Insanity pleas are seldom claimed and rarely successful in criminal cases — but when they are, the fallout can spark strong public reaction and severely test the victims of those violent assaults and their families.

Case in point: Benjamin Davis was acquitted of attempted murder by reason of insanity in 2010, after several mental health experts diagnosed him as schizophrenic and concluded he had been unable to understand or control his actions when he attacked Nicholas Iwamoto and another hiker on the Koko Crater trail in February 2009.

Iwamoto, now 26, was stabbed 18 times and thrown from the crater’s rim; to this day, he struggles with pain and with getting his life back on track.

With acquittal, Davis was ordered into the custody of the Hawaii State Hospital to receive mental health treatment, and Iwamoto believed that Davis would never be freed. So when a state judge ruled last month that Davis could leave the hospital — unsupervised — for twice-weekly classes at Windward Community College, Iwamoto was thoroughly "disgusted" with the decision, calling his one-time attacker "a ticking time bomb."

Many in the public concurred and reacted — which helped spur Mark Fridovich, the hospital’s administrator, and Windward Community College’s chancellor to quickly agree on arrangements for Davis to be escorted to the classes independent of Circuit Judge Richard Perkins’ ruling.

Fridovich said in a written response to Star-Advertiser questions that the hospital, by policy, arranges for "any specific requirements regarding escort, if legally required or clinically indicated" in such cases. He has no desire that the policy, or the law that it reflects, be changed.

"This is not often a problem, in my experience," he said.

Still, this situation has struck a public nerve over perceived laxness for the public’s safety, and whether justice is served for victims and the community good by insanity verdicts. Veteran law enforcers, though, offer compelling insight that there is much in Hawaii’s criminal-insanity laws to safeguard the public.

"I think a lot of anger at these decisions happens because of a misunderstanding of what protections there are both for the public as well as the defendant in (the mentally ill) cases," said Honolulu Deputy Prosecutor Jan Futa. "I don’t have a problem with the law, per se."

About 40 patients are in the Hawaii State Hospital after having been found in court to be not guilty of crimes by reason of insanity, according to Fridovich. An additional 62 have been returned to the facility for violating conditions of release from the hospital after having previously been found not guilty for a crime because of insanity.

Futa said the prosecutor’s office is interested in laws in more than a dozen states allowing verdicts of "guilty but mentally ill" as an alternative to acquittal because of insanity. In those states, defendants can be found criminally liable and required to receive psychiatric treatment while incarcerated, or placed in a mental hospital and, when they are well enough, to be transferred to prison to serve their sentences.

However, Futa noted that, following constitutional considerations, "you cannot find somebody guilty of something if they were not mentally able to be accountable for it. We really need to look into it more to see how other states that might have this kind of statute have resolved that issue."

State Sen. Will Espero, chairman of the Senate Committee on Public Safety, Government Operations and Military Affairs, said he considered introducing a "guilty but mentally ill" bill several years ago but decided it would lack support. There are no current proposals to alter the state’s law on criminal insanity.

In Benjamin Davis’ case, the escort issue had gone to a judge "because that’s what the Legislature has written into the law," said Susan Arnett, a Hono- lulu public defender for the past 28 years. The law requires that such issues are decided by a judge, which is fair, she said.

"At least in court, both sides are represented," Arnett said. "If you take it out of the court, it’s going to become a lot less transparent."

In order for people to stay informed about the circumstance of Davis’ attending classes, she added, "they would need to have it stay in the courts."

"I don’t know that the hospital wants to have the ultimate decision-making power," Arnett said. "Frankly, the danger would be that someone would come and say nobody gets out."

Futa agrees that the statute is sound because the judge relies largely on the recommendation of a board of three mental health experts.

"It does give protection to the public because it leaves that assessment to a professional, and in this case, three professionals," she said.

As Arnett suggested, the public learns about people being acquitted by reason of insanity from court proceedings. That includes violence occurring within the walls of the hospital — as was the case of Micah White, 26, who had threatened and attacked staff members after refusing to take his medicine.

White had been ruled insane for the slayings of his mother and aunt in Kailua in 2004 and reportedly turned violent toward staff in 2010 after refusing his medicine. A judge granted the state health director permission to force White to take antipsychotic medication after White agreed that he posed a danger to himself and others. But did a judge have to intervene?

"I think that’s the decision that ought to have judicial overview," Arnett said. "You’re talking about potentially holding someone down and medicating them."

On the mainland in the past, she added, "patients were not treated well, and they were over-medicated simply as a means of controlling them."

At Hawaii State Hospital in the 1970s, Arnett said, she remembers "this large room and there were some wire walls, and they (patients) were just walking around like zombies. That was back in the days of those heavy-duty medications that just sort of rendered people not being able to speak or carry on real conversation … That, I guess, was the state-of-the-art at the time.

"The judicial overview of things like forced medication, I think, is one of the checks and balances that help make sure that both the patient’s rights are being looked after as well as the need for treatment."

The face that a person is housed at the Hawaii State Hospital after being acquitted of a crime because of insanity doesn’t create a shield from criminal charges within those confines. In recent years, five patients have been prosecuted in connection with offenses at the hospital. In such a case, the offender may be sent to a prison for punishment and, upon completion, returned to the hospital.

"We think that’s the way it should be," Futa said. "They should not be let out just because they served time on one sentence. That doesn’t mean they’re off the hook on the first one that had them at the State Hospital. That’s a whole separate issue."

One of the "perplexing" elements of the insanity issue, Arnett said, is that "there are mental illnesses that are very treatable and there are those that are, at least at this point, less treatable, less successful in treatment."

Further, Arnett pointed out that the insanity defense can be a societal safeguard.

In 1984, Abdul Odood, who had been in and out of mental institutions, stopped taking medicine and stabbed to death boxing manager Douglas Tatting at the Neal Blaisdell Arena.

The presiding judge rejected the insanity defense and convicted him of manslaughter, although a public defender predicted — correctly — that his release after serving the sentence would come earlier than if he was confined for mental health treatment.

"That’s the danger," Arnett said. "As much as people think they may not like the idea of the so-called insanity defense, in fact it allows for much greater length of custodial care and treatment during it."