James Holmes, the 24-year old man who entered a Colorado theater early Friday morning and opened fire–killing 12 and wounding 60–will undergo extensive psychiatric testing over the next several months to determine whether or not he’s competent to stand trial. If doctors find that he was under extreme mental duress during the shootings, he may be able to enter a “not guilty by reason of insanity” plea to the first-degree murder charge currently held against him. The news comes just one day after Holmes first appeared in court, during an eleven-minute proceeding in which Holmes appeared dazed, unconcerned, and even drugged.

But it’s extremely unlikely that the jury will accept such a plea no matter what the doctors find, according to Dr. Keith Ablow. He says that the vast majority of suspects who enter an insanity plea are still taken to mental health facilities once the trial is over, but that juries don’t want to worry about whether or not they will commit the same acts–or worse–once released into the general public; therefore, they don’t take any chances. He writes:

Contrary to popular belief, defendants who are found not criminally responsible by virtue of a mental illness generally remain on locked psychiatry units for several decades–or for life. This has been the case, for example, for John Hinckley, Jr., the man who, in 1981, shot Ronald Reagan to impress actress Jodi Foster. He has remained an inpatient–with some passes to his family home–at St. Elizabeth’s Hospital in Washington, D.C. for more than 30 years.

Ablow says Holmes will have to get through several stints of extensive medical testing first, however, and then be evaluated exhaustively by a team of psychiatrists to determine his mindset and to make sure there’s nothing physically wrong with him. It could take up to a year for the case to go to trial, and if the judge decides Holmes is insane, he may decide to forgo the trial altogether in favor of sending him to a mental hospital.

For now, the victims of his assault and their families will have to seek comfort in one another until a decision is made.