Policy Issues

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

American Bar Association Death Penalty Due Process Review Project

DPIC Report: Battle Scars

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


The U.S. Supreme Court has said a defendant’s mental illness makes him or her less morally culpability 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 DPIC Offers

DPIC 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


Apr 03, 2023

NEW VOICES: Former Florida Prison Psychiatrist Criticizes the Execution of Mentally Ill Prisoners

Dr. Joseph Thornton, a psy­chi­a­trist who for­mer­ly treat­ed death row pris­on­ers as the med­ical direc­tor of a Florida max­i­mum secu­ri­ty prison, called for an end to the death penal­ty for those with severe men­tal ill­ness: We should not be exe­cut­ing any­one, let alone the sick and the bro­ken,” he said. As some­one with over 40 years’ expe­ri­ence see­ing patients with seri­ous men­tal ill­ness who are stig­ma­tized, ostra­cized and blamed for their symp­toms, I believe that recov­ery care, not ostra­ciza­tion, respects life and saves lives.”

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Sep 29, 2023

Federal District Court Finds Scott Panetti Not Competent for Execution

On September 28, 2023, the Western District Court of Texas ruled that the state can­not exe­cute Scott Panetti (pic­tured), a death row pris­on­er with a decades-long his­to­ry of seri­ous men­tal health issues and a diag­no­sis of schiz­o­phre­nia. Despite a state expert con­ced­ing Mr. Panetti’s seri­ous men­tal ill­ness, Texas argued that he is com­pe­tent to face exe­cu­tion because he has some degree” of ratio­nal under­stand­ing. U.S. District Judge Robert Pitman ruled, how­ev­er, that “[Mr.] Panetti is not sane enough to be exe­cut­ed” and that he lack[s] a ratio­nal under­stand­ing of the…

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Sep 28, 2023

Guantanamo Bay Judge Rules 9/​11 Capital Defendant Mentally Incompetent to Stand Trial

On September 21, 2023, a mil­i­tary judge in Guantanamo Bay ruled that Ramzi Bin al Shibh, one of five defen­dants in the 9/​11 case for whom the death penal­ty is being sought, is men­tal­ly incom­pe­tent to stand tri­al. Mr. Bin al Shibh, who has been detained for 21 years, will remain in cus­tody at Guantanamo as author­i­ties attempt to treat the post-trau­mat­ic stress dis­or­der caused when he was forced to under­go enhanced inter­ro­ga­tions” by the U.S. government.

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Sep 07, 2023

9/​11 Victims’ Family Members, Members of Congress Urge Biden Administration to Abandon Plea Negotiations with Guantanamo Detainees

Family mem­bers of some of the vic­tims of 9/​11 have asked the Biden Administration to aban­don cur­rent plea nego­ti­a­tions with Guantánamo detainees that would remove the pos­si­bil­i­ty of death sen­tences for the men accused of plan­ning the 9/​11 ter­ror attacks. Khalid Shaikh Mohammed and his four co-defen­dants have been held for more than twen­ty years, first at CIA black sites where they were sub­ject to enhanced inter­ro­ga­tion tech­niques” and then at Guantánamo, but none has pro­ceed­ed to tri­al. The request came after fam­i­ly mem­bers were noti­fied by the Pentagon on August…

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Sep 05, 2023

Sole Woman on Tennessee Death Row, Age 18 at Time of Crime, Raises New Appeal Based on Youthfulness

Attorneys for Christa Pike, the only woman on Tennessee’s death row, filed a motion on August 30 to re-open her appeals based on a recent deci­sion from the Tennessee Supreme Court. In 2022, the Court ruled in State v. Booker that manda­to­ry life sen­tences in homi­cide cas­es are uncon­sti­tu­tion­al when imposed on juve­niles, draw­ing on U.S. Supreme Court prece­dent that held that juve­niles are less mature, more vul­ner­a­ble to peer pres­sure, and gen­er­al­ly less cul­pa­ble than adults. Ms. Pike’s attor­neys argue that Bookers rea­son­ing applies to all youth­ful defen­dants, not…

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Aug 15, 2023

Charles Ogletree, Death Penalty Scholar and Criminal Defense Advocate, Dies at 70

Charles Ogletree, Jr., a pas­sion­ate advo­cate for racial and crim­i­nal jus­tice, died on August 4, 2023, after a long ill­ness. As a tenured pro­fes­sor at Harvard University, Professor Ogletree spoke and wrote often about the death penal­ty and men­tored many stu­dents, includ­ing both Barack and Michelle Obama. In a 2014 Washington Post op-ed, he crit­i­cized the use of the death penal­ty in the United States, par­tic­u­lar­ly for peo­ple with severe men­tal ill­ness, brain impair­ments, or who suf­fer from the effects of severe trau­ma. He not­ed that bar­ring the death penalty…

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Aug 01, 2023

8th Circuit Lift Stay of Execution for Death-Sentenced Missouri Prisoner with Schizophrenia

On July 29, 2023, the 8th Circuit Court of Appeals lift­ed a tem­po­rary stay of exe­cu­tion that had been issued for Johnny Johnson, a death-sen­tenced pris­on­er in Missouri. Mr. Johnson’s attor­neys allege that he is insane and there­fore inel­i­gi­ble for exe­cu­tion. Barring a last-minute stay from the U.S. Supreme Court, Mr. Johnson will be exe­cut­ed by lethal injec­tion on August 1, 2023, for the 2002 killing of 6‑year-old Casey Williamson.

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Jul 28, 2023

Louisiana Pardon Board Declines to Consider 56 Death Row Clemency Petitions Without Merits Review

On July 24, 2023, the Louisiana Board of Pardons and Parole set aside all 56 clemen­cy appli­ca­tions filed by near­ly every death-sen­tenced pris­on­er in Louisiana last month with­out review­ing the mer­its of a sin­gle one of them. The pris­on­ers asked for their sen­tences to be com­mut­ed to life with­out parole, but the Board made its deci­sion to return the appli­ca­tions based on an advi­so­ry, non­bind­ing opin­ion from the Louisiana Attorney General Jeff Landry. Attorneys for death row pris­on­ers have respond­ed by argu­ing that the Attorney General’s office mis­in­ter­pret­ed the language…

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Jul 24, 2023

Florida Man with Severe Mental Illness Waives Appeals, Faces August 3rd Execution Date

A week after Governor Ron DeSantis sched­uled his exe­cu­tion, Florida death-sen­tenced pris­on­er James Barnes (pic­tured) dis­charged his lawyers and waived his appeals. His exe­cu­tion will now pro­ceed on August 3, 2023. Since February 23, 2023, Florida has exe­cut­ed four pris­on­ers. Mr. Barnes will be the fifth pris­on­er exe­cut­ed by Florida this year and the tenth vol­un­teer executed. 

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