Under Massachusetts law, a person found to be incompetent to stand trial is generally committed for the same term he would have received if found guilty of the crime. The only distinction is that instead of being incarcerated at a state prison, the defendant is confined to Bridgewater State Hospital. The Court may commit a defendant found not guilty by reason of mental illness to Bridgewater or a similar facility for a period of one year. After that year is up, the defendant may be committed for additional yearly periods indefinitely. As this episode points out, such treatment of the mentally ill provides a distinction without a difference.
History shows a number of parallels in the treatment of criminals and the insane.
Criminals used to be punished - really punished. Before the so-called Age of Reason, a convicted criminal might be flogged, whipped, burned at the stake, or have the name of his crime carved directly into his body. One particular punishment stands out in my mind. Enlightened societies created the modern prison and the modern asylum. But I digress.