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Utah's process for the insanity defense in criminal cases would be substantially revised under this bill. For first-degree or capital felony charges, a defendant claiming not guilty by reason of insanity would have to prove, with "clear and convincing evidence," that a mental condition left them unable to understand the nature of their actions or unable to recognize that those actions were wrong—shifting this burden from the prosecution to the defense. The bill narrows what counts as a qualifying "mental condition," expressly excluding personality disorders, psychopathy, sociopathy, paraphilic disorders such as pedophilia, and issues stemming solely from voluntary intoxication or substance use, while covering conditions like schizophrenia, bipolar I disorder, PTSD, and other serious psychotic disorders; it also gives judges discretion, rather than a mandatory duty, to order a state mental health examination when this defense is raised, and requires at least two examinations by a forensic psychiatrist or psychologist after the defendant is first screened for competency to stand trial. For people already committed to state custody after being found not guilty by reason of insanity, the bill would extend mental health status reviews from every six to every twelve months, require review teams to include forensic specialists who weigh violence-risk factors, add victim notification when a defendant becomes eligible for discharge, and create a new process letting the state temporarily revoke and detain a conditionally released defendant who violates their release plan, followed by court hearings to decide whether the person should be redetained, kept on conditional release, or discharged.