In the end, perhaps the question is: What difference does it make if the criminally insane are locked up in prisons or in mental institutions?

Kyle Zwack says that as prisons go, Minnesota's Oak Park Heights is a pretty good one. At least he gets treatment there, something that's far from guaranteed in most prison systems. Still, he says, people with mental diseases get abused in prison—especially by other inmates. "Teasing. Stealing. Beatings. Extortion."

After a dozen years as a convict, Zwack says he'd much prefer being a patient in a mental hospital. "I would be able to continue my education. It would be a better quality living. I wouldn't get victimized by my other co-workers, my other neighbors."

Zwack's mother, JoAnn, says her family has suffered more than it should have because Kyle is labeled a criminal instead of a victim of a brain disease.

"Some friends and some relatives have deserted us when this happened because we have the double stigma of having a person with a mental illness who has committed a crime, and people like to distance themselves and it may be that they don't know what to say. There's [a saying], you know: laugh and the world laughs with you, cry and you cry alone."

But aside from the pain suffered by mentally ill inmates and their families, some legal experts argue society has a powerful practical reason to rethink its habit of imprisoning the criminally disturbed: sending them to hospitals might keep the public safer. People committed to hospitals are treated—and held until doctors decide they're no longer dangerous. Prison inmates usually don't get any treatment at all. And they're released when their time is up, no matter what their mental state.

A not-guilty-by-reason-of-insanity verdict "would have been worse for me, actually," Kyle Zwack says, "'cause I would have done more time. I never would have got out."

Richard Barrett, the psychiatrist who examined Kyle Zwack for his trial in 1987, says the delusions that led Kyle to draw up plans for mass-murder were powerful and fixed: "I'd be curious to know if he still has the intent—if he were let go, if he would still go after these people."

Zwack says the answer is no. But a psychiatrist who examined him in prison a couple of years ago did find Kyle suffers 'persecutory' delusions. Zwack imagined the Masons and the CIA were out to get him, the doctor reported.

Kyle Zwack is likely to go free on parole in about 15 years.

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