Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “INSANITY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1997

The impact of insanity acquittees on Missouri's public mental health system.

Even though state departments of mental health have primary responsibility for the care, custody, and treatment of insanity acquittees, the impact of insanity acquittees on the public mental health system is generally lacking in policy discussions and as a topic for policy research. This issue has received increased attention in Missouri, where insanity acquittees now occupy half of the long-term public psychiatric hospital beds. This article examines the presence of Missouri's insanity acquittees on the state's public mental health system and includes the impact on goals, fiscal costs, inpatient and community psychiatric services, and inpatient treatment staff. As states consider managed care and other cost containment measures, it remains to be seen if the high costs associated with extensive use of hospitalization of insanity acquittees to promote public safety will influence policy changes to more community-based insanity acquittee systems.

Bed Occupancy↗
PubMed1995

The origins of insane asylums in England during the 19th century: a brief sociological review.

This paper explores the origins of insane asylums in 19th century England by comparing the official 'received' medically dominated perspective with an alternative sociological perspective. The major structural changes in provision are addressed as the focus for analysing the differing histories. A brief review is presented of the responses to insane people prior to the national asylum programme following the 1845 Lunacy Act, and of the reform logic that underpinned asylum care. The alternative sociological perspective presents the origins of psychiatric asylums as part of the social and economic changes occurring generally at that time. As such the origins of insane asylums are presented as part of a state-guided 'sanitary' movement which included poor, criminal and insane people within its remit. The effect of state-guided correction was the segregation of insane people from both the general population and other deviants who were formerly classed together. Insane people are thus presented as a group of deviants who departed most radically from the 'rational individualist' qualities of self-control, predictability and responsibility required in the industrialized world of capital social relations that emerged during the last century.

England↗
PubMed1997

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.

Criminal Law↗
PubMed1998

The insanity plea in early nineteenth century America.

In 1846, former New York State Governor William H. Seward defended two murderers using the insanity plea in both cases. Seward contended that the accused became insane due to brutal beatings administered while they were in the Auburn penitentiary. In the William Freeman trial, nine physicians testified that the murderer was insane while eight said he was sane. Juries convicted both prisoners; one was hanged and the other died in prison awaiting a new trial. Seward's legal defense attracted much attention to the jurisprudence of insanity and to insanity in general.

Expert Testimony↗
PubMed1992

Insanity: making law in the absence of evidence.

The Insanity Defense Reform Act (IDRA) of 1984, passed by the United States Congress after two years of hearings, illustrates the dangers of making law in the absence of evidence. In attempting to produce fewer not guilty by reason of insanity (NGRI) verdicts, the lawmakers changed the test definition of insanity, banned ultimate opinion testimony by experts and altered the burden and standard of proof. Yet, when each of these changes was empirically tested, it failed to produce fewer NGRI verdicts. From an empirical vantage point, research now is exploring the common sense constructs of sane and insane that mock jurors consistently appear to use, and these turn out to be complex, relevant and powerfully determinative of verdict. Evidence for partial responsibility judgments, along with two types of culpability judgments--at the moment of the act for the act, and for earlier actions that may bring about the mental disability--have been found. Finally, a sequential schema for insanity, which assesses both types of culpability and their degree has been tested, and the results show the least variance and the greatest coherence with other judgments and ratings of responsibility.

Expert Testimony↗
PubMed1991

The military insanity defense.

This article describes the military insanity defense. The success of the litigated insanity defense is explored through the number of insanity acquittals over a 28-month period. A questionnaire distributed to all United States Army psychiatrists provided information on the number of forensic evaluations performed, the number of not criminally responsible (NCR) opinions made, and the disposition of noncontested NCR opinions. The questionnaire also tested the Army psychiatrists' knowledge about recent changes in the military insanity defense. This pilot study raises interesting questions about the military insanity defense that further research can address.

Forensic Psychiatry↗
PubMed1986

The insanity defense to suicide.

The certification of suicide as the manner of death can result in either the complete loss or a significant reduction in life insurance benefits to the victim's survivors. It is, thus, not uncommon for these beneficiaries to contest suicide as the manner of death. Insanity is a recognized defense in law against suicide. It is recognized in law that, in some cases, an insane man cannot intentionally destroy himself. However, it is also recognized that life insurers can exclude suicide by an insane man from coverage. This article discusses the common law doctrines upon which the insanity defense to suicide is based, with references to judicial opinions from cases which involve contested suicides and the issue of insanity.

Coroners and Medical Examiners↗
PubMed1986

"Insanity" in civil law.

The issue of "insanity" is rarely alluded to in the area of civil law. As a consequence, the legal standard for insanity is not clearly understood by many psychiatrists. The standard derives from case law and is based upon statutory law in the criminal sector. A civil case will be presented where the question of "insanity" was raised. In this case an individual committed suicide and his insurance company refused to pay the beneficiaries of his life insurance policy based upon a provision in his policy that excluded payment in situations of suicide. His beneficiaries sued, claiming that the deceased was insane at the time of his suicide and therefore not responsible for his actions. The standard for insanity in New Jersey and the reasoning of the psychiatrists will be presented.

Expert Testimony↗
PubMed1995

A clinical investigation of malingering and psychopathy in hospitalized insanity acquittees.

This study compares Psychopathy Checklist-Revised (PCL-R) scores, DSM-III-R diagnoses, and select behavioral indices between hospitalized insanity acquittees (N = 18) and hospitalized insanity acquittees who successfully malingered (N = 18). The malingerers were significantly more likely to have a history of murder or rape, carry a diagnosis of antisocial personality disorder or sexual sadism, and produce greater PCL-R factor 1, factor 2, and total scores than insanity acquittees who did not malinger. The malingerers were also significantly more likely to be verbally or physically assaultive, require specialized treatment plans to control their aggression, have sexual relations with female staff, deal drugs, and be considered an escape risk within the forensic hospital. These findings are discussed within the context of insanity statutes and the relevance of malingering, psychopathy, and treatability to future policy concerning the disposition of insanity acquittees.

Adult↗
PubMed1992

The image of the insane in ancient Jewish lore.

This article considers the attitude towards the insane and insanity in ancient Jewish sources. In the Bible, the most famous case of a psychopathological personality is that of King Saul, who was plagued by 'an evil spirit'. Saul also raises the problematic connections between prophecy and frenzy. Madness and confusion of mind are mentioned among the biblical 'curses for disobedience'. In the Talmud, there is a detailed symptomatic evaluation of insanity, in the context of legal liability. It is well-known that some individuals are at times insane, otherwise sane and responsible, which is legally taken into careful consideration. The Jewish historian Josephus describes in his works several cases of psychiatric patients. The most impressive case is that of Jesus ben Ananias, a delirious maniac who announced the fall of Jerusalem while roaming about the streets of the city. It may be argued that no clear attitude of derision or ostracism towards insane patients can be found in ancient Jewish literature. 'The Lord preserves the fools' (Ps 116: 6).

Attitude↗
PubMed1999

The R-CRAS and insanity evaluations: a re-examination of construct validity. Rogers Criminal Responsibility Assessment Scales.

Insanity evaluations are characterized by continued professional debate and the paucity of empirical research. To address the latter, the construct validity of the Rogers Criminal Responsibility Assessment Scales (R-CRAS; Rogers, 1984) was examined via an extensive re-analysis of 413 insanity cases. A series of six separate discriminant analyses was examined to address major components of insanity evaluations. These analyses yielded highly discriminating patterns (M hit rates of 94.3%) and accounted for substantial proportion of the variance (M=63.7%). In general, predicted relationships between individual variables and the discriminant functions were supported. We also addressed the usefulness of the R-CRAS additional variables for the assessment of insanity. We found that these variables contributed substantially to the determination of criminal responsibility. Finally, we pose important and polemical issues for forensic experts conducting evaluations of criminal responsibility.

Crime↗
PubMed1991

Characteristics and outcomes of insanity acquittees in Oklahoma.

The insanity defense is perhaps the most vigorously debated topic at the interface of the legal and mental health systems. This article addresses the need for empirical evidence by providing data on insanity acquittees and their later outcomes in Oklahoma, a jurisdiction not previously studied. Information was obtained on the demographic, legal, psychiatric, hospitalization, and post-hospitalization characteristics of all 61 defendants acquitted not guilty by reason of insanity (NGRI) and treated on the state forensic unit during a 5-year period. Insanity acquittees had few resources, significant psychopathology, and extensive involvement with the legal and mental health systems prior to the NGRI offense. Follow-up of three groups of discharged patients--those released at an initial court review, those who completed the NGRI treatment program, and those who absconded from the forensic unit--revealed that those who escaped from the unit had significantly more arrests and subsequent legal charges than regularly discharged patients.

Adolescent↗
PubMed1992

The insanity verdict, the psychopath, and post-acquittal confinement.

Automatic post-acquittal confinement, an almost inevitable concomitant of a verdict of not guilty or not responsible by reason of insanity has for many acquittees been nothing more than punishment in disguise. Replacement of the insanity defense by statutes that provide for expert witness testimony to show that the defendant lacked the state of mind required as an element of the offense charged, has been found by two state supreme courts to be in accord with constitutional requirements. Procedures can be implemented, with due regard for public safety, so that all offenders, mentally disordered or otherwise, may be dealt with in an ethical, effective and humane manner. The 1992 decision of the Supreme Court of the United States in the case of Foucha v. Louisiana, holding that the Constitution does not permit the continued confinement of a still dangerous, but no longer mentally ill, insanity acquittee, makes it all the more necessary that the insanity defense be abolished and that an offender's mental illness be considered primarily in the context of mitigation, disposition and sentencing, rather than exculpation.

Adult↗
PubMed1999

Identifying insanity acquittals: is it any easier?

Following the highly publicized insanity acquittal of John Hinckley in 1982, legislators throughout the country attempted to reform the insanity defense. At the time, policy makers had virtually no empirical evidence with which to guide their reforms. The focus of this research is to determine if more informed policy-making would be possible today? Results show that more states are able to identify cases involving an insanity acquittal than during the 1980's and provide annual data on the number of rate of insanity acquittals. The data collected by many of the states have significant limitation.

Data Collection↗
PubMed2003

Toward a culture-bound syndrome-based insanity defense?

The American Psychiatric Association's recent inclusion of a Glossary of Culture-Bound Syndromes within DSM-IV draws upon decades of medical anthropological and cultural psychiatric research to afford culture-bound syndromes (CBSs) a newfound legitimacy within professional Western psychiatric nosology. While DSM-IV's recognition of the CBS concept as a category of psychosocial distress has important clinical implications for mental health care practitioners throughout the world, it also has significant legal implications. Given that several CBSs involve a degree of psychological impairment that may satisfy the standard for legal insanity under certain circumstances, this essay focuses on the potential emergence of an insanity defense based on the claim that an immigrant or minority defendant was suffering from a CBS at the time of his or her criminal act. Aimed at initiating interdisciplinary debate over the reification of the CBS concept, the essay discusses the theoretical ambiguity and status of CBSs within professional Western psychiatry, describes what a CBS-based insanity defense might look like, and considers the relevant challenges facing medical anthropologists and cultural psychiatrists, on the one hand, and legal practitioners, on the other. The essay identifies a pressing need for interdisciplinary debate concerning the validity, scope, and viability of CBS-based insanity defenses.

Cultural Characteristics↗
PubMed1998

The effects of motive information and crime unusualness on jurors' judgments in insanity cases.

This study investigated the effects of motive information and crime unusualness on mock jurors' judgments in two homicide cases in which the defendant pleaded insanity. Undergraduates (N = 371) read case information and rendered a verdict, estimated the probability that the defendant was insane, and made additional judgments about the defendant's mental state. The defendant was more likely to be judged insane if the crime was oddly committed rather than committed in a typical manner. Prosecution motive information also affected judgments; the defendant was considered more sane if the prosecution presented evidence of a strong, reasonable motive. Evidence of a "crazy," unreasonable motive, presented by the defense, caused jurors to see the defendant in one of the cases as more insane.

Adult↗
PubMedDate not supplied

Insanity acquittee outcomes in New Zealand.

OBJECTIVE: This paper examines clinical and forensic outcomes for defendants found not guilty by reason of insanity in New Zealand, and explores the implications for policy development and clinical rehabilitation in this population. METHOD: All insanity acquittees disposed of by the courts as special patients after 1976 and released before 2004 are described. Their duration of inpatient care, rates of reconviction and rehospitalization following release are examined. The high resolution rate for violent crime reported to police suggests that reconviction rates are a reasonable proxy for violent reoffending. Factors predicting duration of inpatient care and reoffending are analysed. RESULTS: Severity of Index Offence was the only variable predicting duration of inpatient care of the 135 special patients. Offenders of more serious offences were securely detained for longer periods--averaging 6 years in the case of those charged with murder. Most patients were readmitted over the decade following discharge. Only 6% had violently reoffended 2 years after release into the community. Prior offending, age at release, ethnicity and gender predicted reoffending, but not diagnosis or duration of inpatient admission. CONCLUSIONS: Following discharge into the community, insanity acquittees are reconvicted of violent crimes at a very low rate, although readmission to hospital is common. It may be that insanity acquittees are initially detained in hospital longer than is clinically indicated, and that safe forensic community treatment can occur at an earlier stage of recovery without compromising public safety.

Adolescent↗
PubMed1983

Factors associated with a successful insanity plea.

The authors present data on all insanity pleas (N = 202) in Erie County, New York, between 1970 and 1980. No demographic, criminal history, current offense, or history of mental hospitalization factor was associated with acquittal. Of the variables studied, only the recommendation of the forensic examiner was associated with the court's decision to acquit by reason of insanity. When an insanity acquittal was recommended in the examination report, conviction ensued in only 17% of the cases. The proportion of pleas that were successful varied considerably over the 10 years studied. The authors discuss the critical need for more research on the plea stage of insanity defense proceedings.

Forensic Psychiatry↗