Representative Jessica Farrar (D-TX) has introduced a new bill to the Texas Legislature which could limit jail time for mothers who commit infanticide while suffering from postpartum psychosis. While adoption of this historic bill would not replace or affect the appropriate use of the insanity defense for such crimes – a defense which can eliminate jail time while mandating sustained psychological treatment – it would limit jail time consideration during the penalty phase to two years for mothers deemed to have been under the influence of a pregnancy or lactation related psychosis within 12 months of giving birth at the time of the offense.
George Parnham, the Houston based attorney who defended Andrea Yates, helped draft the legislation and as a practitioner and advocate, I served as a reviewer. Mr. Parnham has been an unfailing advocate and champion of this issue, helping to lead professionals and constituents toward enlightened consideration rather than prejudicial condemnation. Parnham, Farrar, and Dr. Margaret Spinelli, expert witness and author of the book Infanticide, exemplify the convergence of social justice and compassion as they seek to inform and reform social, psychiatric and legal perspectives on maternal mental health issues. You can read the story which broke in Sunday’s Dallas Morning News by Wendy Hundley.
The primarily outraged comments which follow the story – the majority in passionate opposition to the measure – evidence the ongoing stigma of mental illness which seems to escalate to merciless intolerance upon consideration of a mentally ill mother. Is it any wonder that encouraging suffering mothers to reach out for help has proved so challenging? Former New Jersey First Lady Mary Jo Codey has tried to encourage early identification and treatment through her “Speak Up When You’re Down” campaign.
While the death or harm to a helpless infant brings understandable revulsion, jurors are charged with consideration of crime context when deliberating punishment. The insanity defense exists because severe mental illness is a reality which blinds reason. This proposal seeks to include postpartum psychosis as a moderating condition in the penalty phase – it does not seek to remove responsibility for infant welfare.
There is one misquote in the article that is important to correct. Instead of “for every mother who receives treatment, there are ten who are in jail”, that statement should have read, “For every mother whose trial results in mandated psychological treatment only, there are ten who may receive jail time under current legal mandates”.
Providing this new and historic option to jurors during the penalty phase following conviction offers the option of assigning more appropriate and compassionate treatment, including intensive psychological care. By its very existence this legal option serves to decriminalize acts related to severe maternal psychosis, assign appropriate causative factors and add emphasis to the need for awareness, earlier detection, intervention and even the shared responsibility of family and providers in bringing the mother to treatment. Such tragedies can be prevented which is the ultimate goal of the maternal mental health movement.
While many other civilized countries in the world already have an infanticide defense that does NOT include jail time, the United States continues to lag behind in our legal and social understanding of these disorders.
In other activities which bring opportunities for primary prevention and awareness, efforts are underway on the state and federal level, such as The Melanie Blocker Stokes MOTHERS Act, to initiate public awareness campaigns, conduct more research and offer assessment, support and screening to mothers during and after pregnancy. The bill is named after Melanie Blocker Stokes – an intelligent, successful and devoted young mother who leapt to her death as a result of postpartum psychosis. The bill was reintroduced to the 111th Congress by U. S. Senator Robert Menendez in the senate and Congressman Bobby L. Rush in the House of Representatives this past January.
Postpartum psychosis is an extremely rare (less than 1 in a thousand) condition in which a mother may be susceptible to “command hallucinations”, i.e. auditory or visual hallucinations which may order her to kill her children in order to save them and her family or prevent evil. This condition presents a true psychiatric emergency and immediate treatment is required to prevent possible tragedy.
Because psychotic hallucinations may consistently present and involve establishment of a plan eventually resulting in death of the infant, woman or both, it can be difficult for a considering jury to believe the mother is truly insane feeling that “insane people are not logical and could not execute a step by step plan”. Such misunderstanding of the course and content of psychotic illness fuels outrage sometimes resulting in jail terms equivalent to those meant for intentional murder or manslaughter.
One determination of psychosis may be a mother’s own response to troubling thoughts, feelings and urges. A woman with the more common postpartum depression, for example, may have thoughts of harming her baby, herself, wishing to give the baby up for adoption, or regret the baby’s birth, but she is deeply troubled and repulsed by these feelings and usually does not act on them. A woman with the extremely rare form of postpartum psychosis, however, believes these hallucinations are real, that following the commands may save herself and her child from perceived evil, and is therefore more likely to act on such thoughts. Medication can often stabilize pyschosis within days or weeks, ending the transient break from reality.
The bill for a sentence cap now proposed to the Texas legislature is not perfect. It would be preferable that psychological help and treatment be the primary “penalty” for the mother who creates a crime while suffering from the severe incapacitation of postpartum psychosis. But its submission to the Texas legislature marks a critical first step toward helping jurors acknowledge the reality, characteristics and attributions of postpartum psychosis and its role in establishing the degree of culpability for infanticide.
Many thanks to Representative Jessica Farrar, attorney George Parnham, Dr. Margaret Spinelli and Former New Jersey First Lady Mary Jo Codey – all members of the President’s Advisory Council of Postpartum Support International, for continuing to champion legal process, precedent and perspective, for women suffering from extreme postpartum illnesses. It takes strength of character and deep commitment to weather the storms of public outcry that understandably emerge around infant murder. Our nation is further encouraged to search its soul and move toward more empathic understanding of maternal mental illness.