Mentally disordered offenders: Clinical, political and legal developments in the United States

Australians with only passing knowledge of what transpires on the other side of the Pacific are probably aware that law in the United States is neither a stagnant nor a very stable enterprise. Where it intersects with the business of psychiatry, the law’s in‐flux character is especially pronounced. The last decade or so has seen as much change as any, as the law has sought to keep pace with advances in medical theory and technology and with psychiatric reconceptualizations that have affected both the diagnosis and treatment of mental disorders. “Keeping pace” means not just the incorporation of what is new, but sometimes also its rejection (not to mention its exploitation or distortion for partisan legal gain or to accommodate the winds of political change). A review of the more significant legal changes shows the various ways whereby the law has sought to accommodate new developments in psychiatric medicine.