Insanity Assessment: Not Guilty by Reason of Insanity

The claim of “not guilty by reason of insanity,” or “NGRI,” is dramatized frequently in the media and popular social circles. However, it is actually quite rarer, and more difficult to uphold in court, than most outside of forensics may think. The classic “Yates Case” in Texas in 2001 brought much attention to the NGRI rulings that continue to emphasize the importance of untangling the mind at the time the wrongful act occurred, an always challenging task that we as forensic mental health experts are assigned to carry out. In similar fashion, the case you will see illustrated in this chapter details an unfortunate circumstance one healthcare provider found herself in when she suffered an injury at the hands of a patient. The assault itself is not in question, nor is the status of the individual’s present mental competence, but rather the mental state available to the defendant at the time of the event in question. As with many other cases, I may not know the legal outcome of the inquiry. Our job is to be highly analytical to arrive to an opinion and able to explain as best as possible what the diagnosis I may provide means, in simple terms that a court can use to instruct jurors with. It is in this capacity that I often find it most helpful to use basic language and phrases to convey the points I wish to make. We rely on the review of medical, including mental health records, police investigative reports, and legal guides and criteria before examining a defendant. Most importantly, I try to use evidence from the reports and documents I gather to help support the opinions I form and will cite them as much as possible when helping to bolster a report.