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Notes -
I thought that the idea behind "not guilty by reason of insanity" is that the culprit was in a state where they had either no control of their own actions, or were unable to tell their actions were wrong, and so can't be held liable. Having a mind organized enough that you're capable of planning, and being aware of the necessity to hide them, seem to strike at both of these assumptions. Even if there is a form of psychosis that works like this, I'm having trouble seeing the justification for a "not guilty" verdict.
To some extent this gets into the territory of highly jurisdictional stuff (and individual physician interpretation - the law is fuzzier than you might imagine), but as an example:
The voices told me to kill my family and I did it but I knew that wasn't the right thing and couldn't help myself = guilty.
The voices told me to kill my family and I did it because if the voices told me to do it must be the right thing to do = NGRI.
The latter is less common than you'd think. For instance a lot of violent voice are labeled as demons, bullies, and other such things and when assessed patients will say "yeah I knew I shouldn't have listened to Satan because he's Satan."
I'm not really sure if this is a sensible line to draw but it seems to be where it is drawn a lot of the time.
A case like Charles Whitman is probably optimal to think about because his thinking is otherwise totally clear but his violence button was stuck on because of the brain tumor.
Organized and able to plan AND also untethered from reality is thankfully extremely rare, but it does happen, the intuition that it doesn't make sense is more from lack of being common than actual possibility.
I'd say most people this sick are totally disorganized, uselessly impulsive, or both. But not all.
That's what I assumed, and my argument is that we are in the former scenario, implied by Clancy attempting to hide her actions. Of course, if the state operates under a different framework than the argument does not apply.
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