensic psychiatry. Not only is it an opportunity for laypersons (and not a few clinicians) to envision 'hired guns' and 'whores of the court,' but it brings to mind dangerous people being allowed to run amok in society after some token period of hospitalization." (From the Journal of Psychiatric Practice, May 2000)
MegaLaw.com: Mental Health Law

Links to recent mental health court decisions, as well as to each state's mental health laws.
Mental Illness in Jails and Prisons
"They Call Him Crazy"

This Time magazine article illustrates some of the unique problems of consigning mentally ill individuals to treatment facilities rather than to prisons or jails. "[Rodney] Yoder has been involuntarily committed to a Chester, Ill., asylum. ... [Yoder] would rather be in prison. He fought a long legal battle during the 1990s to get himself prosecuted for sending menacing letters to people like Playboy CEO Christie Hefner and the late M&M tycoon Forrest Mars Sr. because he wanted to be sentenced to a fixed term rather than remain committed indefinitely. He lost that battle, so to walk free, he must now convince an Illinois court either that he is not mentally ill or that he is not a threat." (Time, July 11, 2002)
"Criminalizing the Mentally Ill"

From the October 1999 issue of Counseling Today, this article gives a brief overview of the problems that result from incarcerating those who are mentally ill. The author writes that "some jails across the United States are starting to realize the importance of treating mentally ill inmates and are beginning to supply the proper drugs, treatments, and accommodations." (Counseling Today, October 1999)
"Mentally Ill Need Care, Find Prison"

"The number of mentally ill behind bars today is nearly five times the number in state mental hospitals, government figures show. And though serious mental illness afflicts 5.4 percent of U.S. adults, the mentally ill account for nearly 16 percent of all inmates -- about 284,000 people -- according to federal surveys." (Washington Post, Nov. 25, 2001)
"Jailing the Mentally Ill"

This companion website to American Radio Works' July 2000 documentary about mentally ill prisoners includes a photo essay and an overview of the insanity defense. (American Radio Works, July 2000)
Crime and Punishment in America

This is the first chapter of Elliott Currie's Crime and Punishment in America (1998), in which Currie chronicles the burgeoning prison population in America and says that prisons have "increasingly become America's social agency of first resort for coping with the deepening problems of a society in perennial crisis. And it is important to understand that, to some extent, the process has been self-perpetuating." (As published on the New York Times' website on March 1, 1998; registration required)
"The Prison-Industrial Complex"

Eric Schlosser details what he calls America's "prison-industrial complex" and its widespread cultural effects: "The raw material of the prison-industrial complex is its inmates: the poor, the homeless, and the mentally ill; drug dealers, drug addicts, alcoholics, and a wide assortment of violent sociopaths. About 70 percent of the prison inmates in the United States are illiterate. Perhaps 200,000 of the country's inmates suffer from a serious mental illness. A generation ago such people were handled primarily by the mental-health, not the criminal-justice, system." (The Atlantic Monthly, December 1998)
"Mental Health and Treatment of Inmates and Probationers" (PDF)

This 1999 report from the Department of Justice's Bureau of Justice Statistics -- its first comprehensive study of mental illness in correctional facilities -- found that there were approximately 284,000 mentally ill offenders incarcerated in U.S. prisons and jails in 1998, or fully 16 percent of the total population in the nation's corrections systems. Among the report's other findings: mentally ill offenders were more likely to have committed violent offenses; half of the mentally ill inmates reported having at least three prior sentences; and only 60 percent of the mentally ill in state and federal prisons received some form of mental health treatment during their incarceration.
"Mental Health Treatment in State Prisons, 2000" (PDF)

According to this Bureau of Justice Statistics report released in July 2001, one in every eight state prisoners was receiving some form of mental health therapy or counseling at midyear 2000. Among the report's other findings: nearly 10 percent of the inmates at state facilities received psychotropic medication; just over half of the state facilities provide 24-hour mental health care; and only two-thirds of the facilities help released prisoners obtain mental health services.
Criminal Justice/Mental Health Consensus Project (PDF)

[Note: File is 2.7 MB.]
This 453-page report released in June 2002, which was prepared by the Council of State Governments in coordination with other research and policy organizations, was funded in part by the U.S. Department of Justice. The authors provide a general overview of the current system and its shortcomings, and have included 46 "policy statements" that detail ways to improve the criminal justice system's management of mentally ill offenders. To view the report's recommendations online, use this flow chart of select events to navigate through each recommendation. Among other things, the report recommends that inmates be screened for mental illness once they are sentenced and that all corrections officers are trained to recognize signs of mental illness.
"Mentally Ill Offenders in the Criminal Justice System: An Analysis and Prescription" (PDF)

The authors of this report from The Sentencing Project -- a nonprofit research and advocacy organization -- find that "mental disorders among prisoners are estimated to be at least five times more prevalent than in the general population." The report goes on to detail recommendations for improving the system, from funding alternatives to incarceration to providing better treatment to mentally ill parolees.
"Prisons and Jails: Hospitals of Last Resort"

A study of the mentally ill in New York's criminal justice system, conducted by the Correctional Association of New York and the Urban Justice Center. The study found that 15-20 percent of city jail inmates were mentally ill, as well as 7-8 percent of state prisoners. "The vast majority of people with mental illness in the criminal justice system are not dangerous and are not incarcerated for long," the report states. The central premise of the report, its authors say, "is that people with mental illness rarely belong in jail and prison." Among their recommendations, the authors say that mentally ill patients should be diverted from the criminal justice system into mental health facilities and that the "continuum of care" extend beyond discharge.
MacArthur Adjudicative Competence Study

From the MacArthur Research Network on Mental Health and the Law at the University of Virginia, this is an executive summary of the center's study on defendants' competency to stand trial. The study found that "approximately 10 percent of all criminal defendants are perceived by their attorneys as having potentially impaired competence. ... Nonetheless, defendants of doubtful competence are usually not referred by their attorneys for a formal mental health evaluation." (MacArthur Research Network, February 2001)
Advocacy Groups
National Alliance for the Mentally Ill (NAMI)

"Persons who have committed offenses due to behavior caused by a brain disorder require treatment, not punishment," asserts NAMI. Here, NAMI has consolidated all of its resources regarding the issue, including its position paper, titled "The Criminalization of People with Mental Illness" and an overview of the Omnibus Mental Illness Recovery Act, NAMI's initiative targeting state legislatures.
Mental Health in Corrections Consortium (MHCC)

Includes a history of the MHCC, as well as a comprehensive list of related links.
Treatment Advocacy Center

The Treatment Advocacy Center, a nonprofit organization, asserts in this fact sheet that "incarcerating individuals with severe psychiatric disorders costs twice as much as assertive community treatment programs -- some of the most effective plans to treat the severely ill."
American Association of Community Psychiatrists (AACP)

In its position paper on persons with mental illness behind bars, the AACP recommends that the criminal justice system create "alternatives to incarceration for as many non-violent mentally ill offenders as  possible." In addition, AACP recommends that "commitment and sentencing laws should be explored with a view to providing options for conditional release at appropriate stages of a term of incarceration."
Bazelon Center for Mental Health Law

The Bazelon Center's resources include several fact sheets on alternative programs for treating mentally ill offenders, its policy recommendations, and an overview of the federal benefits available to the mentally ill who have been incarcerated.

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