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For more than one and a half centuries, from the first insanity defense commitment of John Hadfield in England in 1800 through the mid-1960s, insane defendants (those not guilty by reason of insanity, or NGRIs) were automatically and indefinitely committed to a secure psychiatric facility until the state determined that they could be released. Until the mid-1960s, most were never released regardless of their crime. Treatment for NGRIs then and today mirrors the standard psychiatric treatment of the time—ranging from simple confinement in pretreatment eras to increasingly more sophisticated interventions such as those available starting in the 1950s. Today, most people found that NGRIs in the United States and elsewhere have a major mental disorder such as schizophrenia or bipolar disorder, and their treatments are ...

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