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Luigi Mangione will assert a psychiatric defense in his state murder trial in the killing of UnitedHealthcare CEO Brian Thompson, the New York judge overseeing the case said at a hearing Wednesday.
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If his attorneys are able to prove Mangione was experiencing an extreme emotional disturbance at the time of the killing, his second-degree murder charge would be reduced to first-degree manslaughter if he’s convicted.
Mangione faces nine felony charges, including second-degree murder and several counts related to criminal possession of a weapon. If he is convicted in the New York case, he faces the possibility of life in prison.
New York state Judge Gregory Carro said he would be unsealing a notice from September about affirmative psychiatric defense and emotional disturbance at the time of the killing.
Carro said the defense needs to submit additional documentation about the psychiatric defense no later than Thursday.
“Despite the name, ‘extreme emotional disturbance’ isn’t an insanity defense, and it won’t get a defendant off the hook,” NBC News legal analyst Danny Cevallos said. “The person is still guilty of an intentional killing. All it does is lower the level of the crime and the prison time that comes with it.”
He went on to say that it is not an easy standard for a defendant to meet.
“To pull it off, though, the defense has to convince the jury, more likely than not, that the defendant was so overwhelmed that he lost control and that there was a ‘reasonable explanation or excuse’ for feeling that way, seeing things the way he believed them to be at the time,” Cevallos said.
Mangione appeared in the courtroom Wednesday wearing a dark navy suit and a button-down shirt. He looked down and was handcuffed when he walked into the room.
He is accused in the fatal shooting of Thompson, 50, on the streets of New York City in December 2024.
A dayslong manhunt for Thompson’s killer captivated the world and ended with Mangione’s arrest at a McDonald’s in Altoona, Pennsylvania.
Mangione also faces federal charges in New York and state charges in Pennsylvania. He has pleaded not guilty to all charges.
Carro ruled last month that prosecutors can use a gun and a red notebook found on Mangione during his arrest as evidence, rejecting the defense team’s argument that the items were seized illegally.
The next court hearing will be in August, and it will be virtual. The trial is scheduled to begin Sept. 8.
CORRECTION (June 17, 2026, 12:17 p.m. ET): A previous version of this article misstated the type of facility where Mangione would serve his sentence if he is convicted under a psychiatric defense. It would be at a regular prison, not a psychiatric facility.
I’m a reporter on NBC News’ breaking news team, covering crime, extreme weather, pop culture and more. I recently covered Hurricane Milton, which devastated the Tampa, Florida, metropolitan area, and the student-led protests at Columbia University.
Chloe Atkins reports for the NBC News National Security and Law Unit, based in New York.
Adam Reiss is a reporter and producer for NBC and MSNBC.
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