What Care for the Criminally Insane Can Teach Us About Mental Health Treatment

PORTLAND, Ore. — In the midst of a harrowing psychotic episode in summer 2009, Annie broke into her ex-husband’s house and used a hammer and scissors to lay waste to plates, knickknacks, clothing, “and honestly, I don’t know what else.”

Had the mother of four, a retired captain in the National Guard, chosen to plead guilty, as a first offender she might have gotten off with the six months she’d already spent in jail.

Instead, she chose to accept the verdict of “guilty except for insanity” — Oregon’s version of the insanity defense. For Annie, who asked that her real name not be used because she fears being stigmatized, that meant accepting state supervision until 2029, when she will be 68.  more

She has no doubt she made the right choice.

When ‘Not Guilty’ Is a Life Sentence

What happens after a defendant is found not guilty by reason of insanity? Often the answer is involuntary confinement in a state psychiatric hospital — with no end in sight.

Despite Ann’s determination to betray no emotion, a drop of sweat rolled down her temple as a guard painstakingly examined her lunch items. That Sunday morning, she had taken two buses, two trains and a shuttle to get from her home to the New York state psychiatric facility where her son is confined. Frustrated, she pushed back a little, but just a little, when the guard took away two sealed bottles of fruit-flavored water, a special treat that Ann had made an extra stop to buy. She watched as he held them up to examine them and concluded that they must contain caffeine — which is not allowed — because they did not read, “Does not contain caffeine.”  more