DIFFICULTIES IN DEFINING INSANITY, APPLYING THE DEFENSE, AND DEALING WITH INSANITY DEFENSE ACQUITTEES RAISE ISSUES THAT BRING THE EFFICACY AND MORAL NECESSITY OF THE INSANITY DEFENSE INTO QUESTION. THE RELATED ISSUE OF WHETHER THE INDEFINITE CONFINEMENT OF INDIVIDUALS TO INVOLUNTARY MENTAL TREATMENT OR HARMFUL STIGMATIZATION SERVES MORAL AND HUMANE PURPOSES IS ALSO IMPORTANT IN DISCUSSING THE INSANITY DEFENSE. IN INDIVIDUAL CASES, WHATEVER THE OUTCOME OF THE INSANITY ISSUE, THE DEFENDANT FACES THE PROSPECT OF INSTITUTIONALIZATION. FROM PRETRIAL EXAMINATION THROUGH POSTTRIAL DISPOSITION, THERE ARE SEVERAL CRITICAL POINTS AT WHICH QUESTIONABLE PRACTICES OCCUR. EXAMINATIONS ARE OFTEN CONDUCTED BY MENTAL HEALTH PROFESSIONALS WHO ARE SUBSEQUENTLY RESPONSIBLE FOR THE CUSTODY AND TREATMENT OF DEFENDANTS, AND THEIR VIEWS AS TO THE DEFENDANT'S TREATABILITY MAY DIMINISH THEIR OBJECTIVITY. THE MAJORITY OF STATES REQUIRE ONLY THAT, IN ACQUITTAL VERDICTS, THE COURT OR JURY DECLARE IF THE GROUNDS WERE INSANITY, WITHOUT RESOLVING THE ISSUE OF WHETHER THE DEFENDANT HAS COMMITTED THE ACT. ANOTHER TROUBLESOME PRACTICE IS RELIANCE ON STATE-EMPLOYED OR COURT-SELECTED INDEPENDENT EXAMINERS SINCE PSYCHIATRIC EVIDENCE IS HIGHLY SUBJECTIVE. ONCE A VERDICT OF NOT GUILTY BY REASON OF INSANITY IS RETURNED, THE DIFFICULT QUESTION OF DISPOSITION ARISES. THE NEED FOR PERIODIC JUDICIAL REVIEW OF COMMITMENTS IS REFLECTED IN THE FACT THAT INDIVIDUALS LOSE USEFUL LIFE SKILLS AND THEIR CHANCES FOR PRODUCTIVE RESTORATION TO SOCIETY DURING LONG-TERM INSTITUTIONALIZATON. REFORMS TO IMPROVE THE USE OF THE INSANITY DEFENSE ARE STIPULATED, AND A SUGGESTED STATUTE DEALING WITH THE INSANITY DEFENSE IS INCLUDED. (DEP)