Monday, March 23, 2009

Should postpartum psychosis be a legal defense when Moms kill kids?

The Dallas News reports on legislation (HB 3318) by Texas state Reps Jessica Farrar and Garnet Coleman that would make postpartum disorder a legal defense for women who kill their children, allowing jurors to hear testimony at the sentencing phase about the medical issues surrounding postpartum psychosis, potentially sentencing the offense as a state jail felony if they believe that's what spawned the tragic event ("Proposed bill would recognize postpartum psychosis as defense for Moms who kill infants," March 23):
If lawmakers approve the measure, Texas would be the first state to have an infanticide law, said George Parnham, the Houston attorney who defended [Andrea] Yates.
"It's something every civilized country has on its books," said Parnham, a strong proponent of the legislation. "The only thing that will change public attitude is education about postpartum issues."
The bill, introduced earlier this month by Rep. Jessica Farrar, D-Houston, applies to women who commit the crime within 12 months of giving birth. If jurors find a defendant guilty of murder, they can take testimony about postpartum issues into consideration during the trial's punishment phase.
If jurors believe that the woman's judgment was impaired as a result of childbirth or lactation, they can find her guilty of infanticide – a state jail felony that would carry a maximum punishment of two years in jail. ...
Postpartum depression is recognized as a legal defense in at least 29 nations, including Britain, which has had an infanticide law on the books since 1922.
"These countries have accepted the reality of postpartum mood disorders," said Susan Dowd Stone, chair of the President's Advisory Council for Postpartum Support International, a California-based advocacy group. ...

Only one or two in 1,000 women develop postpartum psychosis that has been cited in high-profile cases like those of Schlosser, the Plano mother who killed her baby in 2004 by cutting off her arms, and Yates, the Houston mother who drowned her five children in 2001. Both women were found not guilty by reason of insanity and placed in mental-health treatment centers.
For every woman who receives treatment, there are 10 who are imprisoned for the crime, Stone said.
"These are not intentional acts," she said. "That's so hard for the public to grasp."
Postpartum psychosis is a rare condition that generally affects women with extreme sensitivity to hormonal fluctuations and a history of mental illness, Stone said.
Dr. Lucy Puryear, who was a defense expert in Andrea Yates' murder case, has written on this subject over at Women in Crime Ink. I'd be interested to hear her take on the bill. See more background on the subject from Postpartum Support International.
MORE (3/24): From Postpartum Progress, and the Houston Press' Hairballs blog. And since I'd asked for Dr. Puryear's opinion, let me highlight these views she expressed in Grits' comments:
I don't know exactly what the bill says that has been proposed but I'm not sure I'm in favor of conducting a trial and then hearing evidence about postpartum issues that would mitigate the sentance. I AM in favor of what England has, which is when a mother kills a child less than one year of age, the mother is FIRST evaluated by mental health professionals and if found to be suffering from postpartum illness then she is given appropriate treatment. It IS a waste of time, talent, and money to put an otherwise well functioning woman through a lengthy and expensive court process when the issue is medical, not criminal. It would be akin to what is being proposed in Houston, a "mental health court" where persons with mental illness are treated and tried by those who understand the nature of mental illness and it's effect on behavior.

No, I am NOT saying that if you are mentally ill then you should never be held responsible for your behavior. I am saying that if you do not have "control" over your behavior due to your mental illness than your circumstances are different. It is like having a seizure. No one can stop a seizure from happening: the behavior is avolitional, including shaking, eye rolling, wetting your pants, and being confused for a time afterwards. And yes there is medication for seizures, and guess what? People who seizure also stop taking their medication, as do people with diabetes, or heart disease, or any other medical disorder that requires someone to be compliant and tolerate side effects.

I am ranting I realize.

Very few women who suffer from postpartum illness kill their children. Most kill themselves. And of those who do committ infanticide, most kill themselves when released from jail or the hospital. When they are well they can't live with the horror of their actions.

Well, I have to go help some more people with mental illness, otherwise you'd hear more from me. Thanks for listening.

19 comments:

editor said...

This is the slippery slope from Not Guilty by Reason of Insanity to diminished capacity defense such as that in Dan White's case. I don't agree with this. A mother who kills their child needs more intensive treatment than what is offered at a state jail facility. Even that will only be two years at most and no outpatient followup afterwards (well, maybe 90 days) then out with no supervision. If you have ever worked with mothers that have killed their children, when they come out of their psychosis they can be very suicidal. Our insanity laws are not perfect, but it's better than this. I have a great deal of respect for George Parnham and the humane intentions of this law, but the taxpayers don't want to pay for outpatient treatment. So, with our current system, I do not agree with this bill. Yes postpartum psychosis should be a legal defense if used in TCCP 46C defenses.

StirCrazyInTexas.blogspot.com

TxBluesMan said...

That's about the dumbest reason for a defense that I've heard yet from the "let's not hold anyone accountable" crowd.

I get real bad sinus headaches, can we put a defense in the law for those?

Anonymous said...

Typical. If it's not in the "Code of the West" or "like we've always done here in Texas," then it must be hogwash. There's a reason some people gravitate toward being cops; and it's on display whenever blues posts.

Anonymous said...

Bluesy:

Do you not think someone has to be insane to drown her five kids?

Hell, her husband was the one who should have been found competent and tried, she should have been committed from the start.

And I bet you could care less about the state making up evidence on the stand in order to get a conviction.

Rage

sunray's wench said...

I think it should be admissible evidence, if a woman has shown attributable post-natal depression symptoms. It would need to be seen with all the other evidence, with nothing witheld or forgotten about by either side.

It's OK to take responsibility TXBluesMan, but how does one be responsible for one's own mental illness?

Do we have any figures for the number of women in TX each year who are accused, and/or found guilty of deliberately killing their child or children?

Akere said...

We already have an insanity defense and it worked for Andrea Yates so this new bill is not really needed because the existing laws effectively cover this situation.

Some lobbyist must have run out of good ideas and needs something that "sounds good" to justify his salary.

This is a waste time, talent, and money.

Lucy Puryear MD said...

Most of you have posted some pretty sensible comments. It's refreshing. I don't know exactly what the bill says that has been proposed but I'm not sure I'm in favor of conducting a trial and then hearing evidence about postpartum issues that would mitigate the sentance. I AM in favor of what England has, which is when a mother kills a child less than one year of age, the mother is FIRST evaluated by mental health professionals and if found to be suffering from postpartum illness then she is given appropriate treatment. It IS a waste of time, talent, and money to put an otherwise well functioning woman through a lengthy and expensive court process when the issue is medical, not criminal. It would be akin to what is being proposed in Houston, a "mental health court" where persons with mental illness are treated and tried by those who understand the nature of mental illness and it's effect on behavior. No, I am NOT saying that if you are mentally ill then you should never be held responsible for your behavior. I am saying that if you do not have "control" over your behavior due to your mental illness than your circumstances are different. It is like having a seizure. No one can stop a seizure from happening: the behavior is avolitional, icluding shaking, eye rolling, wetting your pants, and being confused for a time afterwards. And yes there is medication for seizures, and guess what? People who seizure also stop taking their medication, as do people with diabetes, or heart disease, or any other medical disorder that requires someone to be compliant and tolerate side effects.

I am ranting I realize.

Very few women who suffer from postpartum illness kill their children. Most kill themselves. And of those who do committ infanticide, most kill themselves when released from jail or the hospital. When they are well they can live with the horror of their actions.

Well, I have to go help some more people with mental illness, otherwise you'd hear more from me. Thanks for listening.

sunray's wench said...

Akere ~ post-natal depression is NOT insanity.

Lucy Puryear ~ absolutely!

Anonymous said...

I suffered from postpartum psychosis several yrs ago. I would break into sweats, felt overwhelming sadness, and kept hearing my dead grandfather calling my name. I did not have a history of mental illness. My husband, parents, and in laws all coordinated times to be with me. Not once was I left alone.
A woman suffering with postpartum psychosis can't hide symptoms. I know I looked absolutely nuts. How about the sane family members not leave children in her care? Hospitals should require at least one adult be informed regarding postpartum psychosis before leaving the hospital. We need more public outreach.

123txpublicdefender123 said...

Dr. Puryear, thank you for all the work that you do.

I am not sure how I feel about the proposed law. On its face, it's pretty similar to the way Texas handles involuntary manslaughter. You get convicted of murder, and then, in sentencing, the jury can consider whether you acted under "sudden passion." If so, your sentencing range is the same as that for a 2nd degree felony, 2-20 years (or probation if you've never been convicted of a felony before), instead of the 5-99 or life you're looking at for a first degree charge. The only difference here is that it would reduce the penalty range to state jail felony punishment instead of second degree.

I agree with Dr. Puryear, that the best thing to do would be to have the woman examined immediately by mental health professionals, and divert the case from the criminal justice system if she was clearly suffering from mental illness. I don't think anything like that has a chance in hell of passing here, though. So, maybe this is a good first step.

TxBluesMan said...

Rage,

Do you really care what I think? Or would you rather see me in a liberal gulag?

I'm not surprised that you want to go after someone that did not kill 5 kids so that your poster child could be set free...


Akere is correct - this is just touchy-feely legislation...

Lucy Puryear MD said...

I think Texas having a law in place for infanticide similar to England is like waiting for my 15 year old son to put the seat down--not gonna happen anytime soon. But I do agree this may be a good first step. But I don't think this will pass either--we are a very anti-mental health state. Public awareness is paramount and yes people should be taught about postpartum disorders so that they can protect mother's and their children. In Houston the Mental Health Association publishes a brochure that now goes home with every new mom describing postpartum illness and where to go for help. Did you know that postpartum depression is the NUMBER ONE adverse outcome after childbirth? It affects more women than bleeding or infection. We can bury our heads in the sand and scoff at these disorders, but 10 to 15 % of all women will suffer from postpartum depression, 1 in 1000 from postpartum psychosis. These are real illnesses that have real consequences for women and their families.

Akere said...

Just because it is a real problem doesn't mean we need a separate extrajudicial mechanism for dealing with it. There are a bunch of safeguards built in for criminal prosecutions that don't apply in other regulator arenas.

Consider the power of Child Protective Services and how they can do some things that the police would never do alone. The big mess with those polygamists might be the first thing that comes to mind but they do all kinds of stuff every day on a smaller scale that isn't subject to the same scrutiny that the justice system gives criminal prosecutions.

I don't see a compelling reason to build a new bureaucracy.

Terence Lenamon said...

As the attorney for Yvette Yallico, who pled guilty to drowning her almost twenty-month old daughter Catherine in 1999 because of “voices,” I am very familiar with filicide issues. I applaud the State of Texas’s efforts to pass this bill recognizing postpartum depression as a legal defense to filicide.

Progressive postpartum depression is one of the least recognized diseases suffered by young mothers despite the fact that almost 80% of women who give birth experience some form of postpartum upset. Although this symptom picture is well described in the research literature, postpartum depression is not recognized in the mental health professional’s legal “bible,” the Diagnostic Statistical Manual of Mental Disorders as a distinct illness. Because progressive postpartum depression is not a recognized legal defense and may manifest itself in combination with other mental illnesses, it is often difficult to determine its role in cases of filicide.

As this Grits for Breakfast article mentioned, people around the world have recognized that filicide, which is sometimes referred to as infanticide, is a distinct form of homicide due to the impact of motherhood on women’s mental status. However, it is interesting to note that even though this country does not officially recognize that filicide is significantly different from other homicides, one U.S. study of filicide found that local district attorneys prosecuted only 64% of 171 cases over a 30-year period. With rising costs and shrinking judicial budgets, this law makes sense on many levels.

- Terry Lenamon

Anonymous said...

Rage said that you'd have to be crazy to kill 5 kids.

I think one would have to be crazy to kill at all, don't you think?

We are all mentally ill to some extent and if the motivation and price, is right, I'm sure you could find a Post hole Digger out there to say you were.

Does anyone have any numbers as to how many children were killed by their mothers last year?

Anonymous said...

Terence Lenamon said,
"With rising costs and shrinking judicial budgets, this law makes sense on many levels."

Are you under some delusion that the mental health system is well funded?

Katherine Stone said...

I appreciate the reasoned discussion of this issue, which I haven't seen in many other places.

Anonymous said...

You win Blues. I have succumbed to your logic that Yates' post-partum psychosis is exactly like your sinus headache.


(In all truth, I've just given up hoping that you have a brain cell left.)

I think one would have to be crazy to kill at all, don't you think?

No. You could be mean. Or hungry.

No one is arguing that all mental issues should qualify as "insane" in Texas. But the ones that make you clearly psychotic should.

Should Dahmer have gotten off with an insanity defense because he liked to eat people? Nope. But if he ate them because they looked like sandwiches and God told him to... probably.


We already have an insanity defense and it worked for Andrea Yates...

Not really. She was convicted of capital murder, and only after the state was busted making up evidence in her first trial was the state (including the judge) forced to acquiesce on some evidentiary rulings in the second trial. Only the widespread publicity and getting their hands caught in the cookie jar forced the correct result in that case. What was patently obvious to people with a brain wasn't enough the first go-round. Our current laws are clearly not enough.

Rage

Anonymous said...

I JUST CAME UPON THIS THREAD. I SUFFERED POST PARTUM PSYCHOSIS AFTER BOTH OF MY DAUGHTERS WERE BORN.
NEEDLESS TO SAY--IT WAS NOT A HAPPY TIME--TO FEEL THE URGE TO KILL MY HUSBAND AND TO COMMIT SUICIDE. I WON'T GO INTO LONG DETAILS. I WAS HOSPITALIZED AND GIVEN PSYCHOTIC MEDS (THORAZINE AND STELAZINE) WHICH MADE MY MIND SO CLOUDY. I WAS RELEASED AFTER ALMOST 2 MONTHS.
WHEN MY 2ND DAUGHTER WAS BORN--THE HOSPITAL WAS AWARE OF MY CONDITION AND AGAIN THE PREGNANCY WAS BEAUTIFUL, BUT 5 DAYS AFTER GIVING BIRTH BY C-SECTION THIS TIME I STARTED INTO MY DEPRESSION.
THIS TIME I WAS HOLDING MY BABY IN THE NURSERY AND BREASTFEEDING HER. THE URGE CAME ON ME TO SMASH HER TO THE FLOOR.

THANKFULLY I WAS ABLE TO KEEP MY WITS--CALLED THE NURSE AND WAS TRANSFERRED TO THE PSYCHIATRIC DIVISION OF THE HOSPITAL. THIS TIME I WENT HOME AFTER 6 VWEEKS--MY DOCTOR ASKED ME WHY I WOULD WANT MORE BABIES AFTER WHAT HAPPENED . WHEN I STATED THAT THIS TIME IT WASN'T AS LONG--SHE STATED THAT NEXT TIME I MIGHT NOT SNAP OUT OF IT. I WAS "LUCKY" I PRAYED SO DESPERATELY AND GOD PROTECTED MY FAMILY AND MYSELF.
THE MIND IS SO FRAGILE AND YOU CAN'T "SEE" THE PROBLEM WITH AN MRI ETC.
I AM A GRANDMOTHER NOW, BUT I HAVEN'T FORGOTTEN HOW I WAS TREATED LIKE I WAS A CRIMINAL--IT'S NO JOKE BEING LOCKED UP IN A PSYCHO WARD WITH REALLY BAD CASES--I'M GRATEFUL TO GOD THAT HE GAVE ME STRENGTH TO FIGHT THE THOUGHTS THAT CAME INTO MY HEAD
I CAN EMPATHIZE WITH ANDREA YATES. SHE IS IN HER OWM MENTAL PRISON UNTIL SHE DIES
DON'T PASS JUDGEMRNT UNTIL YOU'VE TRAVELED THE SAME ROAD