A three-point plan

I believe that our problems with mental health and substance abuse will become far more tractable if we make these legal reforms:

1) Totally eliminate the insanity defense;

2) Fundamentally reform rules about mental fitness to stand trial; and

3) Change medical control over drug access to requirements for prescribed expert information and advice.

In criminal cases requiring an element of mens rea, the so-called "insanity defense" is superfluous anyway, because a jury can determine that the defendant did not have criminal intent. For example, if a mother was so delusional (e.g., from the side effects of psychiatric drugs) as to truly believe that cutting her five-year-old's head almost off would save the beautiful child from hell, that her daughter would go immediately to heaven and be happy rather than be abused by sex traffickers and sold into slavery, maybe it's clear that the mental knowledge of wrongdoing requisite to the crime of murder was lacking.

Some U.S. states have reduced the use of NGRI pleas to nearly zero, by revising presumptions, burdens of proof and procedures. Illinois, unfortunately, is not one. Here, anyone who ever had any contact with the mental health system is encouraged by the criminal courts to consider an NGRI plea when they're charged with almost any felony, all the way down to assault and car theft. It has virtually become a system where a prosecution has to be approved by the psychiatrists before a defendant is even allowed to plead guilty or not guilty.

Judges and juries simply cannot defer to medical experts about whether crimes were committed and whether punishment should be meted out. This is a difficult social task, requiring semi-divine wisdom over the long haul. We have a system of English law which acknowledges the imperfect nature of human judgment and strives to mitigate the errors caused by imperfection. Our system can be compared, very favorably in my opinion, to the Napoleonic or inquisitorial system, which relies on finding the wisest possible humans who are expected to judge more perfectly than others. 

Psychiatrists have proven beyond reasonable doubt that they are not any such wisest possible humans!

Likewise, these "mental health experts" should not be trusted to say whether an alleged perpetrator is fit to stand trial. On any given day, Illinois taxpayers are on the hook for the costs to "hospitalize" at least a handful of defendants who understand perfectly well what their legal situation is, and what the process will be in court. They constantly argue that they shouldn't be at EMHC but want to go to trial ASAP; and as far as I can tell they only need to be "treated" because they disagree with their public defenders about trial tactics and strategy. 

This is absolutely not some manifestation of chemical imbalances in these defendants' brains for arrogant idiots like the crew on the tenth floor at 26th and California to "diagnose" and send back to Dr. Malis-with-malice to cure at EMHC by drugging them to make their trials more fair! It's a scam by petty bureaucrats who are too lazy or too incompetent to do their jobs in a rotten criminal justice system. If a defendant wants his/her day in court, there should be a much stronger presumption of fitness. "Unfit to stand trial" should be as obvious as the Defendant is physically incapable of communicating at all, or even getting out of bed to come to court. 

These reforms to NGRI and UST laws and definitions are pretty easy. I could probably write the bills for our General Assembly in an afternoon. The last reform, to drug policy, is more interesting.

I wrote about this some years ago, and here and there my ideas got some favorable response. I have never received any suggestion or comment that made me think my specific plan to turn drug regulation on its head would not work. I haven't reviewed it myself more recently, in the context of the current, ballyhoo'd "psychedelic renaissance." My instinct is to worry a little more about easier access to dangerous drugs in the short run; but in the end, the only way to simultaneously solve substance abuse and mental health coercion will remain more individual responsibility, less reliance on the supposedly benevolent authority of false "brain experts."

So that's the 3-point program to save the world in mental health: unceremoniously dump the insanity defense; let accused criminals have their day in court; and solve drugs with education and responsibility. 

You're welcome!