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When the tests set out by the Rules are satisfied, the accused may be adjudged "not guilty by reason of insanity" or "guilty but insane" and the sentence may be a mandatory or discretionary (but usually indeterminate) period of treatment in a secure hospital facility, or otherwise at the discretion of the court (depending on the country and the offence charged) instead of a punitive disposal.The involuntary outpatient placement language in the Baker Act took effect as part of the Baker Act reform in 2005.The psychiatrist "based this conclusion on the girl's lack of emotional control, her consistent low scores in areas of judgment on psychological tests, and the likelihood that she would abuse a child." On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media.Andrew Scull argues that Cotton's obsession with focal sepsis as the root cause of mental illness "persisted in spite of all evidence to the contrary and the frightening incidence of death and harm from the operations he initiated".There must be evidence of recent behavior to justify the substantial likelihood of serious bodily harm in the near future.Although the disability rights movement itself began in the 1960s, advocacy for the rights of people with disabilities started much earlier and continues to the present.

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