Billy Milligan and the 24 personalities

Who was Billy Milligan?

Billy Milligan was a real person, and his case is a matter of record. In October 1977, authorities arrested William “Billy” Milligan, then 22, and charged him with the kidnapping, robbery and rape of three women near Ohio State University in Columbus. On December 4, 1978, he was found not guilty by reason of insanity after mental health professionals diagnosed multiple personality disorder, now called dissociative identity disorder. He is believed to be the first defendant acquitted on that basis.

The case: charges and verdict

Before trial, Milligan was sent to Harding Hospital in Worthington, Ohio, for treatment, and after seven months there he was found competent to stand trial. That settled only whether he could take part in the proceedings. The question left for the court was whether he had been legally responsible for the acts charged, and his mental state became the center of the case.

On December 4, 1978, the court found that he had not been. Retro Report later summarized the outcome: his legal team built the defense around the multiple personality diagnosis, and it succeeded. The judge sent him for treatment at what was then the Athens Mental Health Center. That is what made the case historic. When Milligan arrived in Athens, Backdrop Magazine notes, he had just become the first person to use multiple personality disorder successfully as an insanity defense.

What the doctors found

Nine mental health professionals evaluated Milligan. The most famous was Cornelia Wilbur, the psychiatrist known for the case told in the book Sybil, who was invited to observe him and give her diagnosis. Examiners at the time described 10 distinct personalities. In Athens, the hospital's medical director, David Caul, had already treated other patients with multiple personalities and said he wanted to treat Milligan the same way, in the most open and therapeutic setting the hospital had.

The number most people know came later. During his stay in Athens, Milligan asked Daniel Keyes, an Ohio University English professor, to write his life story, and The Minds of Billy Milligan was published in 1981. The book set out 24 personalities, and that figure became the popular shorthand for the case. Doctors later said Milligan's two dozen personalities merged into a single, harmless personality after therapy.

Biography after the verdict

The rest of the Billy Milligan biography is largely a history of institutions. From Athens he was moved to Lima State Hospital for the Criminally Insane, a hospital with a reputation for rough treatment, and he was later held at other state facilities. In 1986 he escaped from the Central Ohio Psychiatric Hospital and spent several months on the run before he was arrested in Miami. He was discharged in 1988, after about a decade in mental hospitals, and released from all state supervision in 1991.

He later filed for bankruptcy while living in California and eventually moved back to Ohio. His sister said he received treatment for the disorder on and off throughout his life and had lived rather quietly after returning to Ohio about five years before his death. Milligan died of cancer in Columbus in December 2014, at the age of 59.

Why some clinicians doubted the diagnosis

Doubt started before the trial. At Harding Hospital, not all of the staff accepted the diagnosis, and some reported that Milligan threatened them with the appearance of a violent personality called Ragen to get more privileges. At the Athens Mental Health Center, David Malawista, then the senior staff psychologist, said some of the staff remained skeptics throughout. His own view, given to Backdrop Magazine, was that Milligan was “putting a lot of it on.”

The larger doubt concerns multiple personality disorder as it was diagnosed at the time. Sybil, the 1973 book behind Wilbur's fame, told of a woman who claimed to have 16 distinct personalities; it sold over 6 million copies and became a television film in 1976. A 1999 article in Psychological Bulletin by Scott Lilienfeld and six colleagues cited figures showing reported cases in the world literature rising from 79 in 1970 to about 6,000 by 1986, and noted that the surge began shortly after Sybil appeared.

Those authors argue for a sociocognitive model, in which alternate identities are role enactments shaped by therapists' cues, media portrayals and social reinforcement. Their evidence included findings that the number of personalities per patient tends to rise during therapy focused on them, that most diagnoses came from a relatively small number of therapists, and that volunteers given the right cues can reproduce many of the disorder's outward features. They added that malingering may be a particular problem among criminals, while calling therapy's influence important but not the only cause.

How it is seen today

The diagnosis survives under a new name. In 1994 multiple personality disorder was renamed dissociative identity disorder, and David Spiegel of Stanford, who led the committee behind the change, has said the new name points to a fragmented identity rather than a person who is literally many people. The American Psychiatric Association's patient guidance, reviewed by Spiegel in 2024, describes two or more distinct identities along with ongoing gaps in memory, and says about 90 percent of people with it in the United States, Canada and Europe had been victims of childhood abuse and neglect.

The argument has not gone away. Richard McNally, a Harvard psychology professor, told Retro Report that the old label had become such a lightning rod in the field that a duller name was probably better. On the legal side, forensic psychologist Joni Johnston told A&E that she did not think Milligan would be found legally insane today, because that finding requires a direct link between a person's symptoms and the crime. A 2021 Netflix docuseries, Monsters Inside: The 24 Faces of Billy Milligan, revisited his background, the charges and his defense.

Verdict

Is Billy Milligan real? Yes. The arrest, the charges, the 1978 insanity verdict, the hospital years and the 1991 release are all documented. Some online retellings credit him, or one of his personalities, with predictions; none of the coverage or research cited here records any. Real or Legend files this record as disputed because its central question is the diagnosis: the 24 personalities were reported by doctors and a biographer, doubted by clinicians who worked with him, and belong to a diagnostic boom that researchers still argue over.