Mangione drops psychiatric defense as trial nears

Luigi Mangione’s lawyers are withdrawing plans to argue a New York murder trial that he was acting under “extreme emotional disturbance,” a move that came a day after they told a judge they would pursue a psychiatric defense tied to a mental health crisis. The

Luigi Mangione’s legal strategy just narrowed—quietly, on paper—while the timeline for his New York state murder trial moves closer.

Defense attorneys are withdrawing plans to argue at Mangione’s state murder trial that he was suffering from “extreme emotional disturbance” at the time of the alleged killing of UnitedHealthcare CEO Brian Thompson in New York City. The decision was laid out in a letter dated June 18 to Acting New York Supreme Court Justice Gregory Carro. according to reports. with the lawyers saying they were “at this time” pulling back the psychiatric defense.

The move follows a day after Mangione’s lawyers told Carro they planned to argue that Mangione “had lost control of his actions” due to an extreme mental health crisis. Under New York law. that kind of argument is meant to reduce criminal culpability by persuading a jury that the defendant’s actions can be explained by an “extreme emotional disturbance.” Carro would decide at trial whether there is enough evidence to reduce the murder charge.

The change lands as Carro also considers whether records related to the psychiatric defense should be unsealed. Carro previously said he will unseal records tied to that defense. though Mangione’s lawyer. Karen Friedman Agnifilo. argued that doing so would impact the federal case against him. according to the AP.

Carro has already been making ruling after ruling that shapes what jurors will see. He dismissed a criminal charge related to possession of a large capacity ammunition magazine, according to Reuters and ABC News. That followed a May ruling that evidence found during an initial search of Mangione’s backpack—including a magazine. cell phone. passport and wallet—must be suppressed. Carro also ruled that key evidence uncovered during a subsequent search of the backpack. including a gun and a red notebook. could be used at trial.

Prosecutors said the red notebook contains diary entries written by Mangione that shed light on his decision to target the healthcare executive.

Mangione, 28, is accused of fatally shooting Thompson outside a Midtown Manhattan hotel in New York City in December 2024. Thompson was shot in the early morning on Dec. 4, 2024, outside a hotel where he was scheduled to speak at an investment conference, authorities said. The killing triggered a massive law enforcement response and investigation.

Investigators said surveillance footage and forensic evidence linked Mangione to the scene, including DNA and ballistics recovered at the scene. Mangione was arrested five days later, on Dec. 9. 2024. in Altoona. Pennsylvania. after being recognized by an employee who recognized him from images released by the New York Police Department.

Police said they have matched the gun found in Mangione’s possession to casings discovered outside the hotel where Thompson was fatally shot. Investigators also matched Mangione’s fingerprints to those found on a water bottle and a protein bar wrapper near the scene of the killing.

The case has unfolded across state and federal lines. Mangione pleaded not guilty in December 2024 to state murder, weapons and forgery charges brought by Manhattan District Attorney Alvin Bragg. Separately, he pleaded not guilty in April 2025 to federal murder, weapons and stalking charges. His New York state trial is expected to begin in September. and he also faces separate charges in Pennsylvania and in federal court.

There is more than the courtroom at stake. Thompson’s death and Mangione’s arrest have drawn intense attention from corporate leaders and from critics of the U.S. health care system. After Thompson was killed. companies said they were evaluating security measures. canceling in-person events. and removing top executives’ biographies and photographs from their websites.

Law enforcement activity tied to the health care industry has continued. In April 2025. police arrested an armed man outside UnitedHealthcare’s headquarters in Minnesota after he made “threats of violence. ” before eventually surrendering. In February 2025. prosecutors in Florida dropped charges against a woman who allegedly threatened a health insurance provider using the words “Delay. deny. depose. ” the same as those on shell casings found near Thompson’s body.

Even with the legal stakes rising, Mangione’s case has gathered unusual supporters. Some fans have expressed support for his legal battles and even written him heart-shaped notes. Earlier this year. a pizzeria worker was accused of posing as an FBI agent after attempting to bust Mangione out of jail.

The shift in Mangione’s defense plans—withdrawn “at this time”—means the psychiatric argument centered on “extreme emotional disturbance” is no longer part of the state trial’s preparation. For now. everything else remains under the judge’s control: what evidence is allowed. what will be admitted. and whether jurors will see the diary entries prosecutors say illuminate why Thompson was targeted.

Luigi Mangione Brian Thompson UnitedHealthcare psychiatric defense extreme emotional disturbance Gregory Carro Karen Friedman Agnifilo New York murder trial Reuters Associated Press Midtown Manhattan hotel Alvin Bragg