"James, now in his 40s, has been in the hospital for almost two decades. This isn’t because he was sentenced to 20 years, or to 25. He was not sentenced at all; he is technically, legally, not responsible. The court believes beyond a reasonable doubt that he committed the act he was accused of, a prerequisite for the state to accept an insanity plea. The plea does not, however, prescribe or limit the duration of his stay. The laws that govern the practice of committing people who are acquitted because of mental illness dictate that they be hospitalized until they’re deemed safe to release to the public, no matter how long that takes...
In 1992, the Supreme Court ruled, in Foucha v. Louisiana, that a forensic patient must be both mentally ill and dangerous in order to be hospitalized against his will. But in practice, “states have ignored Foucha to a pretty substantial degree,” says W. Lawrence Fitch, a consultant to the National Association of State Mental Health Program Directors and former director of forensic services for Maryland’s Mental Hygiene Administration. “People are kept not because their dangerousness is because of mental illness. People stay in too long, and for the wrong reasons.”...
when an N.G.R.I. defense does succeed, it tends to resemble a conviction more than an acquittal. N.G.R.I. patients can wind up with longer, not shorter, periods of incarceration, as they are pulled into a mental-health system that can be harder to leave than prison...
There is no accepted body of research to suggest that lengthy institutionalization leads to better treatment outcomes...
The question, according to Dvoskin, “becomes one of risk tolerance. America has become — to an extreme level that’s almost impossible to exaggerate — a risk-intolerant society.” Fears of people with mental illness persist, even though, according to the best estimates, only 4 percent of violent acts in the United States are uniquely attributable to serious mental illness. One study has found that those with mental illness are actually less likely to be seriously violent than the general population. (In addition, some N.G.R.I.s have been acquitted of nonviolent crimes, like public-order offenses, traffic offenses and prostitution.) Even if a mentally ill person has committed a crime, says Chris Slobogin, director of the criminal-justice program at Vanderbilt University Law School, “it doesn’t mean they’re going to do it again,” especially because their encounter with the forensic psychiatric system means they’ve received treatment. “This is a group of people that are incredibly stigmatized and misunderstood in terms of how dangerous they are"...
Emotions and prejudice easily come into play, even from experts. A 2003 study in The American Journal of Forensic Psychology, for example, showed that doctors are more likely to find minorities incompetent to stand trial and more likely to diagnose psychotic disorders in African-Americans."
This is a bad system.
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