The Insanity Plea: What It Really Means to Be ‘Not Guilty by Reason of Insanity’

The Rojas Case: Ill or Evil?

It was a morning like any other in Times Square: the sidewalks thick with commuters and tourists, the usual weekday rush flowing past the storefronts and billboards. Then, without warning, a burgundy Honda jumped the curb. People screamed and scattered. Some saw bodies thrown onto the hood and windshield; others watched in disbelief as the car barreled forward through the crowd, block after block, cutting a straight line of impact along the concrete. When it finally slammed into a metal barrier, bystanders and security officers dragged the driver—26‑year‑old Navy veteran Richard Rojas—out of the car and fought to restrain him as he struggled and shouted.

By the time the car finally stopped, 18‑year‑old Alyssa Elsman was dead, and more than twenty other pedestrians had been injured. In the aftermath, Rojas was charged with murder, attempted murder, and a stack of related offenses, reflecting the view that he had turned his vehicle into a weapon against everyone in his path. Years later, after a contested trial, a New York jury would decide that he was not criminally responsible for what he had done—because of severe mental illness.

At trial, there was no real dispute about what Rojas had done. The fight was over what kind of mind he had at the time. The prosecution told the jury a story about a man who made a deliberate, depraved choice—a driver who used his car as a weapon, steered it onto the sidewalk, stayed on course for several blocks, and later said things like “I wanted to kill them all” and “You should have shot me.” In that telling, mental illness might explain his rage, but it didn’t excuse it. He still knew what he was doing, and he still knew it was wrong. 

The defense told a very different story. Their experts described a well‑documented schizophrenia that had begun years earlier, during his Navy service, and worsened over time. Family members testified about paranoid behavior and a growing loss of contact with reality. A psychiatrist explained that by the day of the crash, Rojas was hearing commanding voices—telling him to crash into “spirits,” to send people to heaven, and to escape torture that only he could feel. In that telling, the attack was not the act of a sane man choosing evil but of someone whose ability to understand and control his actions had been swallowed by psychosis.

Faced with those two competing narratives—one casting the crash as a deliberate rampage, the other as a psychotic break—the jury had to answer the legal question at the heart of every insanity case: not “Was he sick?” but “Was he, in that moment, still the kind of agent the law is willing to punish as a murderer? 

In the end, the jury accepted the defense’s account. Rojas was found not guilty by reason of insanity—a formal NGRI verdict—meaning that the law recognized the harm he caused but concluded that, because of his mental state, he was not criminally responsible in the ordinary sense. Instead of a conventional prison sentence, he was committed to a secure psychiatric facility, where his confinement is governed by mental health law and ongoing assessments of risk rather than a fixed term of years.

Crime, Choice, and Responsibility

In this case, and in many others, the question for the jury is broadly this: was this person someone who made choices and should be held responsible for their conduct, or were they so impaired and confused that they were not truly responsible for what happened? A verdict of not guilty by reason of insanity—NGRI—is the label the law uses when the answer is “so impaired that ordinary blame no longer fits,” and it points the person toward indefinite psychiatric confinement rather than a conventional prison sentence. 

The idea that some people have mental illnesses or defects that make them less responsible for their actions has always been controversial. Long before modern psychiatry, legal systems recognized that not everyone who caused harm should be treated as fully culpable. Medieval and early common‑law courts often distinguished “lunatics” and “idiots” from ordinary offenders, sometimes exempting them from punishment or shifting their cases into guardianship and confinement rather than execution. Over time, these rough categories evolved into more formal doctrines: children below a certain age were presumed incapable of criminal intent, and people in states of “madness” or “unsoundness of mind” were sometimes found not guilty and confined instead of being hanged.

To see why insanity matters to criminal responsibility, it helps to have a basic sense of how the law defines a criminal act. Generally speaking, there are two elements: the “actus reus,” or guilty act, and the “mens rea,” or guilty mind. Start with the actus reus. But the second element of a criminal offense is called mens rea. Mens rea literally means “guilty mind.” It’s the state of mind—intent, knowledge, or extreme recklessness—that the law requires before it treats a harmful act as a crime. Put more simply: for me to be guilty of a criminal act, I have to perform the action in question (headbutting my classmate), and I also have to do it on purpose, with the kind of mental state the law cares about.

Imagine we’re sitting in class and I suddenly have a violent sneezing fit. I sneeze so hard that my body jerks forward and I accidentally headbutt the person in front of me.

Now ask yourself, did I commit an assault? In one sense, yes—I did headbutt him. Fifteen other people in the class saw me do it, and the person I hit has a lump on his scalp to prove it. Under those circumstances, there’s no way I can deny that contact happened.

But the second element of a criminal offense is called mens rea. Mens rea literally means “guilty mind.” It’s the state of mind—intent, knowledge, or extreme recklessness—that the law requires before it treats a harmful act as a crime. Put more simply: for me to be guilty of a criminal act, I have to perform the action in question (headbutting my classmate), and I also have to do it on purpose, with the kind of mental state the law cares about.

Now change the example. Imagine I’m angry, I lean forward, and I deliberately headbutt the person in front of me. The physical act is the same, but this time I’ve chosen it. In the first case, there’s a harmful movement without a guilty mind; in the second, there’s both the actus reus—the guilty act—and the mens rea—the guilty mind—that together make it a crime.

My headbutt is a trivial example, and I doubt very much that any prosecutor would charge me with anything as a result of my sneezing—any more than they would charge somebody for accidentally knocking over a glass of wine at a restaurant onto one of their fellow diners. We can see, intuitively, that those are mishaps, not crimes.

But what Rojas did was far from trivial, and determining what is called criminal responsibility becomes much more complicated in that kind of case. When a car is driven down a crowded sidewalk and people are killed and maimed, we can’t simply shrug and say, “Well, something bad happened, but nobody chose it.” The law has to ask, in a serious and structured way, whether the person behind the wheel had the kind of mind—intent, understanding, and control—that justifies treating the harm as a crime or whether a severe mental disorder disrupted those capacities enough that we should respond as if he were ill rather than evil. That’s where it starts to get complicated.

In everyday conversation, words like “insane” or “crazy” are used loosely to describe behavior that seems extreme, odd, or upsetting. In law, by contrast, “insanity” is a term of art: it has a specific, technical meaning tied to whether a person’s mental state at the time of the offense meets strict criteria about understanding and control.

To make sense of this, it helps to separate everyday talk about “insanity” from what the law means by it. In ordinary language, we might say “that guy’s really crazy” if he’s erratic, angry, or seems out of touch. In psychiatry, we diagnose mental disorders like depression, bipolar disorder, or schizophrenia. But legal insanity is something much narrower. It doesn’t mean “has a diagnosis” or “acts strangely.” It means that, because of a serious mental disease or defect, the person lacked the kind of understanding or control the law demands before it blames and punishes.

I don’t think I can emphasize strongly enough that the vast majority of people with very serious mental illnesses, such as schizophrenia or severe bipolar disorder, are not any more dangerous than anyone else. Legal insanity is about a very specific kind of breakdown in understanding or control at the time of an offense; most people with severe diagnoses never come close to meeting that legal threshold or posing a serious danger to others. 

A Brief Detour to Victorian England: The M’Naghten Case

The modern legal idea of insanity doesn’t come from psychiatry textbooks; it comes, in large part, from a nineteenth‑century murder case in England. In 1843, a Scottish wood turner named Daniel M’Naghten (pronounced “McNaughten”) became convinced that the British government was persecuting him. Acting under that delusion, he shot and killed Edward Drummond, the private secretary to Prime Minister Sir Robert Peel, mistaking Drummond for Peel himself.

At trial, medical witnesses testified that M’Naghten was suffering from a “disease of the mind,” with delusions of persecution so severe that he didn’t understand the reality of what he was doing. The jury found him not guilty by reason of insanity. The verdict caused an uproar—Queen Victoria herself was reportedly outraged that a man who had killed a high official could escape punishment because of his mental state.

The public reaction pushed the House of Lords to ask senior judges to spell out a standard for when insanity should excuse criminal liability. Their answer became the M’Naghten rules, which still influence insanity law today. Under the M’Naghten rules, a defendant can be excused from criminal responsibility if, at the time of the act, they were suffering from a “defect of reason” caused by a “disease of the mind” such that they either did not understand the nature and quality of their act or did not know that what they were doing was wrong. In other words, the M’Naghten test treats insanity as a very specific kind of “illness that cancels blame”: a disorder of mind so deep that, in that moment, the person either doesn’t grasp what they’re doing or doesn’t grasp that it is wrong. 

When juries today are asked to decide insanity—whether in a Victorian case like M’Naghten or a modern one like Richard Rojas—they are being asked a very specific question, rooted in that history: did this person, because of a disease of the mind, lose the basic ability to understand the nature or wrongfulness of their actions? The answer is what separates ordinary crime from acts the law treats as the product of legal insanity.

In Rojas’s case, the jury’s NGRI verdict is essentially a modern application of that old M’Naghten question. They accepted that he drove the car into the crowd but ultimately believed that his psychosis meant he no longer grasped the reality or wrongfulness of what he was doing in the way the law expects of a responsible adult. In that sense, the jury treated his actions as the product of illness rather than ordinary evil, even though the harm and horror of what happened in Times Square are beyond dispute.

How NGRI Works in Practice

Here’s how it works in practice. When a defense attorney decides to run an insanity or other mental‑state defense, they are not claiming that the act never happened. In most cases, they concede the actus reus—the physical act—and focus instead on whether the defendant’s mind, at the time of the act, met the legal standard for criminal responsibility. 

An insanity plea is what lawyers call an affirmative defense: the defendant is essentially saying, “Yes, I did what you allege. But because of a serious mental disease or defect, I did not have the kind of understanding or control the law requires before it calls that act a crime.” Put more simply, insanity defenses don’t dispute that harm occurred or that the defendant’s behavior caused it. They dispute whether that behavior should be treated as a crime in the full sense—an act carried out with a guilty mind—rather than as the product of a profoundly impaired mind.

In a case like Richard Rojas, the videos and eyewitnesses made it clear that he drove onto the sidewalk in Times Square and hit people; there was no real argument over whether he committed the physical act. The legal fight was over his mental state: whether his schizophrenia and command hallucinations left him with the kind of awareness and control the law presupposes when it labels someone a murderer or whether they had pushed him across the line into legal insanity.

How Forensic Professionals Assess Criminal Responsibility

When the defense raises insanity, forensic clinicians are brought in to help the court answer a very specific question: What was this person’s mental state at the time of the offense, and did it meet the legal criteria for criminal responsibility? Evaluators are not there to decide guilt or innocence; they are there to reconstruct the defendant’s mind at the critical moment and map that reconstruction onto the jurisdiction’s insanity standard. 

And it’s even more complicated than it sounds. When a forensic mental health professional performs this kind of assessment, they have to focus on the defendant’s state of mind at the time the actus reus occurred. The person sitting in front of them for the evaluation may be very different from the person who committed the alleged crime. It’s entirely possible that, once they were brought into jail or a hospital, they were given appropriate antipsychotic medication and stabilized. By the time of the evaluation, they may no longer be hallucinating or gripped by florid delusions, and they may appear calm, coherent, and relatively organized. 

So the evaluator has to look past the current presentation and reconstruct a past mental state, often months or years earlier, using records, collateral interviews, and careful questioning, and then decide whether that earlier mind met the legal criteria for insanity. The person you see in the interview room may be quite different from the person who was behind the wheel, holding the weapon, or standing over the body. In broad strokes, that work usually involves three layers:

Reconstructing the timeline and behavior

Evaluators start by gathering as much information as possible about what happened before, during, and after the offense: police reports, video footage, witness statements, medical records, prior psychiatric history, and sometimes jail or hospital observations. They look for patterns—planning or preparation, evidence of confusion or disorganization, efforts to hide or escape, and changes in speech, affect, and behavior. The goal is to build a detailed narrative of the offense and the surrounding context, not just to assign a diagnosis. 

Assessing symptoms and capacities at the time of the act

The core task is to infer what symptoms were present and how they affected the defendant’s capacities the law cares about. Evaluators ask:

• Was the person experiencing delusions, hallucinations, severe mood disturbance, cognitive impairment, or dissociation at the time?
• How did those symptoms shape their perception of reality, their understanding of what they were doing, their grasp of right and wrong, and their ability to control their behavior?
• Could they think ahead, weigh options, and foresee consequences, or were they acting under distorted beliefs or experiences that made their behavior make sense only within a psychotic or severely impaired frame?

Interviews with the defendant (when possible), collateral interviews with family or associates, and review of prior treatment records all feed into this reconstruction. Structured tools exist to guide insanity evaluations and provide more systematic ratings of impairment, but in everyday practice much of the work still depends on careful clinical judgment and clear explanation.

Connecting clinical findings to legal criteria

• Did this “disease of the mind” produce a defect of reason so significant that the person did not understand the nature and quality of the act?
• Or did it leave them unable to appreciate that what they were doing was wrong?
• Or did it so disrupt volitional control that, even knowing the act was wrong, they lacked meaningful ability to conform their conduct to the law?

A good report doesn’t just say “this person was psychotic” or “this person has schizophrenia.” It walks the reader through how the symptoms affected each relevant capacity and then reaches a reasoned conclusion about whether the legal threshold for insanity was met. In court, experts must be able to explain this chain of reasoning in plain language so jurors can follow it. Only then can jurors understand why two psychiatrists might look at the same facts and still come to different conclusions about criminal responsibility. Even with careful work, these assessments are rarely simple. Reasonable experts can disagree about how far a particular illness disrupted understanding or control, and those disagreements are part of why insanity cases feel so contested—and so emotionally charged—for courts, families, and the public.

Misconceptions About the Insanity Plea

In the wake of high‑profile insanity acquittals, opinion pages and talk shows reliably light up with alarm: commentators warn that “dangerous criminals are getting off on insanity” and “walking among us,” while politicians call for tightening or abolishing the defense altogether. Scholarly reviews of insanity‑defense history note that this anxiety about “violent offenders escaping justice” has helped drive waves of reform, from post‑Hinckley changes in U.S. federal law to state efforts to restrict or even replace NGRI. By this point, you can probably see why insanity cases are so difficult and emotionally charged—and that difficulty is part of why the plea has become surrounded by myths. A few of those myths are worth confronting directly.

Myth 1: The insanity defense is used all the time.

Survey and case‑tracking studies over several decades consistently show that insanity pleas are rare. They are raised in well under 1% of felony cases, and only a fraction of those attempts succeed—often around a quarter of the very small subset in which the plea is actually entered. Most defendants never plead insanity; most who do are convicted. 

In my own work, the gap between public perception and reality has been striking. In more than thirty‑five years of forensic practice in New Hampshire, I have never seen anyone found not guilty by reason of insanity except in cases where the prosecution and law enforcement also agreed that the legal standard was met. Insanity verdicts are not something juries hand out casually over the objection of everyone else in the courtroom.

Myth 2: When insanity “works,” people just walk free.

In popular imagination, a successful insanity plea is a kind of legal escape hatch—“he got off on insanity.” In reality, a Not Guilty by Reason of Insanity verdict usually leads to involuntary commitment in a secure psychiatric facility, often for long periods. Classic national studies and more recent reviews suggest that NGRI defendants frequently spend as much time, or more time, confined in hospitals as they would have spent in prison following a conviction for the same offense. In some jurisdictions, NGRI patients have been found to “lose their freedom for twice as long” as similarly situated convicted offenders. Release is not automatic; it depends on clinical progress, risk assessments, and court decisions and is often influenced by politics and public safety concerns.

Myth 3: Insanity is a legal trick guilty people use to get away with it.

Public opinion studies show that many people dislike the insanity defense and believe it is often abused by dangerous offenders who are “really guilty” and simply manipulating experts and juries. In practice, however, the defense is difficult to mount and even harder to win. It requires admitting the act, presenting extensive psychiatric evidence, and convincing a jury that a severe mental disease or defect destroyed the “guilty mind” the law normally presumes. Courts rely on detailed evaluations, collateral records, and structured criteria for insanity, and the system’s default is skepticism rather than easy acceptance.

For a case like Richard Rojas, these misconceptions help explain the intensity of public reaction. People see the horror of the act, hear snippets of his statements, and assume that an insanity verdict means a dangerous man “got away with murder.” The legal reality is more complicated: the jury accepted that he committed the act but concluded that his mind—given his psychosis and history—did not meet the strict standard for criminal responsibility, and the result was long-term confinement in a psychiatric institution rather than a conventional prison term.

This post has focused on one hard case—Richard Rojas—and on the basic ideas that shape insanity in criminal law: crime and choice, act and mind, legal versus everyday “insanity,” and how forensic professionals try to reconstruct a defendant’s mental state at the time of an offense. Here I’ve used the M’Naghten case and the Rojas verdict to show how the law sometimes treats severe illness as canceling ordinary blame and why that decision is both rare and controversial.

In the next post, I’ll turn to how the insanity standard has evolved in the United States and why different states now use different tests. Some jurisdictions still rely on M’Naghten‑style questions about understanding and wrongfulness; others have added volitional components or adopted broader models influenced by the Model Penal Code. I’ll also look at how these legal standards interact with modern psychiatry, what “MSTO” and related reforms are trying to fix, and how debates over danger, responsibility, and culture keep shaping insanity law today.