The Supreme Court held 6-3 that states can eliminate the insanity defense in criminal cases. The case involved a Kansas man sentenced to death for killing his family in 2011.
Virginia currently permits the insanity defense in criminal cases, though juries are not told what happens if they vote to acquit based on insanity. Some defense attorneys fear that without this information jurors may be reluctant to find insanity, because the jurors mistakenly believe that the defendant will simply be released. In fact, Virginia Code Section 19.2-182.2 requires those acquitted by reason of insanity to be committed to state custody for evaluation to determine whether they present a danger to themselves or others. If so, they are civilly committed to state custody and evaluated until they are medically cleared for release, a process that can take many years.
https://www.reuters.com/article/us-usa-court-insanity/u-s-supreme-court-lets-states-bar-insanity-defense-idUSKBN21A2E6