31: Why Almost Everyone Gets the Insanity Defense Wrong | Case Notes

Summary

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UNMARKED: A True Crime Podcast

Episode 31: Why Almost Everyone Gets the Insanity Defense Wrong | Case Notes
Host: James Buddy Day
Guest: Dr. Joni Johnston, Criminal & Forensic Psychologist
Date: July 12, 2026

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Episode Overview

This episode dives deep into the complexities and misconceptions surrounding the insanity defense in the American legal system. Host James Buddy Day interviews Dr. Joni Johnston, a forensic psychologist renowned for her expertise in evaluating defendants who plead insanity. Together, they explore how the defense is defined, applied, and misinterpreted by the public, and what both legal and mental health experts actually consider when determining criminal responsibility. The conversation also sheds light on the realities of mental illness in the context of crime, challenging the stereotypes often perpetuated by high-profile cases and media representations.

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Key Discussion Points & Insights

1. Defining the Insanity Defense (01:30–03:27)

• Dr. Johnston explains:

  • The legal standard for insanity varies by state (e.g., California's McNaughton Rule).
  • A mere diagnosis of mental illness is not sufficient; there must be a clear connection between the individual’s symptoms and their alleged crime.
  • The key issue is whether the person could appreciate the wrongfulness of their actions at the time.

  “There has to be this connection between the person's symptoms and their illness and the conduct that they've been accused of as criminal.” — Dr. Johnston [02:48]

• Clarifying legal insanity:

  • The defense applies to people who, due to severe mental disorders, genuinely do not perceive reality and cannot recognize their actions as wrong.

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2. Delusions, Premeditation, and Criminal Responsibility (03:27–05:30)

• Case example provided:

  • A man with persecutory delusions against his neighbor takes “rational” steps (police calls) based on irrational beliefs, eventually leading to violence.
  • Dr. Johnston emphasizes that premeditation or threats do not automatically imply legal sanity if those actions are rooted in delusional thinking.

  “…here's premeditation… and yet his reasoning was based on this delusion he had, that he was being persecuted intentionally by his neighbor.” — Dr. Johnston [04:42]

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3. Evolving Legal Definitions and Neuroscience (05:30–08:06)

• Host brings up:

  • Trends in newer cases using the insanity defense linked to neuroscience or concepts like “emotional disturbance” or “irresistible impulse.”

• Dr. Johnston’s perspective:

  • “Irresistible impulse” is not new but rarely results in successful defenses today.
  • Some states don’t allow the insanity defense at all.
  • Juries almost never accept pleas based on psychopathy or personality disorders.

  “Juries in general do not like the insanity plea.” — Dr. Johnston [07:55]

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4. Should the Definition Be Expanded? (08:06–09:42)

• Discussion of extreme cases:

  • Host cites Jeffrey Dahmer’s notorious crimes as an example that challenges the boundaries of “insanity.”

• Dr. Johnston responds:

  • The nature of a crime shouldn’t define legal insanity; focus should always be on the defendant's mental state and whether a severe illness directly influenced actions.

  “…just because somebody has done something horrible should [not] expand our definition of… what insanity is.” — Dr. Johnston [08:54]

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5. Major Depression and Criminal Responsibility (09:42–15:33)

• Host questions:

  • Can non-psychotic mental illnesses like depression form the basis for an insanity plea?

• Dr. Johnston explains evaluation steps:

  • Assessment always begins by identifying whether a severe mental illness was present.
  • She distinguishes between narrowing of focus (often in depression) and psychotic delusions.
  • Asks if, and how, the mental illness drove the actual criminal act—mere apathy or hopelessness is not enough.

  “A narrowing of focus is different from a delusion… I'm going to need to clearly see how that narrowing of focus led to this person hurting somebody else or committing a crime.” — Dr. Johnston [13:30]

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6. The Rarity and Reality of the Insanity Defense (15:33–18:45)

• Faking insanity:

  • While some defendants attempt to fake symptoms, success is highly unlikely due to thorough history checks and evaluations.

  “Most people, I think they're obviously faking it in the way that they think it's supposed to look… The vast, vast majority of individuals who successfully plead not guilty, a reason of insanity, have an extensive history of mental health problems long before the criminal act.” — Dr. Johnston [16:12, 16:37]

• Insanity pleas are exceedingly rare:

  • <1% of criminal defendants plead insanity; only about a quarter of those succeed.
  • Media cases are exceptions, not the norm.
  • Often, prosecution and defense agree when the evidence for insanity is compelling.

  “It's a Hail Mary in some respects, even if it’s legitimate, because there have been plenty of jurors who've said after the fact… I really thought this person was really, really… insane, basically. But I don't want this person out.” — Dr. Johnston [17:28]

  “We hear about the high-profile cases… People are terrified about that. And so it's a scary thing to think about. We don't see the fact that the person, if they are found not healed to, they're going to be… Andrea Yates is still in a forensic hospital.” — Dr. Johnston [19:55]

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7. Serial Killers, Sanity, and the Limits of the Law (20:31–21:38)

• Host’s reflection:
  • Raises the philosophical issue: if a serial killer displays such extreme deviance, doesn’t that imply insanity?
  • Wonders if modern neuroscience should lead us to redefine intent and responsibility.

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8. Mental Illness and Violence: Myths and Media (21:38–22:58)

• Dr. Johnston’s clarification:

  • Most violent acts are not caused by mental illness.
  • Media exaggerates this link; people with severe mental illness are more likely to harm themselves or be victims than to commit violence.

  “I think that this link between mental illness and violence… has been really, in some respects, exaggerated.” — Dr. Johnston [22:31]

  “People with severe mental illnesses [are] likely to hurt themselves… They're more likely to be victims of crime. So there's a link… but it's not the way I think most of us think it is.” — Dr. Johnston [22:47-22:58]

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9. Free Will, Decision-Making, and Legal Accountability (22:58–24:46)

• Host shares research:

  • Parole decisions are influenced by factors like when a judge last ate—a reminder that all human behavior is affected by biological and psychological factors.

  “The consensus of the study was that you were way, way more likely to get parole after lunch because the judges have eaten, so their blood sugar is higher.” — Host [23:08]

• The balancing act:

  • Dr. Johnston notes the justice system is always grappling with the tension between accountability and understanding as science evolves.

  “We’re always looking for that balance between accountability and understanding. And that's a hard one.” — Dr. Johnston [24:41]

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Notable Quotes & Memorable Moments

• Dr. Johnston on jury skepticism:

  “Juries in general do not like the insanity plea.” [07:55]

• Dr. Johnston on media’s impact:

  “Whenever we see somebody who does something violent, the first thing is, oh, it must be mental illness. …That’s not the way I think most of us think it is.” [22:31–22:58]

• Host on legal definitions and boundaries:

  “If you can eat people and kidnap and eat people, you don’t know and you’re still not insane, like, who is insane?” [08:10]

• Dr. Johnston on professional experience:

  “I have worked in a maximum security prison ... I’ve seen some people who do horrendous things. And… that has nothing to do with mental health or mental illness.” [08:40]

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Timestamps for Key Segments

• Definition of insanity defense: 01:30–03:27
• Role of delusions and premeditation: 03:27–05:30
• Evolution and limits of the defense: 05:30–08:06
• Media cases and psychopathy: 08:06–09:42
• Assessment for depression and non-psychotic illness: 09:42–15:33
• Rarity of successful insanity pleas: 15:33–18:45
• Agreeing on insanity in court: 17:52–18:45
• Serial killers and legal “insanity”: 20:31–21:38
• Mental illness, violence, and the media: 21:38–22:58
• Decision-making and free will in the justice system: 22:58–24:46

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Tone & Takeaways

The conversation is clear-eyed, professional, and direct, with Dr. Johnston providing nuanced, evidence-driven perspectives. The myth-busting tone persists throughout: the insanity defense is rare, tightly defined, often misunderstood, and not a “get out of jail free” card. She stresses the importance of separating media spectacles from everyday court realities and advocates for a justice system that seeks both accountability and compassion—without confusing severe crime for proof of legal insanity.

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Transcript

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[A]

Today I'm speaking with Dr. Joni Johnston, an acclaimed criminal and forensic psychologist who's an expert in evaluating the insanity defense. In this conversation today, I want to know what we don't know. What does everybody get wrong about the insanity defense? What does everyone get wrong about mental illness in the legal system? Dr. Johnston's insight in this context is remarkable, and I hope you enjoy this conversation. So, Dr. Johnston, I thought it might be helpful if we maybe start with a definition of the insanity defense, because that's changed over time. So could you give our audience a framework for understanding it?

[C]

Yeah. Well, first of all, it varies from state to state. So different state states have different laws or different standards for evaluating, you know, really what's kind of called criminal responsibility, which we think of as the insanity plea, like in California is the McNaughton Rule, which means that in order to be found legally insane, you have to either, you know, not know that what you're doing was wrong or not really appreciate that what you were doing was wrong. So there's got to be a severe mental illness. There there's got to be, obviously, some mental illness, but that's not enough. And I think people sometimes think it's a diagnosis which is, you know, as opposed to there has to be this connection between the person's symptoms and their illness and the conduct that they've been accused of as criminal.

[A]

So kind of on that basis, fundamentally, I think what the court is looking for, at least kind of in the traditional sense, is the idea that you cannot appreciate the wrongfulness of your actions, so that you're under some sort of, you know, you think your victim is a werewolf or something along that lines, but you truly believe it. You truly have this belief that what you're doing is not wrong. Is that right?

[C]

That's exactly it. You know, it's kind of saying basically that, you know, we need to be able. We need to be held accountable for behaviors that we understand and appreciate are wrong in our society. And I think that's the confusing part. Oftentimes for a lot of people who are looking at different cases, particularly if there seems to be some kind of, you know, quote, quote, premeditation, you know, people will kind of go, okay, well, clearly this person is premeditated. This person left this scene afterwards. And those are all facts that come in as part of the evidence, but none of those in and of themselves means that the person was. Is culpable. So, for example, there was a case where a man believed his neighbor was sending him these messages and torturing him in his house. And it was, you know, he went over there, just like you and I would do if, you know, somebody was playing the music too loud. We go over there and say, would you please turn the music down? Would you please quit doing this? And you did. The store called the police several times, you know, and said, you know, that my neighbor is torturing me, basically. And of course, police went over and it was obvious that there was nothing going on. And I'm sure they suggested the person get help. And, you know, fast forward several months, and the person ends up seriously assaulting this individual because he felt like he had exhausted every possible, you know, you know, rational kind of avenue. He just kind of. So this is somebody who I think would under have understood. He's taken all these steps in his mind to try to get the situation resolved. Now, you know, you and I know that these are not rational beliefs. There was nothing going on. But that's separate, in a way, from what this person truly believed was happening. So this is somebody who, again, took all these steps and ended up, you know, intentionally Going over, planning to go over there and had threatened the person that, if this continues to happen, I'm going to do this. I mean, so you look at this and kind of go, here's premeditation. I mean, this guy's basically saying, if this doesn't stop, I'm going to do A, B and C. And yet his reasoning was based on this delusion he had, you know, that he was being persecuted intentionally by his neighbor.

[A]

So that's. That's kind of an easy and classic way to understand the insanity defense, I would think, in that. In that if you are not perceiving reality properly, if you are suffering from delusions, hallucinations, you. In that you cannot appreciate that what you're doing is illegal, wrong morally, ethically, you are not responsible. But I think what's going on now in contemporary court cases, and I would love your opinion on this, is that that idea is expanding as we understand more about neurobiology. And so now we're seeing cases like Luigi Mangioni, who is pleading emotional disturbance, or. Or cases in which people are saying the condition of their mind at that

[C]

time

[A]

wasn't just that they didn't appreciate. Maybe they did appreciate the wrongfulness of their actions, but they couldn't control what they were doing because of kind of a deeper neurological sense.

[C]

Yeah. And I mean, I think a couple of things to think about with that is that there's a lot of fear oftentimes associated. I mean, people can plead anything they want to. In other words, a defense attorney can be very creative in coming up with a defense that may or may not have validity, at least to a jury. Let's just say that. So there's always been cases, right. Where people have said it was because of this, was because of this. We've had some, you know, some extreme cases and examples of those kinds of things. You know, some of the things you're describing, like the irresistible impulse is not new. I mean, that's kind of been around and that we've kind of gone backwards. So since John Hinckley was found not guilty or reason of insanity, you probably are aware of this, but we've really kind of reversed a lot of the ideas in terms of the law, has been much stricter around insanity pleas. You know, I think it's seven or eight states now don't even have an insanity plea as an option. So we've really seen. I mean, even though it looks like you can point to some cases and kind of go, okay, now people are saying, I have. I'm a Psychopath and I have something wrong with my brain. Right. I mean, there's been cases where people. Personality disorders, I mean, these are things that juries don't typically. Actually, I've never heard of a case where somebody's been successful with that kind of a plea. So in reality we can, you know, again, there's lots of cases. And as we. Our understanding of mental health moves forwards, things will change. I don't know in what direction they will change, but we do know that juries in general do not like the insanity plea.

[A]

What do you think in terms like, are we getting this right? And you mentioned psychopathy and serial killers. And you know, there's that infamous anecdote from the Jeffrey Dahmer trial where his defense attorney says, you know, if you can eat people and kidnap and eat people, you don't know and you're still not insane. Like, who is insane? So there is kind of this argument going on. So are we getting it right? Should the definition be expanded? Should we look at it differently?

[C]

I don't think that somebody's conduct should ever be the criteria for whether they are legally insane or not. And that's not the intent we have all known. I mean, I have worked in a maximum security prison. I talk to inmates almost every day. And I've seen some people who do horrendous things. And, you know, that has nothing to do with mental health or mental illness. So, yeah, I don't think that. I mean, I understand why defense attorney might say that, but again, I don't think that just because somebody has done something horrible should expand our definition of, you know, what insanity is. It is the, you know, when we're talking about insanity, the. As you pointed out, the point behind it is to not hold people criminally responsible for things that they don't have control over. And to have a severe mental illness is something people don't have control over. You know, it's certainly when they're actively symptomatic. So I, I don't think we're. I would not be somebody who would ever argue that we should base an insanity. Sorry. That we should base a successful insanity plea based on the conduct and how bizarre it was or how severe it was or those kinds of things.

[A]

I would imagine you do encounter cases or have encounter cases in which a person has done something because of a mental illness, let's say something like depression, where there isn't necessarily psychotic features, they're not necessarily hallucinating, but perhaps they are delusional based on kind of the tunnel vision. They have or the over. And you know, to go even further, they are, they are seeing the world the wrong way because their, their neurochemicals are off balance. Right. You know, can you, can you apply the insanity defense in that or is there a line there like how do you make that distinction?

[C]

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Visit spinquest.com for more details. Can you what does that mean? You know, in other words, a defense attorney can argue that, you know, can plead insanity and that's going to be part of that argument. You know, when I go in and evaluate somebody, you know, I, I do pretty much the same. Most of my cases, luckily for me are court ordered. So I'm kind of the neutral party to go in. And that's what I, that's what I prefer because it just makes it cleaner. So I go in and do the same thing that I would do if I was testifying for the prosecution of the defense, which I will end up doing based on, I guess, who likes, you know, what I have to say. But I'm a court, you know, appointed person, you know, I'm going to be again, always looking Number one, does this person have a severe mental illness? So let's say major depress. What does that mean for this? That's the first thing I have to say. What does that mean for this particular person in terms of major depression? Has this person been diagnosed with that? Has this person have been diagnosed that in the past? What symptoms does this person have? How is, does it, how is it impacting this person's functioning? How was it impacting this person's functioning at the time that they were, you know, were that this event, that they committed this crime? You know, it's, it's, it's, it becomes a little bit harder right when you're talking about, okay, the person. A narrowing of focus is different from a delusion. So I might believe that my options are limited in terms of, you know, my life is so horrible, I, I can't see past this tunnel that I'm in. It's always going to be this way. I mean, some of the things people, you know, I've always felt this way, I'm always going to feel this way. My life is over. And those kinds of things, things, I mean, that might be part of the fact pattern, but for me, again, I'm going to have to say, okay, that's number one. You know, what was it like for this person at this point in time? Who knew this? Who else saw this? I'm always going to be talking to family members or friends or co workers. You always want to corroborate information, not just the person's telling you that, but other people are seeing what this person is saying. And then it becomes again, okay, how does this relate to hurting somebody else? Because, you know, my first thought, and this is just preliminary, would be that would go along much more worth hurting myself, right? If I'm in this depression and my options are narrow and those kinds of things. So how does that translate into deciding to hurt, you know, hurting somebody else? And it, you know, I'm not saying that can't, that connection can't be made. But I'm going to need to clearly see how that narrowing of focus led to this person hurting somebody else or committing a crime. I keep saying violent, but it doesn't have to be violent. It can be trespassing or any crime. You could plead not guilty by reason of insanity. So that's going to be the issue. And of course, I may do an evaluation and say, yeah, this person was depressed, this person had been depressed for years, or they'd gone through periods. And I don't see a connection between this person's depression and, you know, and their. Or. Or maybe there's a connection, but they legally could understand and appreciate that what they were doing was wrong. Maybe they didn't care. I don't care about my life anymore because I'm so depressed. That's not the same thing, is not seeing, you know, is there being a direct connection between that depression and those thoughts and doing something harmful to somebody else?

[A]

Yeah, I see. I see what you're saying. That's such an interesting evaluation. Do you get a lot of people. When you're doing these evaluations, do you see a lot of people attempting to fake the insanity defense?

[C]

I wouldn't say a lot of people try to fake it. I mean, certainly it happens. And we have some pretty good ways of, you know, I don't want to say catching it. That's kind of the first. I'll say that because it's the first thing that kind of popped in my head. We have some ways of evaluating it. You know, it's interesting because most people, I think they're obviously faking it in the way that they think it's supposed to look. And so we have some relatively sophisticated ways of trying to see if somebody really is faking. Of course, one of the things, too, is history. I mean, the vast, vast majority of individuals who successfully plead not guilty, a reason of insanity have an extensive history of mental health problems long before the criminal act. And that's something you would kind of expect to see if somebody has a severe mental illness. Now, occasionally I see, and I think of one case I saw where it was the person's first real psychotic break. They had a history of bipolar disorder already, but they had never been as manic as they were this. So this was the first time this person got in trouble. And I legitimately believed this person was not criminally responsible. And luckily. And this is the other thing people. I think sometimes it's because we don't ever see these cases. Is the prosecutor and the defense agreed that this person was legally insane. There was never a disagreement about that. So the case just got adjudicated in that way that tends to happen more often than not because of the fact that. Because. I'll tell you why. Because it's. It's not. You know, less than 1% of defendants plead insanity, and less than a quarter of those are successful. So it's not. I mean, you know, a lot of people will say it's a Hail Mary in some respects, even if it's legitimate, because there have been plenty of jurors who've said after the fact, you know, I really thought this person was really, really, you know, insane, basically. But I don't want this person out.

[A]

That is really insightful because you're saying we're talking about 0.25% of all cases. And I think most people are making, you know, most people are understanding the insanity defense based on these huge cases they see in the media, which are extreme outliers of the insanity defense. And that is refreshing to hear that prosecutors and defense attorneys often work together when they are convinced that a mental health issue is appropriate and insanity is driving the defense. Because I think I certainly. I mean, I'm on the outside looking in, but I certainly have the impression of the American justice system that it's very adversarial all the time. But you're saying there are these instances where prosecutors and defense attorneys come together and appreciate what is happening and just kind of try and get the case through the courts to seek the truth. Is that what you're saying?

[C]

Absolutely. I mean, because. Because, you know, it's such a. There's such a high bar of, of success that if you're a defense attorney, you know, you, you know this. And, and again, you're going to be pleading the insanity. I mean, again, I'm not saying it isn't used as a Hail Mary sometimes, because it is right. If you have, if, if the person is caught doing something, you. You have very limited options. So that can happen. I'm not saying that. But what I am saying is that particularly people who are successful is that you have a defense attorney and the behavior is so clear in terms of, you know, it's. It's oftentimes so bizarre and so clear. And there's this history before that. There's a history around that time, other people documenting it. And, you know, it's just clear to everybody involved what happened, and it's horrible. It's just a tragedy all the way around. And yet, if you're a prosecutor or a defense attorney, I mean, what. How does that benefit anybody to put someone in prison who had no understanding of what they were doing at the time? And the other thing is, you know, we know statistically you're more likely to spend a longer amount of time in a forensic hospital than you are in prison. So it's not like. I think sometimes people get afraid that if I find this person legally insane, I'm going to see him on the bus, you know, in six months. That's not likely to happen at all. So, you know, I Mean, there are a lot of, I think, fears around the insanity plea. And I understand that because like you're saying, we hear about the high profile cases, we hear about, you know, serial killers who are pleading insanity, and, you know, that people are terrified about that. And so it's a scary thing to think about. We don't see the fact that the person, if they are found, not healed to, they're going to be. Andrea Yates is still in a forensic hospital.

[A]

Yeah, yeah. In Austin. I think the thing with serial killers, like you say, and maybe this is a good place to leave it, but I think serial killers are insane. I don't think you can be a serial killer without being insane, depending how you make that definition. But if you're a person who is gratified by sadistic, violent sex and goes out and targets strangers, you don't, you know, people you don't know and, and kills them and, and, you know, does whatever for your own sexual gratification. And you do this over and over and over again for a period of years. I mean, to me, I mean, that is insane, you know, and. But I'm not saying they shouldn't be found guilty or that the, the law should excuse that. I just think it raises a bigger question as to how we even view intent, responsibility as we understand more about the mind, as we learn more about the mind.

[C]

Well, I definitely think, obviously psychology to me is such a fascinating topic and we're always learning and trying to, you know, understand, you know, how we think and why we make the choices that we do. But I would again just say in kind of wrapping things up, that, you know, I was seeing people who are very, very sane do really bad things. And I don't think you have to have something mentally wrong with you to do it. That sounds pessimistic because I'm actually basically an optimist because I see people all the time. They do amazing things given, you know, which is extraordinary given some of their, their start in life. But, but I, I don't think. I mean, I think that this link between mental illness and violence, I think, has been really, in some respects exaggerated.

[A]

Oh, really?

[C]

I do. By the media. And the first time, you know, whenever we see somebody who does something violent, the first thing is, oh, it must be mental illness. And, you know, again, when you look at the research, who are people with severe mental illnesses likely to hurt themselves?

[A]

Yeah, definitely.

[C]

Yeah. Far more often than they are. They're more likely to be victims of crime. So there's a link between mental illness and violence. But it's not the way I think most of us think it is.

[A]

Yeah, I think what I'm thinking about is, and I totally hear what you're saying, I don't think we can blame mental illness as a catch all to explain violent crime. But when we, you know, in modern research, when we look at, and I'm talking about, like, how people make decisions, for example, there's a great research study in which they, they, they looked at judges before and after lunch at on parole cases, and they found that, you know, people were 80% or something or it was very, very high number. I'm, I'm definitely not quoting it properly and I'll try and find the study for our viewers, but it was the, the consensus of the study was that you were way, way more likely to get parole after lunch because the judges have eaten, so their blood sugar is higher. And to me, it is part of the ongoing research that shows that the things we do are often out of our control, even though we perceive them to be within our control. And that, to me, really brings into question the whole shape of the justice system and what we're talking about when we're talking about mental health and insanity.

[C]

That's an interesting, I think, observation on your part. And I think it, you know, there's obviously so many possible ways to go with all of this research. I would also say that, you know, if that's true, though, we would expect all of us to be, you know, why is it that. That we so often don't commit crimes and that we so often don't act on impulse or feelings or, you know, so I think it's complicated, and I think we're always looking for that balance between accountability and understanding. And that's a hard one.

[A]

Yeah. Yeah. Well, thank you, Dr. Johnson. This is great.

[C]

You're welcome. Thanks for having me.

[B]

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[E]

Hey everybody, lady luck here and we're celebrating America's 250th birthday. Now all summer long I'm going to be celebrating by playing on finquest.com which is an American owned social casino. It obviously features over a thousand slot games and live blackjack, live craps, live bubble craps. Head on over to spinquest.com get yourself a $30 coin pack for just 10 bucks.

[C]

Spinquest is a free to play social casino void where prohibited.

[B]

Visit spinquest.com for more details.

[F]

Grainger knows when you're a procurement manager for an office park, you're not managing one building, you're managing all of them. And to stay ahead, you need to see through walls and around corners. Lights about to fly fail filters ready to clog HVAC on its last leg. If you wait until something breaks, you're already behind. Count on Granger for quality products, easy reordering and 24. 7 support. Call 1-800-granger click granger.com or just stop by Granger for the ones who get it done.