This study, begun in 1981 and completed in 1982, consisted of extensive research into published materials; the analysis of primary data from the Hawaii State Hospital, Department of Health, and First Circuit Court; consultation with nationally known experts in the field; interviews with local professionals; and attendance at several conferences and hearings. The Commission concludes that the current insanity defense, which excludes mentally ill defendants from criminal culpability, is sound and should be retained in the interests of maintaining a compassionate and fair system of justice. The recommendation that an additional verdict of 'guilty but mentally ill' be added to Hawaii law would pertain to cases there is evidence of mental illness but not to the extent where required to affect the defendant's behavior to the degree necessary to remove culpability. The defendant would be afforded treatment as part of the sentence. Currently, when mental illness is raised as a defense, the state must prove that the defendant was sane. The Commission recommends that the burden of proving insanity be placed upon the defense. Other recommendations include a time limit for entering the insanity defense plea, the certification of sanity commissioners, the supervision of conditionally released penal patients, and the establishment of a penal commitment facility at Hawaii State Hospital. Proposed legislation is included, and judicial decisions bearing upon the insanity defense are appended. A 72-item bibliography is provided.