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Home Local news Luigi Mangione to Mount Psychiatric Defense in UnitedHealthcare CEO Murder Case: What It Could Mean for the Trial
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Luigi Mangione to Mount Psychiatric Defense in UnitedHealthcare CEO Murder Case: What It Could Mean for the Trial

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Luigi Mangione will assert psychiatric defense in murder case in UnitedHealthcare CEO's killing

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Published on 17 June 2026

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NEW YORK — Luigi Mangione plans to pursue a psychiatric defense in his state murder trial over the killing of UnitedHealthcare CEO Brian Thompson, a judge said Wednesday.

Judge Gregory Carro said defense attorneys have notified the court that they intend to argue Mangione was experiencing “extreme emotional disturbance at the time of the occurrence.” The strategy signals that the defense will seek to frame the killing as one carried out under mitigating psychological circumstances.

Under that approach, Mangione would in effect be acknowledging responsibility for Thompson’s death while asking jurors to consider whether his mental state at the time warrants a lesser conviction.

If a jury agrees that Mangione was suffering from extreme emotional disturbance when Thompson was killed, it could convict him of manslaughter rather than murder. Such a verdict would carry a lighter prison sentence.

The defense is distinct from a plea of not guilty by reason of insanity, which can result in a defendant being committed to a psychiatric institution instead of sent to prison.

Carro’s announcement followed a closed-door hearing on the issue held two weeks ago at the defense’s request. The judge said records related to that hearing, as well as the defense’s request to present a psychiatric defense, will be unsealed.

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

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

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

The judge had been set to rule on the matter on Tuesday, but delayed it a day because prosecutors failed to inform Mangione’s jail that he was needed in court.

Mangione sat between his lawyers wearing a blue suit and a light-colored button-down shirt. He is set to go to trial on Sept. 8.

Mangione, 28, has pleaded not guilty to state and federal charges in the Dec. 4, 2024, killing. His federal trial, which involves stalking charges, is set to begin on Oct. 13. He could spend his life in prison if convicted in either case.

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 five days later at a McDonald’s in Altoona, Pennsylvania, about 230 miles (about 370 kilometers) west of Manhattan. At a May 18 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 fueled health insurance cartel.”

Also 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.

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This story has been corrected to show that Mangione could receive less prison time as a result of a conviction using this defense, not be sent to a psychiatric facility.

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