Abstract
There have been substantial developments in mental health law in the United States over the last 10–15 years. One focal point has been the insanity defence, discussed here. The operational consequences of the legal changes remain to be assessed empirically, but informed speculation is possible. Both a description of the reforms and the assessment of their potential effect are relevant to members of the psychiatric profession in Australia, whether they be forensic specialists or traditional practitioners or researchers. Selective consideration of the American experience, as opposed to contemplating wholesale transposition, is the appropriate posture for Australian policymakers.