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Hospital can be worse than prison
No end date
Not criminally responsible, or NCR, means a court found that mental illness left a person unable to appreciate the criminality of their act or to conform to the law. A prison sentence comes with a number: ten years, twenty years, even life without parole. People can get used to a known incarcerated life. A commitment after an NCR finding has no number, and the endless uncertainty about whether release will ever come wears people down. Many patients at Maryland's Clifton Perkins State Hospital who had served prison time preferred prison.
Constant judgment
The second cost is constant judgment. In prison, a man who skips breakfast has skipped breakfast. In a hospital, it gets written into his file as a psychological deficit. A patient who stays in his room to read, or keeps quiet in group therapy, risks having it taken as another sign of illness.
Brian's wait
Brian Bechtold was sent to Perkins in 1992 after killing his parents. After three years there, which matched the average stay, he noticed that people who had committed similar crimes were getting out in four or five years. He began to think he should never have pled not criminally responsible, and his own time there started to look endless.
Why can commitment outlast a prison term?
In Jones v. United States in 1983, the Supreme Court held that a person acquitted by reason of insanity can be held longer than the maximum sentence for the crime. The reasoning was that commitment exists for treatment and protection, not punishment, so it lasts as long as the illness and the danger do. Nine years later, in Foucha v. Louisiana, the Court ruled that a state cannot keep confining an acquittee who is no longer mentally ill, even if the person is still considered dangerous.
How did indefinite insanity detention begin?
In 1800 James Hadfield fired a pistol at King George III in a London theater and was acquitted because he was insane. Under the law then, an acquittal meant he would walk free. Parliament responded within months with the Criminal Lunatics Act 1800, which allowed people acquitted on grounds of insanity to be detained until the king's pleasure was known. That phrase became the standard wording for open-ended detention in Britain for well over a century.
Why is not knowing worse than bad news?
In a 2016 study in Nature Communications led by Archy de Berker, volunteers turned over rocks that might hide a snake and deliver a painful electric shock. Pupil dilation, sweat, and self-reported stress all peaked when the odds of a shock were even, and they were lower when a shock was nearly certain or nearly impossible. The researchers tied the effect to the brain struggling to predict an outcome it cannot call either way.
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