Can a defendant who raises the defense of insanity waive his Fifth Amendment privilege against self-incrimination in a mental health case?

"The trial court's ruling was expressly based on our decision in Matter of Lee v. County Ct. of Erie County, 27 N.Y.2d 432 [318 N.Y.S.2d 705, 267 N.E.2d 452]. In that case we held that a defendant who raises the defense of insanity waives his Fifth Amendment privilege against self-incrimination with respect to his mental capacity and, if he refuses to submit to a mental examination requested by the prosecutor, the court may preclude the defendant from introducing expert testimony on his own behalf. The defendant has not suggested that this procedure is constitutionally flawed (cf. Estelle v. Smith, 451 U.S. 454 [101 S.Ct. 1866, 68 L.Ed.2d 359])."