A forensic psychiatrist has weighed in on what an "insanity defense" could mean for Luigi Mangione's legal proceedings.
As widely reported, the 27-year-old Ivy League graduate was arrested after being linked to the murder of UnitedHealthcare CEO Brian Thompson.
Thompson was fatally shot on December 4, 2024, outside the Hilton Hotel in New York City while walking to an insurance conference hosted by his company.
The assailant fled the scene on a bike, riding it into Central Park. The shooting prompted an intense manhunt.
Mangione was apprehended on December 9 after a McDonald’s employee in Altoona, Pennsylvania, reported seeing a man who matched the shooter’s description.
After the suspect's arrest, he was flown to New York under tight security, with heavily armed police and a media entourage waiting for his arrival.
Judge dismisses the most serious charge against Mangione
Mangione's trial took a significant turn in Lower Manhattan this week when a judge dismissed two charges of terrorism related to Thompson's murder.
Judge Gregory Carro ruled that there was insufficient evidence to support claims that the accused shooter's actions were terroristic.
"The People presented sufficient evidence that the defendant murdered Brian Thompson in a premeditated and calculated execution. That does not mean, however, that the defendant did so with terroristic intent," Judge Carro said, per ABC7.
Mangione’s defense team had argued for the dismissal of state charges, citing double jeopardy due to his federal charges, which include the potential for the death penalty.
Possible Insanity Defense: What It Could Mean for the Trial
As the trial progresses, one of the key legal strategies under consideration is an insanity defense.
Forensic psychiatrist Dr. Amanda Goldstein took to TikTok to discuss what this could entail for Mangione's case.
She explained that if his defense team pursues an insanity defense, it would first require an evaluation to determine whether he is competent to stand trial.
Dr. Goldstein further explained that if Mangione were found to be "insane," he would likely be required to undergo treatment with antipsychotic medications to stabilize his mental state, which could take "several weeks".
She also noted that the medication usually comes with "unpleasant side effects," adding that once Mangione's condition stabilized, he would be re-assessed to see if he could return to a rational state to stand trial.
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Outside the courthouse, Mangione has garnered a considerable following, as his online fundraiser has amassed over $1 million in donations, NBC News reported.
Despite the dismissal of the terrorism charges, he still faces significant legal challenges, including the second-degree murder charge.
As the case moves forward, legal experts, including former prosecutor Michael Bachner, expect the possibility of an insanity defense to play a key role in Mangione’s defense strategy.
"Or it's going to be something called extreme emotional disturbance defense where, I'm not insane, in a legal sense, but I was under some type of extreme emotional disturbance that prevented me from creating the intent necessary to commit an intentional murder," Bachner shared.