Luigi Mangione to use psychiatric defence in health CEO murder trial, judge says

Luigi Mangione plans to assert a psychiatric defence at his state murder trial, claiming he was suffering from extreme emotional disturbance when he gunned down UnitedHealthcare CEO Brian Thompson, a judge said Wednesday.

That could mean less prison time if he's convicted.

A jury that accepts such a defence would be obliged to convict Mangione of manslaughter, which carries a maximum sentence of 25 years in prison, instead of murder, which could put him behind bars for the rest of his life.

An emotional disturbance defence isn't available in Mangione's federal case, where he also faces a possible life sentence.

New York Judge Gregory Carro announced the defence’s decision in court two weeks after holding a secret hearing on the matter.

He said he will unseal a transcript and other records from that hearing once redactions are made.

Carro said Mangione’s lawyers first raised the possibility of a psychiatric defence last year in a letter that was filed under seal and confirmed their decision at the 3 June hearing, which the judge said was held in secret at the defence’s request.

“The reasons for the sealing was to give the defence an opportunity to determine whether they were going forth with that defence and the nature of that defence,” Carro said.

Carro said he didn't expect the development to delay Mangione's trial, which is scheduled to begin with jury selection on 8 September. His next pretrial hearing is scheduled for 11 August.

Assistant District Attorney Joel Seidemann said he wants Mangione evaluated by a prosecution psychiatrist. To facilitate that, Carro said, Mangione could soon be moved to New York City’s Rikers Island jail complex from a federal jail in Brooklyn, where he has been held since shortly after his December 2024 arrest.

Mangione, 28, has pleaded not guilty to state and federal charges in the 4 December 2024 killing. His federal trial, which involves stalking charges, is set to begin on 13 October.

Mangione, sitting between his lawyers and wearing a blue suit, didn't appear to react as Carro spoke. At a hearing in February, Mangione railed against the prospect of two trials, telling Carro: “It’s the same trial twice. One plus one is two. Double jeopardy by any commonsense definition.”

An extreme emotional disturbance defence wouldn't absolve Mangione of responsibility for Thompson's killing. It is not the same as a not guilty by reason of insanity defence, which would allow a defendant to go to a psychiatric facility instead of prison.

Mangione’s lawyer, Karen Friedman Agnifilo, said unsealing the transcript of the secret hearing and materials related to his psychiatric defence will harm him in his federal case.

“The reason why we asked for the sealing is that this defence is not available federally and Mr. Mangione is being prosecuted federally and this is prejudicial to his defence to the exact same facts,” Friedman Agnifilo said.

The judge had been set to rule on the matter on Tuesday, but was forced to delay it a day because prosecutors failed to let Mangione's prison know that he was needed in court.

Thompson, 50, was killed as he walked to a Manhattan hotel for UnitedHealth Group’s annual investor conference. Surveillance video showed a masked gunman shooting him from behind.

Police say “delay,” “deny” and “depose” were written on the ammunition, mimicking a phrase used to describe how insurers avoid paying claims.

Mangione, an Ivy League graduate from a wealthy Maryland family, was arrested at a McDonald’s in Pennsylvania five days later.

At an 18 May hearing, Carro ruled that a gun and notebook that prosecutors say link Mangione to the killing can be used as evidence against him. The gun, a 3D-printed pistol, matches the one used to kill Thompson, prosecutors said.

The notebook describes wanting to “wack” a health insurance executive and rebelling against “the deadly, greed fuelled health insurance cartel.”

On Wednesday, Carro dismissed a charge related to a gun magazine that he had ruled inadmissible because it was found during an initial search of Mangione’s backpack at the McDonald’s.

To establish an emotional disturbance defence, Mangione's lawyers must show that the disturbance was so extreme it robbed him of self-control; that, in his mind, he had a reasonable explanation or excuse for the disturbance; and that he killed Thompson while “under the influence” of that disturbance.