Two Women Commit The Same Crime: One Is Legally Insane But The Other Is Not. Huh?

NEWS ABOUT RESILIENCE: Jessie Close and I will be speaking at a book party Tuesday, January 13th, at Fountain House in Manhattan beginning at 6 p.m. Fountain House is a fabulous clubhouse program whose roots date back to the 1940s. If you would like to attend, please send an RSVP via e-mail to Ashley Womble at Unfortunately, Glenn Close will not be there since she is appearing in a Broadway play.

Glenn and Jessie will be featured on the CBS Morning News that Tuesday morning and will be on the Dr. Oz show on Wednesday. 

How Can One Defendant Be Legally Insane And The Other Not Insane When They Both Commit The Same Crime?

Monifa Sanford

Monifa Sanford

Washington Post reporter Dan Morse has been covering a horrific case that raises thorny questions about our criminal justice system and defendants suspected of having mental disorders.  

Zakieya Avery

Zakieya Avery


Two Washington D.C. area women are about to go on trial in Maryland for stabbing four children, two fatally, as part of an exorcism.

A psychiatrist has told the court that Monifa Sanford, age 22, was legally insane when she participated in the stabbings. However, a different psychiatrist told the court that Sanford’s cohort, Zakieya Avery, age 29, was not insane when the stabbings happened.

How is it that doctors can find one of the accused “legally not responsible” for her actions, yet the other sane enough to face two counts of first-degree murder and two counts of attempted first-degree murder?

On January 17, 2014, Montgomery County police entered a townhouse in the suburb of Germantown after a neighbor spotted blood outside it. They found two of Avery’s children, one-year-old Norell Harris and two-year-old Zyana Harris, dead from stab wounds. Avery’s other two children, ages five and eight, had been stabbed but had survived.

The women, who reportedly called themselves “demon assassins,” apparently believed all four children were possessed by demons that could only be driven away during an exorcism that included stabbing.

In his most recent story, reporter Morse quoted Larry Fitch, a former director of the Office of Forensic Services at the Maryland Department of Health and Mental Hygiene and currently a University of Maryland law school instructor, saying there is a condition of shared delusion called “folie a’ deux’ but it is rare. Morse wrote:

When two people commit a homicide, Fitch said, it’s less likely that both are driven by psychoses than only one is. He gave two possibilities: A sane person plots a killing and an insane person has an inability to resist; or an insane person is acting out a delusion and a companion is simply too meek – even in a clinically sane way – to resist.

Prosecutors said  Avery had adopted the title of “commander” while Sanford called herself “sergeant.”

Unfortunately, news accounts about the case have not included detailed information about either woman’s background. We do not know their IQs or whether either had been diagnosed as having a mental illness.

In Maryland, a successful insanity defense yields a finding of “not criminally responsible.” The state law reads:

“A defendant is not criminally responsible for criminal conduct if, at the time of that conduct, the defendant, because of a mental disorder or mental retardation, lacks substantial capacity to: 1) appreciate the criminality of that conduct, or 2) conform that conduct to the requirements of law.”

As reporter Morse explained in his article, the law essentially holds that people so delusional or mentally ill that they commit a crime but can’t comprehend that it’s a crime should be locked in a hospital, not a prison.

This case pinpoints a number of problems when it comes to society meting out justice.

The most obvious is defining mental illness.

While the American Psychiatric Association has tried to codify in the DSM-5 what is and isn’t a legitimate mental disorder, psychiatrists often disagree and will continue to disagree as long as diagnoses are based on reported actions and patient interviews versus biological evidence.

So is it really surprising that in this case, two different doctors examining two different women, who are charged with committing the same crime, have come up with different opinions?

This is not a new issue for the courts. In every major case when the insanity defense is raised, prosecutors find doctors willing to testify for a fee that the accused was sane and defense attorneys find doctors willing to testify for a fee that the accused is insane. In some foreign countries, the court appoints three doctors that answer directly to the court to avoid the appearance of either side buying testimony, but that is not the norm here.

The second issue this case raises is how difficult it is for us to determine if someone “appreciates the criminality” of their conduct.

I remember interviewing a man sentenced to death because he’d killed a close friend of the family. He had a long history of schizophrenia. When the police responded to the shooting, he ran away but was quickly apprehended. He told investigators that he understood that it was wrong to murder another human being. He told them that he knew it was illegal.

But he also explained that he hadn’t killed anyone because the victim was not a human being. An alien had invaded his body. When asked why he had run from the police, he explained that he was afraid they were aliens too who were masquerading as humans.

To me his case proves a flaw in our current standard. The man knew it was wrong to murder another human being, knew it was illegal, and ran from the police, yet I would argue that he certainly didn’t “appreciate the criminality” of his conduct. A judge and jurors disagreed and he was eventually executed.

Which brings us back to the so-called “demon assassins.”

Writer Morse quoted Fitch, who clearly had knowledge of mental illness and forensics given his background, making the following statements.

The crime itself speaks to a certain amount of mental illness, Fitch said, noting that perfectly sane people believe in exorcism but that no legitimate faith holds that people need to be killed during the process.

“On the face of it, this sounds pretty crazy,” Fitch said. “I’ve never heard of anything quite like it.”

That Avery ran out the back door when officers entered her townhouse may have played a factor in her evaluation (that she was not insane at the time.) One element of “not criminally responsible” is not understanding that a crime was committed.

Fleeing the home “is certainly consistent with knowing she did wrong,” Fitch said.

Is it?

A friend of mine, Robert Cluck, was stunned when he read Fitch’s quotes, so much so, that he sent a letter to The Washington Post. The newspaper has yet to publish it, but I want to share it with you.

Letter to the Editor 

“Fleeing the home ‘is certainly consistent with knowing she did wrong.”” is certainly not a statement consistent with what is now understood about the workings of our brains.  There have been many excellent fact-based, insightful books and articles written recently about neuroscience should Mr. Fitch wish to lean more.  

In recent years there has been an explosion of knowledge about the modularized nature of the brain and the functions of those modules, as well as the interconnections between those modules and mental and other health challenges that can arise by malfunctions, etc.  That understanding of brain structure and chemistry–an understanding in part gained through scientific studies of brain dysfunction–is slowly (far too slowly) seeping into “traditional” psychiatry and into discussions of “criminal” acts and the law.  

In the interests of justice and compassion, and with other objectives including the prevention of self harm and harm to others, our society and the legal system in particular, must become far better informed about the current state of neuroscience.  We need to leave behind the largely well-intentioned but often, in hindsight, harmful “best guesses” of the past.  

Very briefly, “fleeing” is a very primitive act of our neural systems.  Actually, it’s so primitive that virtually anything to which the word “alive” can be applied can sense “danger” and flee.  In contrast, “knowing” that one has done what society defines as “wrong,” and being able to act responsibly, as society defines “responsible,” are functions of a greatly advanced brain with “executive” functions as we understand them.  

“Flight” from a danger perceived by very basic animate (and even plant?) processes does not in itself mean, or perhaps even suggest, that the “executive” processes of the brain were functioning in a way that could be adjudicated as “wrongful,” i.e., criminal, act. 

None of the above means that Sanford and Avery should be released from confinement.  But I think that judgments on what is best for society and for individuals in matters such as this must be based on our best knowledge, not on simplistic statements based on long outdated hypotheses.  

And a broader point in conclusion: there are hundreds of thousands of individuals incarcerated in jails, prisons, and like facilities across our country who have serious mental illnesses.  How that situation can be considered as other than cruel and unjust I do not know.  Fortunately there are initiatives under way to try to correct these injustices, but those initiatives face great challenges.  Much more must be done. 

Robert Cluck

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.