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Not at all. People literally walk out of psych facilities all the time in the US.
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Do you mean to say that the US lacks secure units for people who are ordered to be involuntarily detained as criminally insane?
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When you are committed, it becomes a medical, not a criminal justice issue when you are released.
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Is that because insanity is a medical thing?
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FWIW, some states have eliminated the insanity defense, and it was upheld by the SC.
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And others have determined that people can be detained on medical grounds long after they would have been released from a criminal justice angle...and it was upheld.
It has also been ruled that people can be retried and resentanced after an aquittal for insanity when it is decided the people are no longer insane.