Not guilty by reason of insanity (NGRI): Adjudication, clinical outcomes and rehabilitation

Criminal responsibility has long been determined based on two critical elements: the guilty act (actus reus) and the guilty mind (mens rea). Within this context, mental illness has been identified as one of the critical elements which could impair mens rea and the responsibility has been given to mental health experts to assist the court in determining the contribution of abnormal mental states to criminal conduct in cases involving the insanity defense. In this chapter, we will examine the jurisdictional differences in the specific provisions of the insanity defense across Africa and consider critical lessons that may be learned from shared experiences. The challenges raised by indefinite incarceration because of NGRI verdicts in some cases as well as post-discharge re-integration within resource-constrained settings in Africa will also be highlighted.