Most states have long recognized a form of the insanity defense, based on the defendant’s mental illness, defect, or inability to understand that the criminal act was wrong. In pleading an insanity defense, the defendant admits the criminal conduct, but asserts a lack of culpability based on mental illness. Many states still model their insanity defense on the old English rule of law (the M’Naghten rule from 1843) in which the defendant asserts he (1) did not know the nature and quality of the act, or (2) did not know that it was wrong.

And it is an affirmative defense to a prosecution under any federal statute (federal law) that, at the time of the offense, the defendant was unable to appreciate the nature and quality of his acts, or the wrongfulness of his acts. See 18 U.S.C. §17.

When a defendant is found not guilty by reason of insanity it does not mean he necessarily goes free. States often have requirements for treatment or institutionalization after such a finding. And some states require, at a minimum, confinement in a treatment institution or facility for the length of time the person would have received if convicted—so a defendant may end up spending more time confined than if he did not raise such a defense.

The law regarding the availability, definitions, and nature of the insanity defense vary from state to state, and are usually located in a state’s statutes.

In Utah, the insanity defense is recognized and allows a defendant to claim they were not responsible for their actions due to mental illness at the time of the offense. Utah follows a modified version of the M'Naghten rule, which requires the defendant to prove that they either did not understand the nature of their actions or did not understand that their actions were wrong due to a mental defect. This is codified in Utah Code Ann. § 76-2-305. If a defendant successfully pleads insanity, they are not simply released; instead, they may be committed to a mental health institution. The period of commitment is determined by the court and may be equivalent to or longer than the prison sentence that would have been imposed if the defendant had been convicted. Additionally, under federal law, specifically 18 U.S.C. § 17, an affirmative defense is available if the defendant was unable to appreciate the nature and quality or the wrongfulness of their acts due to a mental condition at the time of the offense. The application of the insanity defense and subsequent treatment or institutionalization requirements are complex and typically require the expertise of an attorney to navigate.