NGRI-What's your take?

[MMC.RN]

Hello All!

First off I want to say that I am a forensic psych RN working maximum security admissions with adult males. I'm not sure if anyone will respond to this, but I just wanted to see what everyone's take is on NGRI pleas. Do you think that they are given too easily? Should a personality disorder such as antisocial personality disorder qualify you for an NGRI? How does each state differ regarding NGRI's?

In my state, I feel that they are given way too easily. We have a lot of patients, who in my opinion, do not deserve one and should be in prison. We recently had some fairly high profile news articles come out about our facility, especially in regard to one of our patients who is getting conditionally released so it's been a hot button topic amongst the staff. The judge who is releasing him was the one who presided over his trial changed his mind and actually said that he didn't deserve an NGRI in the first place, but because he is no longer a danger to others due to his health condition he has to be released.

[SarahMaria, MSN, RN]

I also work in a maximum security forensic psychiatric hospital on a long-term unit, not admissions. Most of my patients are NGRI. I agree with you that individuals with primary diagnoses of PTSD or, no real psych diagnosis at all, should not receive NGRI and should be in prison. Some of my NGRI patients take no psych meds which just doesn't seem right. I believe that patients who are truly mentally ill, take psych medications, and didn't know that what they were doing was wrong, should receive NGRI because they need the treatment. The sociopaths and malingerers usually do not meaningfully participate in treatment and will not get better, so they should be incarcerated in prison.

NGRI is historically a very unsuccessful defense, less than 1/10 of 1% are successful. It seems amazing that so many seem to fake it.

[EKUGRAD, BSN, MSN, RN, CNS]

I also work in a maximum security forensic psychiatric hospital on a long-term unit, not admissions. Most of my patients are NGRI. I agree with you that individuals with primary diagnoses of PTSD or, no real psych diagnosis at all, should not receive NGRI and should be in prison. Some of my NGRI patients take no psych meds which just doesn't seem right. I believe that patients who are truly mentally ill, take psych medications, and didn't know that what they were doing was wrong, should receive NGRI because they need the treatment. The sociopaths and malingerers usually do not meaningfully participate in treatment and will not get better, so they should be incarcerated in prison.

NGRI is historically a very unsuccessful defense, less than 1/10 of 1% are successful. It seems amazing that so many seem to fake it.

I hope my take on reading this is wrong. Are you saying that PTSD, Post-Traumatic Stress DISORDER, is not a legitimate mental illness with psychiatric diagnosis? It seems that you are placing sociopaths, malingerers and PTSD patients together as not really mentally ill. I volunteer weekly to facilitate a PTSD recovery group at my local V.A. (V.A. can't afford to offer it but that's another story) and when these guys are truly living in a flashback, they are really in an altered reality, internally responsive, where wrong may be right and down may be up. Meds are marginally effective early in treatment, usually to treat transient depression or "Survivor's Guilt". Personality disorders cannot easily be diagnosed or quickly treated inpatient anyway. That's like trying to treat alcoholism in a bar.

I have done this line of work a long time and find that, for the most part, only the symptoms of pedophilia and pyromania cannot be controlled by meds or therapy.