A Description of the Design and Costs of an Insanity Acquittee Conditional Release, Monitoring, and Revocation System

Abstract

Conditional release, monitoring, and revocation are important components of insanity acquittee systems because they help to balance public safety with the treatment needs of insanity acquittees. We describe a state conditional release system within the United States that uses existing personnel to assess risk and make release decisions as another model for how to design and implement an insanity acquittee conditional release system. The State of Missouri's system had low costs per client associated with monitoring insanity acquittees in the community. However, substantial time commitments by actors in the mental health and criminal justice systems were required to ensure a high level of public safety in the release process. In addition, hospitalization was used extensively to protect public safety, which in part has resulted in insanity acquittees occupying approximately 50% of the state's long-term public psychiatric hospital beds. It is possible that other jurisdictions may be able to design insanity acquittee conditional release systems that still provide an acceptable degree of public safety yet do not incur some of the substantial costs associated with lengthy hospitalization and indefinite community oversight found in Missouri's insanity acquittee system.