The insanity defense is actually part of a group of defenses called affirmative defenses, which mean you're guilty, but you have a good excuse. Affirmative defenses include impossibility, duress, justification and entrapment. And they all involve the same intent. With impossibility, you intended, for example, to steal a necklace. But that was legally impossible, because your husband already paid for it. Only insanity involves no intent, because the person didn't even know what he or she was doing. The insanity defense is the least used defense, in less than 1%. I think entrapment is probably used the most. It has to involve a preexisting condition and it usually results in being locked away for life. And the USA is the only country in the world that wants to do away with it. It even goes back to prehistory. Ancient Rome had it and even the prophet Muhammad had a version of it.
Insanity is one of the most indefinite words in our language. We all live by the rules of the society we were brought up in, so someone relaxing on a beach in the Bahamas would think that it was insane to move to Alaska. A popular music fan would definitely call me insane for spending 13 hours listening to Wagner's Ring Cycle. We have to have laws in society, so while it would be insane to rob a bank when I got a bit short of money, society would rightly call me a criminal. But the overuse of nanny state laws can make law a grey area. Why the "F" should I be classed as a criminal for parking my car outside my own front door. When it comes to crimes such as rape and murder, it is fairly clear cut. The odd punch up between friends who have fallen out and rival sports fans is largely overlooked, as long as no one receives any injuries that wont heal within a day or so. But splitting someone's head open with an axe is not acceptable. Problems start, when people see this as insane. Because while in one sense it is, people like this are not safe to live in society. So what do we do. Treat them in hospitals and make them write 100 timed I must me good, then send them home. Or lock them up and lose the key.? I personally prefer the latter.
Insanity only applies to people society rejects, and modern Americans reject even each other, with a quarter of them still claiming the sun revolves around the earth, and the mass media now reduced to claiming half the country is a cult. Why should the legal system care about psychological evaluations, when academics can't even use a fucking dictionary?