The mental health evaluation in the legal insanity plea is a type of forensic assessment that provides expert opinion on whether the individual was criminally responsible for committing the alleged crime.
The evaluation predicts the mental state of the individual at the time of committing the alleged crime and gives an opinion on the legal criteria of insanity, i.e., whether the individual lacked substantial capacity to understand the wrongfulness of his or her conduct or to control his or her behavior.
This is required for the court to decide whether the individual can be held legally responsible for his or her alleged actions despite having committed a crime, and whether he or she has to be treated in a different setting (e.g., a psychiatric hospital, a forensic hospital, a special unit in the prison) than a regular convict.
What is the Insanity Defense?
Before we discuss who can conduct an insanity defense assessment, it is essential to understand what the insanity defense is. Insanity pleas are very, very rare, used in solely a small fraction of 1% of criminal cases. In a criminal trial, “insanity” does not mean “crazy” or “insane” in a colloquial sense. Instead, it’s a well-defined term with a strict, narrow definition.
The insanity defense is a legal defense strategy that claims that a defendant is not criminally responsible for their actions due to a mental illness or defect. The insanity defense means “not guilty by reason of insanity.”
Examples that meet the criteria for an insanity defense include schizophrenia with psychosis, manic psychosis, postpartum psychosis, delirium-induced psychosis, advanced alzheimer’s disease, seizures, other neurocognitive disorders, or medication-induced psychosis, brain tumor, or abscess.
Common non-psychotic mental illnesses, such as depression, PTSD, panic attacks, or “temporary insanity,” do not meet the criteria for an insanity defense. However, if a defendant is seeking an insanity defense, or if that defense fails, seeking prior psychiatric help and demonstrating that they no longer pose a danger to others can still be beneficial.
Who Can Conduct an Insanity Defense Assessment?
The qualifications for conducting an insanity defense assessment may vary by state and jurisdiction. Generally, the mental health professional who conducts the assessment must meet the following criteria:
- Highly Experienced Board-certified in forensic psychiatry or psychology:
The legal system prefers an expert with some years’ standing, substantial relevant board‑certified forensic training, and practical forensic experience. The evaluator should have sufficient psychological field expertise and legal knowledge to serve as a reliable expert witness in the jurisdiction’s court.
Ideally, the evaluator must be a highly trained or experienced forensic evaluator specializing in insanity defenses, competency to stand trial, or violence risk assessment.
- Have a thorough understanding of the legal criteria for the insanity defense:
An evaluator must be familiar with and able to apply the legal tests for insanity in the state where the trial is taking place. The legal criteria for the insanity defense may vary by state and jurisdiction. However, the most common legal criterion for the insanity defense is:
M’Naghten Rule: A person is legally insane when, as a result of mental disease or defect, he did not know the nature and quality of the act or, if he did know, that he did not know the act was wrong (often interpreted as a legal or a moral test).
Irresistible Impulse Test: A person is legally insane when, as a result of mental disease or defect, he could not control his behavior even though he knew right from wrong (often interpreted as a self-control test).
Durham Rule/Durham Product Test: A person is legally insane when, as a result of a mental disease or defect, his unlawful act was caused by the disease or defect (often interpreted as a product test).
ALI Substantial-Capacity Test: A person is legally insane when, as a result of mental disease or defect, he lacks substantial capacity either to (i) comprehend the criminality of his conduct or to (ii) conform his conduct to the requirements of the law (often interpreted as a hybrid test).
- Have experienced testimony skills:
The Evaluator must be prepared to withstand cross-examination and articulate a clear, accurate, and objective expert opinion based on solid reasoning and evidence.
Why is a Psychiatric Evaluation Beneficial to Support an Insanity Defense?
- They have a medical background that allows them to diagnose mental illness.
- They are board-certified, which ensures adherence to practice standards.
- They can prescribe and manage medications (and can testify as to whether medications were tried and failed, or not tried at all).
- They can connect legal implications such as insanity, competency, and the likelihood of future violence to documented facts.
- They are considered experts in the subject matter to which their testimony relates. They can evaluate biological, psychological, and socioeconomic variables that may contribute to behavior (including parental alienation as a possible psychological stressor).
- They understand nervous system disorders, disabilities, and impairments in social functioning that can affect actions.
- They understand and adhere to the ethical standards of forensic medical practice and can determine whether someone is malingering (faking a disability).
- They provide well-prepared reports and findings that will present a credible case to the jury.
- They can be evaluated by the jury as a credible expert in the subject matter they are discussing, and can help ensure that the defendant receives a fair trial with proper justice.
The Takeaway
An insanity defense assessment is an evaluation conducted by an online psychiatrist to determine whether a defendant meets the legal criteria for the insanity defense. The qualifications for conducting an insanity defense assessment may vary by state and jurisdiction.
However, the chosen expert must be able to conduct a psychiatric interview with the accused, can gain access to, and understand, the available circumstantial evidences (e.g. hospital records, police files, voluntary witness accounts) and can apply the relevant legal criteria (M’Naghten, MPC etc.) to generate a legally clear report on whether the defendant is eligible for such a plea. A psychiatric evaluation serves as evidence in court, providing the judge with crucial information about a defendant suffering from a mental illness.
