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Insanity, madness, lunacy, and craziness are caused by certain abnormal mental or behavioral patterns. Insanity can manifest as violations of societal norms, including a person or persons becoming a danger to themselves or to other people. Conceptually, mental insanity also is associated with the biological phenomenon of Infection (that mental illness is infectious) as in the case of . In contemporary usage, the term insanity is an informal, un-scientific term denoting "mental instability"; thus, the term insanity defense is the legal definition of mental instability. In medicine, the general term psychosis is used to include the presence of and/or in a patient;M A Papadakis L M Tierney, S J McPhee (2025). 9780071376884, Lange Medical Books/McGraw-Hill. ISBN 9780071376884 and psychiatric illness is "psychopathology", not mental insanity., David Shankbone, Wikinews, 5 October 2007.
In English, the word "sane" derives from the Latin adjective sanus, meaning "healthy". Juvenal's phrase mens sana in corpore sano is often translated to mean a "healthy mind in a healthy body". From this perspective, insanity can be considered as poor health of the mind, not necessarily of the brain as an organ (although that can affect mental health), but rather refers to defective function of mental processes such as reasoning. Another Latin phrase related to our current concept of sanity is compos mentis ("sound of mind"), and a euphemistic term for insanity is non compos mentis. In law, mens rea means having had criminal intent, or a guilty mind, when the act ( actus reus) was committed.
A more informal use of the term insanity is to denote something or someone considered highly unique, passionate or extreme, including in a positive sense. The term may also be used as an attempt to discredit or criticize particular ideas, beliefs, principles, desires, personal feelings, attitudes, or their proponents, such as in politics and religion.
During the 18th century, the French and the British emphasised a need for humane treatment of the clinically insane, though the criteria for diagnosis and placement in an asylum were considerably looser than today, often including such conditions as speech disorder, speech impediments, epilepsy, and depression or being pregnant out of wedlock.
Europe's oldest asylum was the precursor of today's Bethlem Royal Hospital in London, known then as Bedlam, which began admitting the mentally ill in 1403 and is mentioned in Geoffrey Chaucer's Canterbury Tales. The first United States asylum was built in Williamsburg, Virginia, circa 1773. Before advancements in therapeutic treatment during the 19th and 20th century, these hospitals were moreso used to isolate the ostracised mentally ill from society rather than cure them or maintain their health. Pictures from this era frequently portray patients bound with rope or chains, often to beds or walls, or restrained in .
Most courts accept a major mental illness such as psychosis but will not accept the diagnosis of a personality disorder for the purposes of an insanity defense. The second question is whether the mental illness interfered with the defendant's ability to distinguish right from wrong. That is, did the defendant know that the alleged behavior was against the law at the time the offense was committed.
Additionally, some jurisdictions add the question of whether or not the defendant was in control of their behavior at the time of the offense. For example, if the defendant was compelled by some aspect of their mental illness to commit the illegal act, the defendant could be evaluated as not in control of their behavior at the time of the offense.
The forensic mental health specialists submit their evaluations to the court. Since the question of sanity or insanity is a legal question and not a medical one, the judge and or jury will make the final decision regarding the defendant's status regarding an insanity defense.
In most jurisdictions within the United States, if the insanity plea is accepted, the defendant is committed to a psychiatric institution for at least 60 days for further evaluation, and then reevaluated at least yearly after that.
Insanity is generally no defense in a civil lawsuit, but an insane plaintiff can toll the statute of limitations for filing a suit until gaining sanity, or until a statute of repose has run.
One famous example of someone feigning insanity is American Mafia boss Vincent Gigante, who pretended for years to be suffering from dementia, and was often seen wandering aimlessly around his neighborhood in his pajamas muttering to himself. Testimony from informants and surveillance showed that Gigante was in full control of his faculties the whole time, and ruled over his Mafia family with an iron fist.
Today feigned insanity is considered malingering. In a 2005 court case, United States v. Binion, the defendant was prosecuted and conviction for obstruction of justice (adding to his original sentence) because he feigned insanity in a Competency to Stand Trial evaluation.
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