Biases & Vulnerabilities

Mental Illness

There is no categorical ban on the execution of people with mental illness. A small number of states have laws that create an exemption for some seriously mentally ill defendants.

Resources on Severe Mental Illness and Death Penalty

Resources on Severe Mental Illness and Death Penalty

American Bar Association Death Penalty Due Process Review Project

DPIC Report: Battle Scars

DPIC Report: Battle Scars

Military Veterans and the Death Penalty (Features information on PTSD and other combat-related mental health problems)

Overview

The U.S. Supreme Court has said a defendant’s mental illness makes him or her less morally culpable and must be taken into consideration as an important reason to spare his or her life. However, as was initially the case with intellectual disability and young age, the Court has not barred the death penalty for those with serious mental illness. When the Court prohibited the death penalty for the intellectually disabled and for juveniles, it found that they were members of identifiable groups who have diminished responsibility for their actions and hence should not be considered the worst and most culpable defendants. Many mental health experts believe that people with severe mental illness such as schizophrenia and bipolar disorder may have similar cognitive impairments that interfere with their decision-making. The American Psychiatric Association and the American Bar Association, among others, have called for a ban on the death penalty for those with severe mental illness.

Some defendants are so mentally ill as to lack all understanding of their crime and its consequences and may be considered mentally incompetent. Such individuals may be unfit to stand trial or be found not guilty by reason of insanity. If they are convicted and become incompetent while on death row, they cannot be executed, under earlier Supreme Court precedent. However, most people with mental illness — including many with severe mental illness — are not mentally incompetent.

Mental health issues have broad impact in death-penalty cases. One in ten prisoners executed in the United States are “volunteers” — defendants or prisoners who have waived key trial or appeal rights to facilitate their execution. Mental illness also affects defendants’ decisions to represent themselves, their ability to work with counsel, and jury’s perceptions of their motives and whether they pose a future danger to society if they are sentenced to life in prison.

At Issue

There are at least three hurdles to excluding the severely mentally ill: 1. Unlike age and intellectual ability, it is difficult to define the class of mentally ill defendants who should be exempted and to determine whether their illness affected their judgment when they offended. 2. States have so far been reluctant to adopt such bans, though society continues to evolve in terms of its understanding of mental illness. 3. The membership of the Supreme Court has shifted since some of the earlier exemptions were decided. Nevertheless, the prior decisions could serve as important precedents, capable of being extended to the mentally ill.

What DPI Offers

DPI has tracked the various state legislative efforts to address the mental illness issue. It frequently highlights instances in which mentally ill defendants receive unfair death-penalty trials, face execution, or have been granted clemency or other relief. It also gathers statements from relevant leaders in the mental health field regarding this issue.

News & Developments


News

Sep 24, 2026

William Thompson Faces Execution in Florida Amid Dementia, Terminal Illness Concerns

UPDATE: On September 25, counsel for William Thompson filed a new federal lawsuit in the Middle District of Florida, accusing several state actors and prison healthcare providers of denying Mr. Thompson of his “constitutional right to adequate medical care.” The lawsuit does not challenge Mr. Thompson’s death sentence or scheduled execution but rather asks the federal court to require that the named officials provide constitutionally required medical care for Mr. Thompson. The lawsuit asks for…

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News

Jul 28, 2026

Article of Interest: Former Tennessee Execution Official Calls on Governor to Pause Executions in Consideration of the Trauma that the “Chaotic” Process Inflicts on Staff

Prompted by the recent botched execution attempt of Tony Carruthers, a former Tennessee execution official is pleading with Governor Bill Lee to pause executions in the state. In his detailed account, Ian Congleton described how his participation in executions left him with lasting post-traumatic stress disorder, anxiety, and depression. In his op-ed in The Tennessean, he ascribed his trauma to “the chaos surrounding how executions were handled and the feeling that, unless TDOC [Tennessee…

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News

May 20, 2026

130,000 People Urge Clemency for Tony Carruthers in Advance of Tennessee’s Planned Execution

Absent court action, Tony Carruthers is scheduled to be executed in Tennessee on May 21, 2026, despite untested DNA evidence, an innocence claim, and serious mental illness concerns. On May 18, faith leaders, civil rights advocates and community members marched to the state capitol to urge Governor Bill Lee to grant Mr. Carruthers clemency or stay his execution to allow additional DNA testing, delivering a petition with over 130,000 signatures. Gov. Lee announced on May 19 that he has no plans…

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News

May 07, 2026

South Carolina Judge Rules Death-Sentenced Prisoner John Wood Not Competent for Execution

A South Carolina circuit court judge has found that death-sentenced prisoner John Wood cannot be executed because of his severe schizophrenia. The constitutional thresholds established by the U.S. Supreme Court in Ford v. Wainwright (1986) and clarified in Panetti v. Quarterman (2007) and Madison v. Alabama (2018) determine that a prisoner may not be executed if they are unable to rationally understand the reason they are being put to death. Judge Grace Knie issued a 12-page written decision on…

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News

Apr 20, 2026

Texas Death Sentence Vacated for Mentally Ill and Intellectually Disabled Man After Half-Century on Death Row — And Nearly 40 Years Without a Lawyer

By the time 21-year-old Clarence Curtis Jordan shot a man during a grocery store burglary in 1977, he had been struggling for most of his life with hallucinations and intellectual deficits. His IQ score placed him in the bottom 0.5% of the population. He identified the president as “John Hill” and said he often saw “old, weird, burnt-up looking people” watching him. The Texas Court of Criminal Appeals (TCCA) found him incompetent to be executed in 1988. But Mr. Jordan then fell through the…

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