One thing I learned about mentally ill criminals is....just because they are mentally ill, don't make them mentally stupid. I think that applies to nearly all the mentally ill people in the world. Nearly all the mentally ill criminals I dealt with, understood clearly the difference between right and wrong, even if they were not taking their medication. And it is not a strange fact that mentally ill criminals will use their mental illness as an excuse, just the way people uses PTSD or post partum or whatever they can grab on to as a mitigation.

During my time, we had several inmates who were "unfit to stand trial". Such individuals were placed in the mental health ward and it was the responsibilities of the mental health staff of that ward to bring such individual back up to speed. Success rate was quite remarkable.

Charles Meach helped change the law so when he murdered the four kids at Russian Jack, he faced prison time instead of API time which he got with his first murder.