Mental Health Defenses in California: What You Need to Know

September 30, 2025
Brownstein Law Group

In California, one out of every seven adults is living with a mental illness. Over the years, advances in treatments and decreased social stigma around mental health have made diagnosing and treating mental illnesses much easier. However, mental illnesses can still create issues in the criminal justice system. 

This article answers questions such as “When is a mental health diagnosis a complete defense to a crime?” and “When can a mental health issue help a defendant qualify for a diversion program?” It also discusses how mental health issues can affect the sentence in a criminal case. Finally, it explains how a Marin County criminal defense lawyer can help you or your loved one with mental health issues in a criminal case. 

Criminal Defenses in California

Each crime in the California Penal Code has a list of factors that must be present for a person to be convicted of that crime. At trial, the prosecutor must prove – beyond a reasonable doubt – that the defendant did each one of those things – and that their mind was in the proper state when they did. If they succeed, the defendant will be convicted. 

A criminal defense is a way for a defendant to attack the state’s case by creating doubt in the minds of the jurors. A special category of defenses called affirmative defenses can help defendants completely avoid conviction. There are two types of affirmative defenses: justification and excuse. 

In a justification defense, the defendant basically says, “I did the crime, but I had a good reason.” Self-defense is a justification defense. In an excuse defense, the defendant argues, “I committed a crime, but I cannot be held responsible for my actions.” Most mental health defenses fall under the excuse category. 

California’s Insanity Defense 

California allows defendants to raise the insanity defense. While the prosecutor is responsible for proving the crime, the defendant is responsible for putting on evidence of this affirmative defense. But while the state must prove its case beyond a reasonable doubt, the defendant only has to prove their insanity defense by a preponderance of the evidence. 

To prove the insanity defense, a California defendant must prove two things: 

  1. That they were under the effect of a mental illness at the time of the crime, and 
  2. The mental illness prevented them from understanding the nature and quality of their actions at the time or their ability to understand right from wrong. 

Many serious mental health issues, such as schizophrenia or bipolar disorder with psychotic features, can support an insanity defense in California. If there is proof that the condition directly affected the defendant’s ability to understand what they were doing or know that they were doing something wrong, the defense may succeed. But criminal defendants should make note of two things.

First, California law states that conditions based on “a personality or adjustment disorder, a seizure disorder, or an addiction to, or abuse of, intoxicating substances” cannot be the sole basis of an insanity claim. People with these conditions must show something in addition to their mental illness – such as hallucinations or delusions – before their insanity defense can succeed. Your Marin County defense attorney can tell you more. 

Second, you may have heard the term “temporary insanity” in movies or television shows, but the reality is more complex. Feelings of anger or jealousy – no matter how strong – cannot support an insanity defense. However, California courts have allowed the defense to proceed when a defendant’s mental health issues were temporary rather than permanent, such as brief psychosis brought on by a new prescription drug. 

A successful insanity defense leads to a verdict of Not Guilty by Reason of Insanity (NGRI). The defendant will not have a criminal record. But contrary to popular belief, an NGRI verdict does not allow a person to go free. Instead, the defendant must live in a state hospital and undergo treatment. The maximum term of hospitalization is the same as the maximum jail term for the crime, but it can be extended if a judge finds that the defendant still poses a danger to the public. On the other hand, an NGRI defendant can be released or sent to outpatient treatment if a judge rules that their mental illness is no longer an issue. 

Important Note: Insanity vs. Incompetency 

People sometimes confuse insanity and incompetence, but they are very different. Insanity considers the defendant’s mental state when the crime happened, while incompetency looks at the defendant’s mental abilities at the time of trial. Specifically, the judge will determine whether the defendant’s mental illness might prevent them from understanding the trial process or assisting in their defense. Additionally, if a person is found incompetent, the trial is paused until they are able to stand trial. If a person is found NGRI, they are committed to a hospital as previously noted. 

Other Ways That Mental Health Issues Can Affect California Criminal Cases 

Insanity is the only true mental health defense in California because it is the only one that completely prevents a criminal conviction. However, there are other circumstances where mental health conditions can result in reduced charges or other favorable outcomes. 

  • Diminished actuality. Many crimes require that a person take an action with a particular purpose in mind. For example, burglary requires that a person enter a building with the intent to commit a felony once inside. Lawyers call this “specific intent.” The diminished actuality doctrine allows defendants to introduce evidence of their mental illness to show that they did not act with the required specific intent. 
  • Diversion. In pretrial diversion, the judge pauses the case until the defendant completes certain programs or milestones. If the defendant successfully completes the program, the case is dismissed. 

California law allows defendants to ask for diversion to undergo mental health treatment. The requirements are complex, so be sure to ask your Marin County criminal defense lawyer. In felony cases, a diverted case can be paused for up to two years. During the diversion period, the defendant’s treatment providers will provide regular progress reports to the court. 

Note: California has special diversion programs for veterans with service-related mental health conditions such as posttraumatic stress disorder (PTSD). Your defense attorney can tell you more. 

  • Sentencing. California’s court rules require that judges consider the circumstances of the crime as well as the defendant’s personal characteristics during sentencing. This analysis includes the defendant’s mental health. The judge must take the defendant’s mental health conditions into consideration even when they cannot fully support an insanity defense. 

Get Legal Help With Your Criminal Case 

Depending on the circumstances, California law allows defendants to use mental health issues in many ways. But to mount a proper defense or take advantage of programs like diversion, you’ll need legal help. If you need help with a criminal case in San Francisco or Marin County, contact Brownstein Law Group. Our attorneys have the experience and the drive to help you mount the best possible defense. Call 415-795-9059 or use our online form to learn how Brownstein Law can help you fight for your freedom.