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CENTENNIAL, Colo. — On day 44 of the Aurora theater shooting trial, Dr. Raquel Gur testified that James Holmes was legally insane at the time he opened fire on a movie theater. She is one of 20 mental health professionals who evaluated the defendant’s mental state. The gunman may face the death penalty for killing 12 people and injuring 70 in July, 2012.

Gur is the second psychiatrist to tell the jury the shooter is insane; two others testified that the defendant was sane when he gunned down a crowd of movie-goers.

Dr. Howard Weiss, a Denver psychiatrist and neurologist with 27 years of board certified clinical practice, brought light to some questions surrounding the insanity plea, mental illness and the shooter’s mental state.

Q: How do you know if a person is feigning or faking the symptoms of a mental illness (or how do you detect malingering)?

“It’s not a black and white answer. You have to have many years of experience and training to ascertain the mental status of a person. You take into account many things. There’s no test or anyone psychological thing you can do to really prove whether a person is faking (a mental illness). It boils down to clinical judgment. You can never ultimately know for certain if a person is feigning symptoms.”

��:��The Aurora shooter wrote a list of self-reported symptoms and possible diagnoses, including schizophrenia, in his notebook. FBI reports also showed he web searched dozens��of terms��related to mental illness and specific mental diseases.

How often are people with a severe mental illness aware of their own mental defect or symptoms?

“That’s very, very unusual. Generally people have no insight into that… That’s surprising to me, but nothing is entirely impossible in medicine or psychiatry. There are always exceptions.”

Q: Dr. Raquel Gur testified Tuesday that the shooter still, to this day, experiences a delusion that makes him believe killing others will enhance his self worth. If the shooter truly suffers from this delusion presently, could he pose a potential risk of harming others again?

“You can’t say one way or another. But if that’s correct, he still believes that, then absolutely I’d be concerned. He probably can’t ever be outside direct supervision for the rest of his life.”

Q: If the defendant were to be found sane by a jury and institutionalized at a mental health facility, would it be possible for him to be released?

“That’s a question for a lawyer.”

Q: Is it possible for someone suffering from a severe form of schizophrenia to know right from wrong in the eyes of society?

“Some would say yes, some would say no. Ultimately it’s a legal question. One percent of insanity defenses are a success. There are many, many psychotic people who are convicted of crimes and they’re absolutely out of their minds; but under the law they’re culpable for having committed heinous acts. And even psychotic people who are found innocent remain psychotic for the rest of their days.”

Q: How often are people suffering from schizophrenia violent toward others versus violent toward themselves?

“That’s a good question that hasn’t yet been answered.”

(*Writer’s note: One study published by the����that people with a “major mental illness are two to six more likely than the general public to commit violence”, and only 15 percent of victims are strangers to violent offenders. Still, most people with mental illness are not violent.)

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Editor’s note: CU News Corps will honor the victims of this tragedy with every post via this graphic.��