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NGRI Commitment Pathways
There are three potential pathways a judge can order at the commitment hearing following a Not Guilty by Reason of Insanity (NGRI) verdict, depending on the individual’s clinical needs, level of risk, and treatment recommendations. As outlined in 730 ILCS 5/5-2-4 and reflected in the flow chart, potential pathways include:
- Pathway 1: Absolute Discharge is ordered when the individual is found not in need of mental health services and is released from custody with no further IDHS involvement.
- Pathway 2: Conditional Release is ordered when the individual needs outpatient mental health services, including treatment and monitoring of the conditions of release.
- Pathway 3: Secure Inpatient Treatment is ordered when the individual needs mental health services and requires inpatient care due to a risk of serious physical harm to themselves or others.
IDHS qualifies discharge as absolute to denote discharge from custody and subsequently no involvement from IDHS. The treatment team may recommend step down from pathway 3 secure inpatient treatment to pathway 2 conditional release. Less frequently, the States Attorney may petition and judge approve a revocation of conditional release and increase supervision of treatment in a secure inpatient setting. The period leading up to commitment for treatment followed by the three possible pathways are outlined below from least restrictive to most restrictive.
Period Leading Up to Commitment for Treatment
Index Offense, Insanity Defense, NGRI Verdict
In Illinois, the commitment of an individual found NGRI is not automatic. An individual found NGRI may be confined to a mental health facility only if they are committed pursuant to the statutes 725 ILCS104-25(c) or 725 ILCS 115-3/4 set forth in 730 ILCS 5/5‑2‑4.
Evaluation Ordered 730 ILCS 5/5-2-4(a)
After a finding or verdict of Not Guilty by Reason of Insanity the individual is ordered to the Illinois Department of Human Services for an evaluation as to whether he or she is in need of mental health services.
The evaluation order shall specify whether the commitment evaluation shall be conducted on an inpatient or outpatient basis.
Documentation Sent: 730 ILCS 5/5-2-4(a)
Within 5 days of the evaluation order, the Circuit Court shall submit the order finding NGRI as well as the following support documentation pursuant to statute:
- Arrest report
- Criminal charges
- Arrest record
- Jail record
- Any report prepared under section 725 ILCS 5/115-6 of the Code of Criminal Procedure of 1963 (i.e., examination reports by clinical experts)
- Any statement prepared under Section 6 of the Rights of Crime Victims and Witnesses Act.
Supporting documentation is due within 5 days of the evaluation order.
Pre-Placement Evaluation (Inpatient Only): 730 ILCS 5/5-2-4(a)
If the court orders that the commitment evaluation must be completed on an inpatient basis, IDHS first completes a pre-placement evaluation to determine the appropriate hospital for that commitment evaluation to take place. In other words, the pre-placement evaluation is not the commitment evaluation itself, but a preliminary step.
Upon receipt of that notice, the sheriff promptly transports the individual to the designated facility. The individual remains in jail during the period of time required to determine appropriate placement.
Within 20 days of inpatient evaluation order, IDHS notifies the sheriff of the designated facility where the evaluation will be completed.
Commitment Evaluation: 730 ILCS 5/5-2-4(a)
If the court order allows the commitment evaluation to occur on an outpatient basis, or does not specify that inpatient placement is required, IDHS generally proceeds directly with the commitment evaluation.
Commitment Evaluation Report is due within 30 days of the evaluation order.
Commitment Hearing: 730 ILCS 5/5-2-4(a)
The court holds a hearing, as provided under the Mental Health and Developmental Disabilities Code to determine if the individual is:
- In need of mental health services on an inpatient basis means:
“a defendant who has been found not guilty by reason of insanity but who, due to mental illness, is reasonably expected to inflict serious physical harm upon himself or another and who would benefit from inpatient care or is in need of inpatient care” 730 ILCS 5/5-2-4(a),(a-1)(B).
- In need of mental health services on an outpatient basis means:
“a defendant who has been found not guilty by reason of insanity who is not in need of mental health services on an inpatient basis, but is in need of outpatient care, drug and/or alcohol rehabilitation programs, community adjustment programs, individual, group, or family therapy, or chemotherapy.” 730 ILCS 5/5-2-4(a),(a-1)(C).
- Not in need of mental health services: An individual who does not meet criteria for involuntary admission.
Following the hearing, and if mental health services are needed, the court issues an order to IDHS for outpatient treatment under conditional release or secure inpatient treatment.