The "insane criminal" is a person who has become insane after the commission of a crime for which the person has been found guilty or for whom insanity is not sufficiently integral to the offense to yield a verdict of not guilty by reason of insanity. The "criminally insane" person has been judged by a court or appropriate State officials to be not guilty of a crime because the harmful behavior stemmed from mental illness. The "insane criminal" is under sentence for a crime, and all mental health services rendered must take this into account. The health care services must be either rendered in the prison context or in secure facilities outside the prison. The latter approach poses significant problems. Modern mental health professionals also recommend against mixing noncriminal mentally ill persons with mentally ill criminals. A number of States have built mental health facilities specifically for insane criminals. The criminally insane are legally not criminals and are not under a sentence. Their commitment to a mental hospital is done under civil procedures. Their behavior, however, may still pose a threat to themselves and others. Although not legally criminals, they may behave like criminals. This poses special problems for housing and managing the criminally insane. 22 references