The Unconditional Release of Mentally Ill Offenders from Indefinite Commitment: A
Study of Missouri Insanity Acquittees .
D. M. Linhorst and MSW,
Bull. Amer. Acad. Psychiatry & the Law
27(4): 563-579, 1999.
Using a database of all Missouri insanity acquittees committed on July 1, 1997 (N
= 873) and all insanity acquittees unconditionally released from 1986 through 1997 (N= 193), this
study calculated the lengths of commitment and identified variables associated with the
unconditional release of insanity acquittees from indefinite commitment by the mental health and
criminal justice systems. The study found that 85 percent of insanity acquittees were still under
commitment 5 years after acquittal and 76 percent 10 years after acquittal. Factors that decreased
the odds of being unconditionally released included never having been married; having a psychotic
disorder, a mood disorder, a substance abuse disorder, or mental retardation/borderline
intellectual functioning; and having committed a serious crime. These results support achievement
of the intended goal of Missouri's insanity acquittee statute, which is to maximize public safety
considerations, but have had the unintended effect of increasing the inpatient insanity acquittee
population, resulting in fewer resources for voluntary patients.