Criminality of discharged insanity acquittees: fifteen year experience in Maryland reviewed.

In the wake of the insanity acquittal of a would-be presidential assassin, there have been several recommendations directed toward limiting or abolishing the defense of insanity for criminal charges. 1.2.3 In Maryland, the Governor appointed a task force to study the issue and to advise the community of whether reform of existing law should be undertaken. • While there is some data on the follow-up of insanity acquittees, most studies reflect a relatively brief period of aftercare. Pasewark et al. 6 compared forty-two men and eight women who had been found not gUilty by reason of insanity (NGBRI) with a demographically matched group of incarcerated felons to study length of time of institutional detention and rearrests over a five-year period after their discharge. Morrow et al. 7 also have reported a five-year follow-up of mentally disordered offenders. A review of the literature, however, has failed to reveal a longer-term follow-up study of the arrests and convictions of discharged insanity acquittees. This lack of reported experience about the fate of discharged insanity acquittees over a substantial period of time in the community is a problem faced not only by the Governor's Task Force but also by other policy-making and advisory groups. The youth of most insanity acquittees, the seriousness of their original charges, and the potential chronicity of their mental illnesses suggest the need for study of their criminal experience over longer periods of time than has been done so far. The objective of the present study was to report a compilation of the arrests, convictions,and incarcerations of a large cohort of insanity acquittees in Maryland over a fifteen-year period after discharge from the hospital. The study also attempted to assess the seriousness of the new offenses in relation to the potential for physical harm to members of the community and to assess the adequacy of the five-year time frame for aftercare currently recommended by statute. Such data may assist the Governor's Task Force in its deliberations on the future of the insanity defense in Maryland. Clifton T. Perkins Hospital Center (CTPHC) is a 246-bed security hospital that provides pretrial psychiatric examinations for men accused of felonies in all judicial circuits and a comprehensive treatment program for men adjudicated NGBRI of violent offenses. The average length of inpatient treatment for insanity