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The Conditional Release of Insanity Acquittees: Three Decades of Decision-Making

Dr. McDermott and Dr. Scott are Professors, Mr. Busse and Ms. Zozaya are Staff Research Associates, and Dr. Quanbeck is Assistant Professor, Department of Psychiatry, Division of Psychiatry and the Law, University of California-Davis School of Medicine, Sacramento, CA. Ms. Andrade is Research Analyst, Napa State Hospital, Napa, CA. Presented in part at the annual meeting of the American Academy of Psychiatry and the Law, Chicago, October 27–30, 2006. This research was conducted as part of a collaborative effort between Napa State Hospital and UC Davis School of Medicine, Department of Psychiatry and Behavioral Sciences, funded by the California Department of Mental Health. Address correspondence to: Barbara E. McDermott, PhD, Division of Psychiatry and the Law, UC Davis School of Medicine, 2230 Stockton Boulevard, Sacramento, CA 95817. E-mail: bemcdermott{at}ucdavis.edu

The problem with the practical application of decision-making regarding release of mentally ill defenders lies in the inherently ambiguous definitions of mental illness and dangerousness, both of which are necessary for the continued commitment of insanity acquittees. In this study, we examined how clinicians make release decisions in a forensic facility, with particular attention paid to how such decision-making may have changed over time. Records were reviewed to determine documented criteria indicating readiness for release. The results indicated that compliance and treatment response were the primary reasons that the patients were judged ready for release. In addition, increasing attention to the use of substances as a risk factor was evident in the records, with substantially more documentation found in the most recent decade. Our data suggest that clinicians view three concerns to be of primary import when making release decisions: responsiveness to and compliance with the treatment, substance use, and risk of violence.

This article has been cited by other articles:

				P. K. Fox Commentary: Biases That Affect the Decision to Conditionally Release an Insanity Acquittee J Am Acad Psychiatry Law, September 1, 2008; 36(3): 337 - 339. [Abstract] [Full Text] [PDF]