hold persons responsible for their acts when they do not know, or can't control what they're doing" (p. 16). However, acquittal of MDOs by reason of insanity has for centuries generated intense public misgivings. So long as doubt exists that MDOs, especially those who commit violent crimes, can be cured, "courts will go on sending psychopaths to prison as a punishment rather than to psychiatrists for a cure" (Hibbert, pp. 219-220). Many nonviolent MDOs are treated the same as common (mentally healthy) criminals.
According to Menninger (1968), "no one a hundred years ago believed mental illness to be curable" (p. 258). Advances in medical treatment of mentally ill persons have enabled authorities in developed countries to consider alternatives to conventional criminal punishment of MDOs; however, in most of Asia, Africa and Latin America the scarcity of psychiatrists, funds and facilities for treating MDOs condemns them to relative oblivion. For example, according to Liu (2000), despite the enormous economic progress China has made in the past quarter century, less than 11,570 psychiatrists serve more than a billion people (up from 100 in 1950) (p. 129). He said the treatment choices of mentally ill patients and their families in China are largely confined to traditional healers and witch doctors (p. 128). In many parts of the less developed world, MDOs languish untreated in jails and prisons, as the United Nations has documented (United Nations Interregional Care and Justice Institute, 1993).
The Circular American Approach to MDOs
Pre-20th century treatment. According to Harrington (1999, May), "it was a widespread practice in eighteenth-century America to house insane paupers, . . . in jails and poorhouses" (p. 10). However, as American society became less agricultural and rural and more industrial and urban, correctional system reformers such as Dorothea Dix urged that MDOs be segregated from society and that incarceratin...