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In an attempt to clarify my own thinking and to provide a way for summarizing the relevant issues, I have organized some of the more important ones in the following table. Each of the broad categories, Defendant's Degree of Planning, Defendant's Appreciation for the Consequences of the Crime, Defendant's Thinking & Decision-Making Nature of the Crime, and Jury and Legal Considerations. Each category is then evaluated on three or more specific items. For each item, a low rating (e.g., 1) is evidence towards an NGRI defense (assuming the deficit is due to mental illness), while a high score is likely to denote someone without a valid insanity defense. Although not presented here to conserve space, I would rate factors such as the defendant's credibility, memory, and factors such as time and multiple previous interviews that could interfere with recovery of valid information.

Not all of the factors listed are of equal significance. I regard the Defendant's Degree of Planning as of secondary importance, since some forms of mental illness (paranoid schizophrenia) are defined primarily by delusions or poor judgment (bipolar disorder). Paranoid schizophrenics can be extremely organized and plan extensively-but poorly. One cut off his testicles and sewed up the wound with his mother's sewing needle. Although he accomplished the task, he complained to his physician that he never expected it to hurt so much. In the table, five areas of planning regarding the offense and its aftermath are listed for consideration (to commit offense, to escape or avoid apprehension, estimated probability of getting caught, legal strategy if caught, plans for handling affairs if caught). The reader is referred to the table for items in the categories discussed below.

The Defendant's Awareness of the Consequences of the Crime is central to most definitions of (legal) insanity. This dimension is rated on a continuum from "no knowledge" to "full appreciation" across twelve categories (awareness act was illegal, awareness of seriousness of the crime, etc.). The issue of how much awareness (and) on which dimensions should negate an insanity defense is subjective. Based on the Texas statute, some might argue that a rating of "2" ("some knowledge," without any appreciation) would indicate the defendant was sufficiently aware of an issue to be held accountable. I suspect most defense attorneys would embrace a higher standard, and could perceive a defendant with less than full appreciation on several items as NGRI. It is not clear if it would be useful to sum scores from items in each category or whether a particularly low score on some critical items might warrant an insanity verdict. These issues can be researched and is one way that the rating scheme presented here could be developed into a more formal instrument.

The next section of the table, Defendant's Thinking & Decision-Making, focuses on the form rather than content of the defendant's thinking. Delusions (false, irrational beliefs) are the most important psychiatric symptom for the insanity defense. Even if a person hears voices telling him to kill someone, acting on this hallucination is unlikely unless there is a psychotic belief that gives the voice authority, or the person has other problems in reality testing. Paranoid delusions are an obvious example, but deficits in judgment, attention and concentration, and ability to think through consequences should not be overlooked. All are common in psychiatric populations. Many of these same factors may be impaired in mentally retarded or brain-damaged persons. All these groups are likely to be less able to foresee consequences and to envision alternative problem solving strategies. Severely psychotic patients often have an inability (or at least, disinclination) to question the validity of delusions or hallucination, even when contemplating the most dire of actions.

Under Nature of the Crime, one examines whether the crime had an understandable motive and whether the defendant attempted to escape. In Bigby v. State (1994) the Texas Supreme Court ruled that a defendant's flight from the scene is evidence of awareness of wrongdoing and thus weighs against an insanity defense. However, people may flee from the scene for other reasons, such as fear of being physically harmed. In a capital murder case I was involved in, a clearly delusional defendant was consumed with ridding himself and his family of two 'evil' young men, playing video games in his living room, until after he shot them. At that moment, he saw two dead and bloody men in his house and realized his situation. Surprisingly, the Bigby court was silent on the issue of disposing of evidence or other efforts to escape suspicion. Bigby v. State also held that lay witnesses may give testimony regarding sanity if they were in a position to observe the defendant's mental state at the time of the offense. Lastly, were the defendant's actions consistent with his or her typical goals and values? Although people can be inconsistent for many reasons, atypical actions combined with mental illness amounted to an insanity defense under Durham, and this fact pattern can be persuasive even though no longer an official standard.

The last section of the table specifically assesses the three aspects of NGRI on which mock jurors base in their decisions. They are in descending order of importance, with the third issue being of more interest to legal scholars than to jurors. An attorney may also want to assess the client's NGRI claim according to the different insanity standards promulgated over time, in a manner similar to the table above. Table 2 lists the NGRI various clauses that have enjoyed widespread use along with Judge Bazelon's standard.

Table 1
Factors relevant to a defendant's moral culpability and appreciation of the nature of the crime.
© Steve Rubenzer, January 2002

		none 1	minimal 2	significant 3	considerable 4	thorough 5	Impair-ment due to SMI*?
	to commit offense
	to escape or avoid apprehension
	estimated probability of getting caught
	legal strategy if caught
	plans for handling affairs if caught
		no knowledge 1	vague knowledge 2	knowledge without appreciation 3	some appreciation 4	full appreciation 5
	Legal issues
	awareness that act was illegal
	awareness of seriousness of crime
	awareness of possible legal consequences
	awareness of incriminating evidence
	Moral
	awareness that society would disapprove
	awareness of family viewpoint
	awareness of religious prohibition, if relevant
	Principles
	congruence of crime with own principles, values
	cognizant of message sent to others, implications of actions
	Impact
	awareness of impact of crime, etc. on own life, family, etc (if caught)
	awareness of impact of crime defendant's family (if caught)
	awareness of impact of crime on victim, victim's family if relevant
		Definitely True 1				Definitely False 5
	defendant experienced hallucinations that contributed to the crime
	motive for crime based on delusions or irrational beliefs that were the product of mental illness
	defendant overlooked important facts or considerations
	defendant overvalued or misinterpreted ideas or facts to a marked and unreasonable degree (i.e., paranoia)
	defendant made logical errors not expected of a normal adult
	decision making during crime was markedly less effective and mature than normal for this defendant
	defendant did not question wisdom of actions, attempt to weigh outcomes
	defendant did not generate alternative coarse of actions
	Defendant was unaware of motivations that would be apparent to outside observers (insurance payment)
	crime has clear rational motive with good probability of success
	defendant attempted to evade arrest or suspicion
	crime was consistent with person's usual goals and values
	"Craziness" at time of offense
	Culpability of defendant in bringing about his or her craziness
	Legal justification (I.e., perceived self-defense)

* SMI = serious mental illness

Table 2
Insanity Standards

Insanity Standard/Criteria	Yes	No	Unclear
Did not know right from wrong (illegal; Mc'N)
Act was a product of mental disorder (Durham)
Did not appreciate criminality of act (ALI)
Irresistible impulse (ALI)
Unable to appreciate nature and quality or wrongfulness (IDRA)
Cannot justly be held responsible (Judge Bazelon)

Conclusion
The insanity defense is less mysterious than often portrayed. Serious mental illness can be reliably diagnosed (although it often is not), and most insanity acquittals are the result of agreement of the defense and prosecution. The majority of insanity judgments are made on a simple formula-the obvious presence of severe mental illness at the time of the offense. It clearly helps if there is no evidence of intoxication and the crime was out of character. When the matter is not resolved on these issues, examination of the factors discussed here will help clarify ways in which a mentally ill person may be deficient in his or her judgment in ways that are not apparent to outside observers. The table may also serve as a means to illustrate relevant factors to opposing counsel or the jury.

References
Ake v. Oklahoma, 470 U.S. 68 (1985).

Bigby v. State, 892 S.W.2d 864 (1994).

Durham v. United States, 214 F.2d. 862 (D.C. Cir.) (1954).

Finkel, N. J., & Slobogin, C. (1995). Insanity, justification, and culpability toward a unifying schema. Law and Human Behavior, 19(5), 447-464.

MacDonald v. United States, 312 F.2d 847 (D.C. Cir. 1962)

Melton, G. B., Petrilla, J., Poythress, N. G., & Slobogin, L. A. (1987). Psychological evaluations for the courts: A handbook for mental health professionals and lawyers. New York: Guilford Press.

Melton, G. B., Petrilla, J., Poythress, N. G., & Slobogin, L. A. (1997). Psychological evaluations for the courts: A handbook for mental health professionals and lawyers (2nd ed.). New York: Guilford Press.

Pasewark, R. A., & Seidenzahl, D. (1979). Opinions concerning the insanity plea and criminality among mental patients. Bulletin of the American Academy of Psychiatry and the Law, 7, 199-202.

Perlin, M. L. (1996) The insanity defense: Deconstructing the myths and reconstructing the jurisprudence. In B. D. Sales and D. W. Shuman (Eds.), Law, mental health, and mental disorder (pp. 341-359). Pacific Grove, CA: Brooks/Cole.

Rogers, R., & Shuman, D. W. (2000). Conducting insanity evaluations. (2nd ed.), New York: Guilford.

Rogers, R. (1984). Rogers Criminal Responsibility Scales (R-CRAS) and test manual. Odessa, FL: Psychological Assessment Resources.

Steadman, H. J., McGeevy, M. A., Morrissey, J. P., Callahan, L. A., Robbins, P. C., & Cirincione, C. (1993). Before and after Hinckley: Evaluating insanity defense reform. New York: Guilford.

United States v. Brawner, 471 F.2d 969 (1972).

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