Counsel should consider obtaining a psychiatric assessment when a serious offense is involved, the accused has a history of mental illness, has attempted suicide, or exhibited personality disorder in the courtroom. An accused should also be examined where there is a complete or partial inability to recollect events or circumstances associated with the alleged offense. Obtaining a psychiatric assessment is the least problematic when the accused is out on bail, willing to be assessed, and has sufficient funds to retain the required experts. If bail is refused and the assessment must be conducted in jail, a private assessment is still preferable to a court ordered remand for observation. A court ordered psychiatric remand is governed by sections of the criminal code. The concern at a hearing to determine fitness to stand trial is to determine the accused's ability to follow the proceedings and to instruct counsel. Under the criminal code of Canada, a person is considered legally insane when 'he is in a state of natural imbecility or has disease of the mind to an extent that renders him incapable of appreciating the nature and quality of an act or omission or of knowing that an act or omission is wrong.' Persons found not guilty by reason of insanity are held in custody, treated, and have their mental heath status reviewed regularly by a board that reports findings to the Lieutenant Governor, who has the authority to take action deemed appropriate. Other topics considered are whether anyone other than the accused can raise the insanity defense, whether the accused must submit to a psychiatric examination by a Crown expert, and whether the jury should be advised of the consequences of an insanity verdict. Forty-seven footnotes are provided.