Abstract

The insanity defense is perhaps the most vigorously debated topic at the interface of the legal and mental health systems. This article addresses the need for empirical evidence by providing data on insanity acquittees and their later outcomes in Oklahoma, a jurisdiction not previously studied. Information was obtained on the demographic, legal, psychiatric, hospitalization, and post-hospitalization characteristics of all 61 defendants acquitted not guilty by reason of insanity (NGRI) and treated on the state forensic unit during a 5-year period. Insanity acquittees had few resources, significant psychopathology, and extensive involvement with the legal and mental health systems prior to the NGRI offense. Follow-up of three groups of discharged patients--those released at an initial court review, those who completed the NGRI treatment program, and those who absconded from the forensic unit--revealed that those who escaped from the unit had significantly more arrests and subsequent legal charges than regularly discharged patients.

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