Mental Illness and Mental Health Defenses: Perceptions of the Criminal Bar

As the number of state mental hospital beds declines, persons with persistent mental illness are increasingly encountered by those working in the legal system. Attorneys may have little experience in working with this population. 

This research involved a 32-item written survey of the 492 members of the criminal bar in South Carolina. Demographic variables were surveyed, and attorneys were asked to define two common terms describing mental illnesses (delusion and psychosis) and the legal criteria for verdicts of not guilty by reason of insanity and guilty but mentally ill. They were also asked to identify the most severe mental illness (schizophrenia). Attitudes about these verdicts and about working with defendants who are mentally ill were also surveyed. 

Results indicate that attorneys are fairly knowledgeable about mental illness, but not verdicts involving mental illness, particularly the verdict of guilty but mentally ill. Most attorneys prefer to work with clients who do not have mental illness. However, as they become more experienced interacting with defendants who are affected by mental illness, they become more knowledgeable and are more willing to defend them. 

A large majority believe that their law school education about mental illness was inadequate. When comparing attorney occupations, public defenders were the most knowledgeable about mental illness and mental health defenses, followed by prosecutors and private defense attorneys. Judges were the least knowledgeable group.

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By:   Frierson RL¹, Boyd MS², Harper A².

¹Dr. Frierson is Professor of Clinical Psychiatry, University of South Carolina School of Medicine, Columbia, SC. Dr. Boyd is Staff Psychiatrist, Dorn VA Medical Center, Columbia, SC. Dr. Harper is in private practice, Columbia Psychiatric Associates LLC, Columbia, SC. Dr. Boyd is currently in private practice, Vista Psychiatric Consultants, LLC, Columbia, SC. richard.frierson@uscmed.sc.edu.

²Dr. Frierson is Professor of Clinical Psychiatry, University of South Carolina School of Medicine, Columbia, SC. Dr. Boyd is Staff Psychiatrist, Dorn VA Medical Center, Columbia, SC. Dr. Harper is in private practice, Columbia Psychiatric Associates LLC, Columbia, SC. Dr. Boyd is currently in private practice, Vista Psychiatric Consultants, LLC, Columbia, SC.

  

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