Excluding personality disorders from the insanity defense--a follow-up study.
S. M. Reichlin, J. D. Bloom and M. H. Williams,
Bull. Amer. Acad. Psychiatry & the Law
21(1): 91-100, 1993.
Examining the effects of Oregon's statutory reform excluding personality disordered individuals from
the insanity defense, we previously identified a study sample of insanity acquittees, each of whom
was given a primary diagnosis of a personality disorder during subsequent evaluation at the state
hospital. In the present study we explore the relationship between that diagnosis and the pretrial
psychiatric diagnosis presented to the trial court. By reading the forensic mental health evaluations
used at trial we found that 50 percent of our study sample of 34 personality disordered patients were
diagnosed with psychotic disorders, affective disorders, retardation, and organic brain disorders. In
addition to investigating the diagnosis offered as evidence at trial, we performed assessments of 38
mental health reports using published standards for forensic evaluation reports. We found
compliance rates in the various categories ranged from 8 to 84 percent with a mean of 45 percent.
We question the value of the mental health input to these trials, and believe that the data tend to
validate past aspersions of forensic practice.