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When the tests set out by the Rules are satisfied, the accused may be adjudged "not guilty by reason of insanity" or "guilty but insane" and the sentence may be a mandatory or discretionary (but usually indeterminate) period of treatment in a secure hospital facility, or otherwise at the discretion of the court (depending on the country and the offence charged) instead of a punitive disposal.The insanity defence is recognized in Australia, Canada, England and Wales, Hong Kong, India, the Republic of Ireland, New Zealand, Norway and most U. states with the exception of Idaho, Kansas, Montana, Utah, and Vermont An 18 year-old girl with agitated depression successively had her upper and lower molars extracted, a tonsillectomy, sinus drainage, treatment for an infected cervix, removal of intestinal adhesions—all without effecting improvement in her psychiatric condition.However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement. For the landmass comprising North, Central and South America, see Americas.There must be evidence of recent behavior to justify the substantial likelihood of serious bodily harm in the near future.Moments in the past, when an individual may have considered harming themselves or another, do not qualify the individual as meeting the criteria.

The involuntary outpatient placement language in the Baker Act took effect as part of the Baker Act reform in 2005.

The state of Hawaii is an archipelago in the mid-Pacific Ocean. The extremely diverse geography, climate, and wildlife of the United States make it one of the world's 17 megadiverse countries. The United States emerged from the thirteen British colonies established along the East Coast.

Numerous disputes between Great Britain and the colonies following the French and Indian War led to the American Revolution, which began in 1775, and the subsequent Declaration of Independence in 1776.

"that every man is to be presumed to be sane, and...

that to establish a defense on the ground of insanity, it must be clearly proved that, at the time of the committing of the act, the party accused was laboring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or if he did know it, that he did not know he was doing what was wrong." have been a standard test for criminal liability in relation to mentally disordered defendants in common law jurisdictions ever since, with some minor adjustments.

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