The laws were completely revamped by the Insanity Defense Reform Act in the wake of the John Hinckley Jr. verdict.
A defendant can be found incompetent to stand trial if he is unable to understand the nature and consequences of the proceedings against him and to assist properly in his defense.
Per Federal Rule of Criminal Procedure 12.2, a defendant intending to pursue an insanity defense must timely notify an attorney for the government in writing.
Once such a verdict is handed down, the defendant has the burden of proof of showing that his release would not create a substantial risk of bodily injury to another person or serious damage of property of another due to a present mental disease or defect.
The U.S. Court of Appeals for the First Circuit found that civil commitments were within the power granted to Congress under the Constitution's Necessary and Proper Clause as an extension of the government's custodial responsibility for federal inmates.