Defense of Schizophrenia

NC's Legal Standard for Insanity (M'Naghten Rule)

Under the M’Naghten Rule, a defendant is legally insane if, due to mental disease or defect, they:

"Did not know the nature and quality of the act they were doing, or, if they did know it, did not know it was wrong."

So, a schizophrenic defendant would need to prove that at the time of the offense, they:

• Were so impaired by their illness that they didn’t understand what they were doing, or

• Thought they were doing something right (e.g., believing they were acting under divine command, or that the victim was a threat due to a delusion)

What if the person seeking to use insanity as a defense had voluntarily stopped taking his or her medication?

For the insanity defense to apply, the key question is what the defendant's mental state was at the time of the offense — not necessarily whether they chose to stop taking meds.

• If the person was actively psychotic or delusional during the offense, then the cause (e.g., stopping meds) might be less relevant than the effect (psychosis).

• However, prosecutors often argue that stopping medication voluntarily shows the person could have avoided the psychotic episode, and therefore should be held responsible.

Example: A person with schizophrenia stops taking meds, has a delusion, and commits assault. A judge might ask: Did they understand what they were doing was wrong, or did their psychosis make them think they were defending themselves from an imagined threat?

Diminished Capacity Defense

This partial defense is more flexible. It argues that the defendant's mental condition prevented them from forming the required intent — for example, the "specific intent" needed for assault or resisting arrest.

Here, voluntary non-compliance with meds does not necessarily defeat the defense. One could argue:

• The person was not rational or capable of making an informed decision to stop his or her meds; or

• His or her lack of insight into their illness (a common symptom in schizophrenia) made the non-compliance part of the illness itself.

IMPORTANT: If you are considering either of these defenses, a psychiatric expert is integral to the success.

• Merely being off medication or having a diagnosis isn’t enough.

• The burden is on the defense to prove insanity, usually through expert psychiatric evaluation and testimony.

• The trial might include expert witnesses from both the defense and prosecution.

Alternatives

Mental Health Diversion Programs

• In some counties, particularly for non-violent misdemeanors, courts may offer mental health treatment instead of jail.

• Requires active participation in therapy, medication, and monitoring.

Mitigating Factors at Sentencing

• Even if found guilty, schizophrenia may be used to ask for reduced sentencing, probation, or treatment-based alternatives.