Psychiatrists have an important role to play in addressing issues central to the M'Naghten Rules and making these accessible and comprehensible to court and jurors in particular. Insanity is a legal construct designed to determine the extent to which a person may be deemed criminally responsible for a criminal act and is often difficult to reconcile within medical and public paradigms of mental illness and justice. Principles are offered to guide psychiatrists who are called to give evidence in cases where the mental illness defence has been raised.

The rate of suicide in NSW prisons has been declining over the past 10 years, but remains approximately 10-fold that of the NSW community. Suicide was the leading cause of death among NSW inmates from 1995 to 2005. Suicide is a rare event, making its prediction a difficult task, with the prison environment a further compounding factor. This review highlights a number of factors, which appear to be common in many cases. Increased monitoring during the first week of incarceration may be an effective intervention. It is recommended that consideration be given to the length of time spent on remand and the value of custodial sentences of