
What happens after a defendant is found not guilty by reason of insanity? - mcone
https://www.nytimes.com/2017/09/27/magazine/when-not-guilty-is-a-life-sentence.html
======
thomastjeffery
> people who have been found not guilty by reason of insanity or who have been
> arrested but found incompetent to stand trial — are involuntarily confined
> to psychiatric hospitals.

Here, "psychiatric hospital" literally means "prison with carpets". There are
locked doors instead of bars, and caretakers instead of guards, but it's a
prison all the same.

My brother had a mental breakdown ( _not violent or criminal_ , but
threatening enough to himself for police to be involved), and ended up in the
state "hospital" for quite a while. I almost wish it was a prison instead,
because at least prison is honest about what it is.

These "hospitals" may be necessary for some, but as soon as you walk inside,
you take a deep dive into the uncanny valley, and you yourself begin to
question your own sanity. I won't even try to imagine what it would be like to
be thrown inside with no trial, and told that you can't leave unless you prove
to your accusers that you are adequately "normal"

The worst thing about the situation is that my brother didn't believe or
understand he was ill, and the state gave him every reason to be angry, and
reject the situation, rather than come to terms with it.

Thankfully now, he is in an assisted living facility, is allowed to leave, and
can feel more like a human being, but while he is _very_ normal, functional,
etc. he can't just go find work and go live his life. There doesn't seem to be
an end game, and that alone is its own prison.

~~~
fish_fan
I have committed myself twice, once for being suicidal and once for life-
ruining anxiety. It did not help in the way I expected. You are essentially
not allowed to express confidence in your own health because your caretakers
will assume you’re overeager and take it as evidence you need more time in the
hospital. Don’t get it twisted, though, your stay length is entirely
determined by convincing health insurance companies that any time there will
reduce recidivism.

The smart people “play” healthy, not admitting ongoing doubts and concerns.
Why? Because you go to the hospital to make rapid medication changes. The
therapy offered is often insufficient, both in terms of one-one-one therapy
and simply what you can cover during your stay. Overstaying is enough to make
anyone clinically depressed. It can also cost a lot; while it is illegal to
fire for mental health leaves, it is not uncommon to get let go for “unrelated
reasons”, to prevent paying for future stays, or simply because they’re
uncomfortable supporting their employees to this extent.

Mental health hospitals are aimed at maximizing the number of beds in use,
ensuring everyone is at least as medicated as the doctor thinks they can
handle, and pumping insurance companies for money. If you are considering one,
use it to prevent crises, not to expect any kind of therapy suited for long-
term help. The simply do not have the available attention, funding, or even
reliable pharmaceutical research to make a dent in the latter.

To be honest, I have high hopes for psychedelics to make fruitful, therapeutic
use in a short stay. As it is I’ve lost faith in the pharmaceutical industry
to demonstrate the pills they make are effective, let alone not harmful to the
general population. 3/5ths of the mental health prescriptions I’ve been given
have been pulled from the market, linked to high suicide rates, or linked to
other serious medical issues (no shit, Risperdal made me lactate as a male.)

...and of course, the absolute worst part is seeing people you know will never
function in society, many rimes without family. I suppose better the asylum
than the street, but we will likely always need long-term mental health care
in publicly funded facilities.

~~~
ThrustVectoring
Ironically, a great way to get out of psychiatric commitment is to cancel or
threaten to cancel your health insurance.

~~~
limeblack
Can you elaborate? I have my guesses what you mean but want to be sure I'm
inferring correctly.

~~~
ThrustVectoring
I lifted it from this:
[https://twitter.com/twitkeels/status/860158814900953089](https://twitter.com/twitkeels/status/860158814900953089)

------
RcouF1uZ4gsC
You've got to get the ordinary man into the state in which he says 'Sadism'
automatically when he hears the word Punishment." And then one would have
carte blanche. Mark did not immediately follow this. But the Fairy pointed out
that what had hampered every English police force up to date was precisely the
idea of deserved punishment. For desert was always finite: you could do so
much to the criminal and no more. Remedial treatment, on the other hand, need
have no fixed limit; it could go on till it had effected a cure, and those who
were carrying it out would decide when that was. And if cure were humane and
desirable, how much more prevention? Soon anyone who had ever been in the
hands of the police at all would come under the control of the N.I.C.E.; in
the end, every citizen.

\- C.S. Lewis - That Hideous Strength

~~~
pnathan
Lewis did put his finger on a nasty little quality of modern man with that
quote. I don't know that the Hideous Strength is a good book - it's positively
regressive in quite too many ways - but that quote there could stand to be put
in plaques in many offices as a caution.

------
KGIII
Tom, name made up, is a friend of mine. Sort of... I knew Tom for only a short
while but I still write him letters and send him a few dollars every couple of
weeks.

When Tom was just 18, he had finished school and was headed off to a large
university on a sports scholarship. Not having any money, and coming from a
poor family, he looked forward to this. It was going to be his big break.

But, Tom needed a wardrobe fit for a nice university. So, Tom went to the mall
and proceeded to steal some clothing. Security tried to stop Tom so he pushed
the security guard and ran away.

Tom, of course, went to jail. The DA offered Tom a 30 day sentence in a plea
agreement and Tom, deciding his life was over, took a razor blade and cut his
own throat.

Tom's 30 day sentence resulted in 10 years in a State mental hospital.
Curiously, when he was released from the mental hospital, they still made him
serve his 30 days.

Tom, now having nothing and a giant scar where normal skin once was, tried to
meander through life as best as he could. This is where I met Tom. Tom loved
drinking and doing drugs. His childhood years of experimentation had been lost
to the system and Tom was making up for that. Tom and I had good times. I
eventually moved on and no longer spent time with Tom. I'm not sure who was a
worse influence on who, but that's immaterial and a story for another time.

One day, Tom had had enough. He just wasn't going to function and decided to
end it all. He went down to the facility where he normally met his providers
and took someone hostage. This, of course, resulted in the police being
called.

Tom, for all his brilliance, was having none of it. The police came through
the door and Tom attacked the first one through the door with his knife.

I'd like to say he put up a good fight, that he gave a good showing, and that
he fought long and hard. No, he did no such thing. Cops being cops, Tom hadn't
made it more than a couple of steps before they shot him.

Tom survived and is now back in that same State hospital. His letters tell me
that he is even back in the same room. He expects to remain there for the rest
of his life and likes to think he was sane, but just desperate, when the
shoplifting occurred. He strongly suspects the system has made him even less
sane and even more unstable. He seems to be okay with spending his life there.

All for some clothing to fit in at university...

~~~
ddorian43
Sorry buddy, but Tom was never "ok". You don't end your life for 30 days
probation.

~~~
mrguyorama
Having experienced the desperation and sickness that is the desire to "end it
all", it is one of the most far from "okay" states that exist. There is (very
nearly) no healthy and justifiable reason to take your own life.

------
mabbo
There was a very high profile case in Ontario over a decade ago. Basically,
the man went into an absolute psychotic state on the travelling bus and cut
the head off a stranger while everyone else on the bus ran for their lives.

A decade later, he's been released- under a lot of conditions and on a lot of
medication, but people are very upset that he'd ever be free at all. In
interviews, he's a very interesting person. "Regret" and "shame" aren't strong
enough words.

It's a hard debate- if he was not guilty due to a medical condition, then he
was not found guilty and shouldn't be in prison, certainly. But he did cut a
guy's head off. Would you want to live next to the guy who did that _while not
in control of himself_?

It's the extreme end of the situation, to be certain, but extremes are a great
place to examine any system.

[https://en.wikipedia.org/wiki/Killing_of_Tim_McLean](https://en.wikipedia.org/wiki/Killing_of_Tim_McLean)

~~~
seiferteric
It is interesting because different people and different countries seem to
have different ideas about he purpose of the the justice system.
Punishment/retribution, correction/rehabilitation, or protecting the public.
Someone like this may not be guilty due to insanity, but still be a danger to
the public for example.

~~~
kelnos
The thing that I worry about in these cases is the lack of "enforceability" of
treatment. If keeping the person in control of themselves (such that they
don't become violent again) means they need to be on medication for the rest
of their lives, how do we ensure (post-release) that they'll always be on
their meds?

I know of people on various medications for psychiatric reasons that have
(against their doctor's recommendation) gone off their meds because they
didn't like the side-effects. That might be fine (if unfortunate/difficult)
for a mental illness that doesn't drive the sufferer to violence, but in the
case where it does, how can you responsibly release someone if you don't have
a mechanism to ensure they stay on their medication?

~~~
lazyasciiart
Mechanisms to enforce medication usage in the community do exist, usually by
in-person visits to supervise taking medication. One such program is the
"Assertive Community Treatment" model that exists in a couple different places
in the US, here's a report from the King County (WA) group:
[http://www.kingcounty.gov/~/media/health/mentalHealth/Docume...](http://www.kingcounty.gov/~/media/health/mentalHealth/DocumentsAndPDF/PACT_One_Year_PACT_Outcomes_2009.ashx?la=en)

I think the actual 'enforcement' in the way you are thinking would be backed
up with some kind of court ruling that they were required to take the
medication, I'm not so sure how that angle would work.

------
throwawaydbd
This happened to a family member of mine and it's honestly the best possible
outcome for people as out of touch with reality as he is. This may not be the
best system for some that get caught in it, but it does serve a purpose in
dealing with the criminally insane.

He was too dangerous and unpredictable to live with us anymore. The rest of
the family kept weapons under our beds of various kinds, hoping to God we
would never need to use them. A group home was a joke, he would have assaulted
someone within a week. He would escape and start driving on the wrong side of
the road on purpose for "reasons". We hid the keys, but he was above normal
intelligence despite his insanity and would always find them. He would attack
his family and the neighbors when he thought we were after him.

His prospects were jail and homelessness, we were so happy when he ended up in
a high security mental facility, ecstatic.

Now he's in a place that's better than jail or being homeless where people
care about him at least a slight amount and there's relative safety. He's not
surrounded by criminals, behind bars, or dying on the street.

Yeah, it's not a great place to be, but the best outcome an extremely
schizophrenic large male can hope for. He doesn't deserve jail because he has
no bearing on what is allowed in society and attacks people out of fear. When
he's calm it can seem like you're talking to a normal person for a few
minutes. Then he goes off the rails... But still there's a really intelligent
shard of sanity in there somewhere.

------
nodesocket
Just finished Manhunt: Unabomber[1] on Netflix. According to the show, it was
Ted Kaczynski's entire defense to rebuttal his charges saying forensic
linguistics and the FBI agent who "cracked" the case had no precedent. The
agent was in fact a traffic cop before becoming an FBI agent and had little
formal linguistics training. Instead Ted's defense behind his back went with
insanity and tried to get him to plead to "save his life". Ted chose to plead
guilty instead of insanity fearing his ideology and manifesto would be ignored
if he pleased insanity.

[1] [https://www.discovery.com/tv-shows/manhunt-
unabomber/](https://www.discovery.com/tv-shows/manhunt-unabomber/)

~~~
jimmies
I have read his manifesto. That was actually not a bad read at all. I think
some of the circuits in his brain was damaged and not functioning right, but
certainly not all of it. Most of the points he brought up is logical and still
applies till today.

~~~
cwkoss
Makes you wonder if his time in the MKULTRA program had anything to do with
his decision to be violent.

------
joecool1029
In Canada they get treatment and are set free without restrictions:
[https://en.wikipedia.org/wiki/Killing_of_Tim_McLean#Aftermat...](https://en.wikipedia.org/wiki/Killing_of_Tim_McLean#Aftermath)

~~~
craftyguy
Slightly off-topic, but

> After the incident, People for the Ethical Treatment of Animals attempted to
> run an ad in the Portage Daily Graphic comparing the killing of McLean to
> the consumption of animals

WTF peta?

~~~
rjeli
yes, that is the intended response

[http://slatestarcodex.com/2014/12/17/the-toxoplasma-of-
rage/](http://slatestarcodex.com/2014/12/17/the-toxoplasma-of-rage/)

~~~
craftyguy
peta is the donald trump of 'rights organizations'

------
zf00002
Louis Theroux did a 2 part documentary where he visited an Ohio psychiatric
hospital that housed people who were found not guilty by reason of insanity.

[http://www.imdb.com/title/tt4546868/](http://www.imdb.com/title/tt4546868/)

~~~
KGIII
Theroux's got a lot of stuff on YouTube. It may be copyright infringement, I
don't know. I do know that it sits there, unchallenged, for years. He has lots
of good documentaries up. I highly recommend all of them.

------
dmix
> In most states, like New York, there is no limit to the duration of that
> commitment.

Couldn't the supreme court rule this type of punishment as "cruel and unusual
punishment"? Technically there is a policy of reviewing "every 2 years" in
perpetuity, so it's not like they don't have a formal punishment.

They mention a Supreme Court ruling regarding "due process" but not the 8th
amendment. So it's basically as if this is sidestepping the constitution by
pretending they aren't being punished?

[https://www.wikiwand.com/en/Eighth_Amendment_to_the_United_S...](https://www.wikiwand.com/en/Eighth_Amendment_to_the_United_States_Constitution)

~~~
stevenwoo
Do you consider it much different from the practice of denying parole when
convicts continue to profess innocence instead of professing contriteness? If
someone is really innocent, they are in the catch 22 of staying in prison for
life because parole boards deny release but if they just lie and pretend to
feel contrite they get out on parole right away after serving time. There was
a case on NPR recently but there's a name for the phenomena -
[https://en.wikipedia.org/wiki/Innocent_prisoner%27s_dilemma](https://en.wikipedia.org/wiki/Innocent_prisoner%27s_dilemma)
plus documentaries about similar cases - West Memphis Three, etc.

~~~
kelnos
The thing about that is, in practical terms, the prisoners are making a
terrible choice by sticking to their guns. They options are:

1) Keep professing innocence and stay in prison.

2) Lie and express remorse, and maybe get out.

3) Lie and express remorse, and maybe get out... and then work to
retroactively exonerate yourself, when you're on the outside and actually have
some chance of doing so without a lucky guardian angel taking interest in your
case while you're in prison.

There are no legal ramifications to "admitting" guilt and expressing remorse.
You already have the conviction on your record, so in the eyes of the law, you
committed the crime, end of story.

I'm sympathetic to the parole board here, to be honest (which feels really
weird to say). While they of course know abstractly that some innocent people
are in jail and shouldn't be, they don't have much to go on when it comes to
the prisoner in front of them. They have the prisoner's conviction record,
without enough context to make a guilty/not-guilty call of their own (and do
we even _want_ them making a call along those lines?), and their purpose is to
determine if the potential parolee is likely to re-offend. They _have_ to
assume the conviction record is correct, or it's basically impossible for them
to do their job. And if it _is_ correct, and the prisoner professes innocence,
they can't responsibly say that releasing them is a good idea.

Beyond that, if the prisoner is indeed innocent, there is a process for
dealing with that outside the parole process. It's not perfect, and it's
difficult for a prisoner to gain access, and I'm sure could stand to see some
large improvements, but the parole process just isn't the place to get your
sentence reduced because you actually are innocent.

~~~
dmix
> the prisoners are making a terrible choice by sticking to their guns.

Being a convicted felon has long repercussions outside of your original jail
time where this calculated - seemingly rational - strategy you discuss is only
a short term one...

There is an important point brought up in the OP's linked wikipedia page:

>> Medwed's Second Look clinic, a group dedicated to the release of innocent
prisoners, assisted lawyers in his eighth parole board hearing which was
successful, releasing him onto indefinite parole. _Overturning the original
conviction would be hampered by his admissions of guilt at his parole
hearings._

The admission of guilt extends well beyond the release from prison. Including
jobs, reputation, future convictions... not to mention the possible
compensation he could receive for if the original wrongful conviction is
overturned.

------
tryingagainbro
Sorry but this is common sense. "I killed him but I was insane and I want to
get out," nope, sorry but I don't think you should my neighbor unless someone
makes sure that you are sane.

