Highlights From My Notes From A Forensic Psychiatry Conference Last Week

– Contrary to popular belief, the insanity defense is not overused. It’s used in only about 1% of felony trials and successful only about a quarter of the time it is used. 90% of people who successfully plead insanity had been diagnosed with a disorder before they committed their crime.

– Felons found insane usually get locked up in forensic hospitals even longer than sane felons are locked up in prisons. Some statistics say that by pleading insanity you increase your time behind bars by 50 – 100%

– For some reason, there is a law saying juries are not allowed to be told what will happen to defendants if they return a certain verdict. Juries assume that if a defendant is found “not guilty by reason of insanity”, they will be released scot-free. Although this is completely false, no one is allowed to tell the jury this. So it’s really hard to win an insanity defense simply because juries think it will mean a felon will be put right back on the streets.

– Forensic psychiatrists have become very effective at determining which criminals who plead insanity are “faking it”. They usually rely on patterns of mental disease which psychiatrists know but criminals don’t. For example, they’ll start by asking “Do you hear voices?”, and most fakers, anxious to please, say they do. Then the psychiatrist will ask questions like “Which side of your head do the voices come from?” and “Do you ever have smells associated with the voices?” Still eager to please, the fakers will choose a side of the head for their voices to be on, and make up smells that happen at the same time as their voices. But real schizophrenics don’t generally hear their voices to one side or hallucinate smells, so this decreases the likelihood that they’re telling the truth. Some of these questions are very tricky – for example, one psychiatrist asks both “Do you ever hear secret messages for you from the TV or radio?” and “Do cats and dogs ever give you secret messages?”. The first is very common in mental illness; the second practically never happens. Unless you’re a psychiatrist yourself, you’re not going to know these things and you’ll end up claiming symptoms that make no sense.

– Some criminals also claim to be mentally retarded, especially in states where it’s illegal to execute retarded people. The process for catching these people is equally elegant. They are asked to take a multiple-choice vocabulary test with easy, medium, and difficult words. Real mentally retarded people will do okay on the easy words but perform at chance on the medium and difficult words. Fakers will also do okay on the easy words – they are smart enough to understand that even mentally retarded people know some things – but then they intentionally throw the medium words and do worse than chance. On the difficult words, the fakers honestly don’t know them and so they go back to performing at chance again. Computers can detect these patterns and easily and confidently point out a fake.

[is it contrary to the Virtue of Silence to reveal such things? Nah; I checked and other much more prominent media have discussed them already. Any criminal Googling ways to fake insanity effectively already has enough sources to work from.]

– My notes say Baxter vs. Harold, but I must have miscopied because Google can’t find it – but anyway, it was a case in which New York State took nine hundred something felons who had finished their prison terms and transferred them to mental institutions because they were “too dangerous to let back on the streets”. One of the felons sued, and the court agreed that this was illegal, and the state could not confine prisoners after their sentence ended just because of high risk. Some bright scientist decided to turn this into a study and see how many of these designated “high-risk offenders” actually re-offended after [unreadable] number of years. The answer was 22. 22 out of nine-hundred or something. I wish I could find this study online. The point is that forensic psychiatrists were terrible at predicting who is or is not a future risk, although the forensic psychiatrist giving the talk assured us confidently that they are much better now.

[several pages of mandalas and other geometrical figures where these notes should be; apparently I got distracted]

– A fragment of a story from one of the examples we were given: “She said she started the fire because her ninth child was taken away by Child Protective Services, just as her previous eight children had been.” This wins my prize for “best single-sentence argument for some kind of parenting license or eugenics or something”

– Another fragment of a story: “The night before his execution, murderer Troy Gregg sawed through the bars of his cell, donned a homemade prison guard uniform, and accomplished the first death row breakout in Georgia history. He was beaten to death in a bar fight later that night.”

– A fragment of a story told by the keynote speaker: “My interest in murder cases started when I was a child. When I was five, my babysitter Wilson was arrested for strangling his wife. He served three years in prison. When he got out, he was my babysitter again. Those were less safety-conscious times.”

[several pages of notes in a moderately successful attempt to write English in an ideographic script. Unfortunately, I can’t remember what the ideographs mean well enough to decode the content.]

– Dutiful recording of a claim by the keynote speaker that a vastly disproportionate number of death row inmates have the middle name “Lee”.

– During a death penalty case, jurors who don’t believe in capital punishment (and therefore would throw the case for reasons other than the defendant’s guilt or innocence) are automatically excluded from participating. But those jurors are usually more liberal, and the pro-capital-punishment jurors who get tapped are usually more conservative. Liberal jurors are usually more likely to acquit any type of criminal, and conservatives more likely to convict. Therefore, in certain cases it can be easier to get a death penalty conviction than a life in prison conviction, because you’re throwing the most merciful jurors out of the potential pool.

– Psychologist who works with death row inmates on a daily basis says “There’s not one defendant I ever met who ever considered not committing his crime because he was worried about getting the death penalty.” He said this makes him think death penalty is not an effective deterrent. I can’t help but wonder if maybe all the people it effectively deters don’t end up on death row talking to a forensic psychologist.

– The keynote speaker worked on the case of an Ohio school shooter who tried to plead insanity. Later, the shooter changed his mind and said he had only done that because he was bored, but pleading insanity was also boring so he would just accept the sentence. He somehow managed to make it into the courtroom for the sentencing hearing wearing a shirt reading “KILLER”. When asked if he wanted to address the victim’s families – usually a chance for some last minute apologizing, he said (and I quote) “The hand that pulled the trigger that killed your sons now masturbates to the memory”, then gave them the finger. This is my new go-to story when someone says that evil is merely the absence of good.

– Said during a capital trial by a none-too-bright con: “On advice of my accountant, I invoke my Fifth Commitment rights”.

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41 Responses to Highlights From My Notes From A Forensic Psychiatry Conference Last Week

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  3. Dave says:

    several pages of notes in a moderately successful attempt to write English in an ideographic script. Unfortunately, I can’t remember what the ideographs mean well enough to decode the content.

    This… must be some new meaning of the word “successful” with which I was not previously acquainted.

  4. Brian says:

    It makes me really, really sad that English is not an ideographic language. Post that section of your notes so we can all get to work on that.

  5. JRM says:

    Quick notes:

    1. Some states tell juries what will happen to those found insane, then tell the jury not to worry about it. (Juries aren’t supposed to consider penalty or punishment.) California tells juries what will happen upon a defense or prosecution request (CALCRIM 3450.

    2. Different states have different insanity rules. Even hallucinations may not be sufficient to make an insanity defense (“Victim was an angry witch who shorted me on my meth, so I shot her.” In fact, victim is a six-year-old girl. You might not succeed there, because shooting your dealer is still not nice.)

    Direct agreement notes:

    3. My sense is that most forensic psychologists are good at determining malingering and its degrees, FWIW. So I think that’s right.

    4. Insanity’s a tough go. Legal insanity is way different than, “crazy bastard.” Jurors are none to keen on it generally; all of the successful insanity defenses I’ve seen involved the prosecution conceding the point.


  6. Yogonath says:

    I can’t help but wonder if maybe all the people it effectively deters don’t end up on death row talking to a forensic psychologist.

    That’s certainly a possibility. However, if there were any sizable number of would-be criminals who considered committing a capital crime but were successfully deterred by thinking of the death penalty, then I would expect to also find at least some criminals who had the same thoughts but ultimately went the other way. A complete absence of the latter seems to me like it favours the simpler hypothesis that they don’t consider it at all.

    • Doug S. says:

      If what I’ve read is accurate, the general consensus among researchers is that the deterrence effect of punishment is very much dependent on the would-be criminal’s estimate of the chances of getting caught and very little on the severity of the punishment…

    • Mary says:

      The laws decreeing that those under 18 could never be executed lead to a vast increase to gangs using 17 and 16 year olds as their enforcers.

  7. Kaj Sotala says:

    Any criminal Googling ways to fake insanity effectively already has enough sources to work from.

    You’re assuming that the criminal Googles “how to fake insanity” as opposed to Googling e.g. “symptoms of schizophrenia”. If I had to fake something, my first impulse would be to do research on the subject itself – if I hadn’t read this post, I don’t think it would even have crossed my mind to explicitly search for “how to fake X”.

    But somebody could plausibly happen to read your article, later commit a crime, and then remember that they need to do a search on the ways to fake insanity.

    On the other hand, if they end up faking insanity even after reading your mention about it being hard to win an insanity defense and such a win leading to an extended imprisonment even in the rare cases when it is successful, well…

  8. Vertebrat says:

    The bad news is, he’s a murderer. The good news is we finally found a babysitter!

  9. Ishmael says:

    Why is the Ohio shooter a better example of evil, than a man who killed three people but said he was sorry about it at the trial? What about a man who apologizes for killing four people? Showing disrespect for the people he killed, and for the process of punishing him, seems inconsequential in comparison to the act he is being punished for.

    • BenSix says:

      Perhaps one could argue that some people commit murder in a state of temporary moral blindness, and can prove themselves to be at least redeemable by showing contrition afterwards. But, yes, if one has killed methodically it makes little difference how one behaves afterwards – at least until the debatable religious conversion ten years down the line.

      • Randy M says:

        I think he is getting at a more obvious example, rather than an example of greater magnitude. But to Scot, being a consequentialist/utilitarian/non-moral realist, saying he’s trying to prove the existence of evil is ironic, or at least imprecise. As a former psych intern, the interest in the mental states is understandable.

    • Yogonath says:

      You’re talking about how much harm he caused, but that has nothing to do with how evil he is (which is about intentions).

      For example, if he had accidentally missed his targets he would have caused almost no harm, but he would not have been in any way less evil.

  10. Julia says:

    The people who are really good at faking mental illness are people who have been genuinely ill in the past but aren’t at the moment. I saw a woman put on a *spectacular* display of mania – big arm gestures, babbling nonsense words, cackling, telling me about what the voices were saying, talking so fast it took me a long time to get a word in edgewise. I could never have faked it so convincingly. Unfortunately she said something that contradicted her claim that she should be placed on mental health watch, and when I pointed this out, she changed mannerisms completely and began telling me I didn’t know how to do my job. The next day she told us she’d faked the whole thing because she wanted to avoid her roommate. But it was a brilliant performance, especially the part where they led her down the hall afterwards singing Christmas carols.

  11. sam rosen says:

    Guess? The middle name Lee is a Southern thing and the South is more likely to have the death penalty.

  12. lrs says:

    The case is Baxstrom v. Herold, 383 U.S. 107 (1966), before the Supreme Court of the United States. This is perhaps pedantic of me, but I feel compelled to clarify that the holding of that case is actually quite limited.

    New York law at the time afforded an individual faced with civil commitment the opportunity to have the question of his sanity decided by a jury. However, the process prescribed by law was different if individual was a prison inmate, in which case he did not have access to a jury in this manner. The Supreme Court held only that this regime was a violation of the constitutional guarantee of equal protection under the law, as it denied prison inmates the procedural protections that were available to citizens generally.

    So, it remains constitutionally permissible for the state to confine prisoners after their sentences end just because of high risk. When the state seeks to do so, Baxstrom requires only that it avail the prisoner of the same procedural protections that would apply to a free man facing the same fate.

  13. Douglas Knight says:

    Said during a capital trial by a none-too-bright con

    What does “con” mean?

    I read it as “conman,” but “non-too-bright conman” doesn’t make a lot of sense, and it’s a gratuitous detail. If it were part of an attempt to mimic retardation, that make him a conman, but then you wouldn’t have said “none-too-bright.” In retrospect, it sure looks like “convict.” I think the criminal justice system calling people at trials convicts is very bad. If “con” has drifted from its origin in “convict,” I suppose it might not be so bad if it has come to mean “suspect or convict,” but the discrepancy of usage seems dangerous and this seems like a bad category to exist.

    • Scott Alexander says:

      This is my fault and not that of the original presenter. The person was not a con at the time, but was later convicted.

  14. Randy M says:

    “Said during a capital trial by a none-too-bright con: “On advice of my accountant, I invoke my Fifth Commitment rights”.”

    This is a missed opportunity; if he (can I assume he?) had said “commandment” it would have such amusing irony, considering its a capital case.

    • Eric Rall says:

      It could also form the basis of a religious freedom defense, provided the defendent could claim to follow a particularly nasty variant of the Wicked Bible.

      • Anonymous says:

        On that wikipedia page:

        “Historically, the omission of “not” was considered quite a common mistake. Until 2004, for example, the style guide of the Associated Press advised using “innocent” instead of “not guilty” to describe acquittals, so as to prevent this eventuality.”

        This is wonderful. Hooray for the Associated Press until 2004 (when they changed it for boring legal accuracy reasons and merely urged caution not to drop the “not”).

  15. Deiseach says:

    “She said she started the fire because her ninth child was taken away by Child Protective Services, just as her previous eight children had been.” This wins my prize for “best single-sentence argument for some kind of parenting license or eugenics or something”

    Funny, that wins my prize for “best example of what treating people like bacterial cultures will result in: we won’t help this woman improve her life, we won’t help her get her kids back, we won’t address why she keeps having children if she is deemed unfit to raise them, we won’t address wider problems of poverty, illness, inequality and desperation, but we will neuter her like a cat or a dog and then say ‘problem solved'”.

    • Anonymous says:

      Deiseach, I wonder what keeps you personally from doing all these things, or giving your own money to charities that do them.

      Apparently you think arbitrary costs should be forced onto others to make all these things happen.

      And how do you even know the kids want to go back to her?

      • oligopsony says:

        What prevents her is, obviously, the fact that she is but one person, with limited capacities, &c. &c. As for her doing what small things are, why do you suppose she isn’t?

        • Anonymous says:

          Ah, of course, she doesn’t have the capacity. What a shocker. I guess she did her moral job by declaring arbitrary obligations on other people who never consented to take such a responsibility.

          I have zero children. I have never attacked a child or inflicted a need on a child. I have never consented to be responsible for the needs of a child. Therefore I have zero obligations to feed or take care of children. And I very definitely have zero obligations to work so that idiot moms who pop out 9 (NINE!) costly vulnerable babies can get extra services.

        • oligopsony says:

          Technically, if you reread, you’ll notice that D. refers only to how people think and behave. Perhaps you think such factual claims are incorrect, but all this metaphysics about “obligations” and so on is your own.

        • Anonymous says:

          o., I was responding to the implied political demands for legal, i.e. mandatory financial obligations. If D. is a libertarian and I totally misread, then I apologize.

      • Andrew says:

        I, on the other hand, think it’s generally a good idea for society to provide a robust safety net (which the USA isn’t), but still think that Deiseach is missing the point. The woman in question may or may not be suffering from said wider social problems, but that’s immaterial. The point is that the world would be a better place if some people didn’t have children (this woman being a rather likely example of that, regardless of wider social problems), and it would be nice if some non-evil way to address that problem existed.

    • g says:

      we won’t […] we won’t […] we won’t […] we will […]

      Who’s “we” here? If it’s not Scott, I don’t understand why you’ve attached your complaint to his words as you have. If it is Scott, I don’t understand on what basis you say that he won’t/will do those things. (Or that he wants other people not to do / to do those things.)

    • Crimson Wool says:

      She is an arsonist. She is culpable, morally and legally. Most poor people, most mentally ill people, most people who are desperate, do not become arsonists. Those are not actual mitigating factors. This is not someone stealing to eat, this is not someone lying about their felony history to get a job to feed their family, this is not someone cheating on a drug test. This is a human being, willfully and purposefully, starting a goddamn fire which could (presumably) have burnt someone to death or permanently maimed them.

    • Army1987 says:

      Well, both the woman and Child Protective Services are quite sphexish.

      • Paul Torek says:

        Technically no, since she escalated upon the 9th repeat, which is exactly what the sphex wasp would never do. A little more learning than that would, however, indeed be nice.

    • Mary says:

      Such women habitually resist, strenuously, any attempt to improve their lives because in their eyes, you are making them worse. They are picking the path of least resistance because they like it.

  16. oligopsony says:

    Whatever else he was, the positively evil fellow certainly was insane, wasn’t he? Or does the field not construct insanity that way?

    • Anonymous says:

      Insanity legally (having no particular medical definition) means that the individual is unable to discriminate right from wrong. Individuals such as sociopaths who are capable of recognizing whether acts will be viewed by society as right or wrong, but don’t adjust their behavior to accord with those norms, are not given exemptions.

      • Randy M says:

        Is it that broad? I would have thought it meant not recognizing reality from hallucination. I’m willing to forgive someone who shoots at me because he literally sees me as a demon, less so someone who gets such a visceral thrill from murder he thinks that outweighs my pain, or other self-serving justification.

        • Eric Rall says:

          My understanding is that in practice, the rule is interpretted very closely to your preferred rule. The insanity defense seems to be very closely related to the doctrine of “mistake of fact”: if you committed an otherwise-criminal act because you honestly misunderstood the facts of the situation such that you thought your actions were proper (for example, you are accused of stealing a suitcase from baggage claim, but you only took it because you mistook it for your suitcase), then you are not guilty of the crime.

        • Mary says:

          The rule is that you
          1. Do not understand the nature of your acts
          2. Do not understand that they are against the law.