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A Nation In Denial About Mental Illness


Wednesday, Mar. 27, 2002

Many people find it hard to believe that Andrea Yates was insane when she killed her children. Indeed, one cannot really blame them, because in judging Yates, they are simply drawing on widespread beliefs about insanity.

While understandable, this common perspective - shared by the Yates jury - does not accurately reflect the reality of Andrea Yates's mental state at the time of the killings. It underlines instead the dramatic chasm that divides public perceptions and myths about mental illness from what psychiatrists and other experts know to be its reality.

Why Yates Seemed Sane To Many

Why do people resist the conclusion that Andrea Yates may have been insane? The evidence seems to negate insanity in a number of ways.

First of all, Yates planned her actions carefully. She waited for the one hour when no other adults would be in the house. (Her husband had already left for work, and her mother-in-law had not yet arrived to babysit.) .

In addition, she seemed efficient and unrelenting in her actions. Rather than being overcome with emotion, she appeared strangely numb and under control - more like a merciless soldier than a distraught mother. She killed five, one after the other. And when her oldest son, Noah, resisted and fought for his life, Andrea overpowered him and would not let go. She forced him to die in the same tub water in which she had killed all four of his siblings - several of whom had vomited and defecated as they died.

Further, even after the terrible killings, Andrea was able to speak coherently, to sound rational, and to retain her composure. Immediately upon drowning her defenseless children, Andrea called the police and confessed. She was calm as she explained what she had done. And then, when the police arrived at her home, she continued to act unperturbed about the grotesque slaughter that she had only moments ago carried out. The police found the bodies lined up neatly, still wet, on Andrea's bed.

Moreover, Andrea Yates understood the nature of her actions. She did not mistakenly believe that she was washing the laundry or putting out a fire. She had in fact premeditated the deaths of her four young sons - Noah, John, Paul, and Luke - and her six-month-old daughter, Mary, before that fateful day. This left many among even those who are generally sympathetic toward those standing trial in criminal court skeptical. How could Andrea have been insane, they wondered, if she knew exactly what she was doing the whole time?

And finally, Andrea understood that society - including her husband, her mother-in-law, and the police - would disapprove of her actions. She knew, in other words, that she was committing a criminal act that would be condemned by all.

That was all she needed to qualify as sane. The test for insanity in Texas, quite similar to that in most states, is whether the defendant understood that what she was doing was wrong.

For all of these reasons, Andrea does not resemble the image many of us have of the truly insane. In the popular imagination, an "insane" person is disheveled, raving, and has no idea what she is doing. She is full of passion and rage and cannot respond to reason or think about her community's moral commitments.

An insane person accordingly, by the lights of many, does not coldly plan and premeditate killings of children and then calmly talk about what she has done. Such behavior is the mark of a rational, depraved and evil heart. A person who would perpetrate such acts in such a manner deserves to suffer punishment.

The defense accordingly faced substantial obstacles stemming from both law and social expectations when it attempted to convince the jury that Yates was not guilty by reason of insanity.

The Reality of Mental Illness: A Portrait From a Poe Story

The image of mental illness that dominates the popular imagination, however, is inaccurate. It ignores the reality of mental illness, even at its most serious and debilitating.

For a more accurate portrait of madness, consider the narrator in "The Telltale Heart," a short story by Edgar Allan Poe. The narrator stresses that he is not mad - indeed, could not possibly be mad, given how calmly and carefully he planned and carried out an unjustifiable killing of a man with a deformed eye.

Poe's narrator challenges the reader, "How, then, am I mad? Hearken! and observe how healthily - how calmly I can tell you the whole story." He later comments, "Madmen know nothing. But you should have seen me. You should have seen how wisely I proceeded - with what caution - with what foresight - with what dissimulation I went to work!"

It is hard to read these descriptions now and not think of Andrea Yates - her calm, her caution, and her foresight, and yet her utter madness.

Like Yates, Poe's narrator suffers from a psychotically distorted perception of the world. He "hears" the beating of a dead man's heart and boasts that, "I heard all things in the heaven and in the earth. I heard many things in hell." Yates claimed to have "heard" Satan's message that her children had to be killed if they were to be saved.

The reader of the Poe story can tell that the narrator, despite his protestations, is completely out of his mind. Under the Texas criminal law, of course, he might not have qualified for the defense - since he seems to have understood both what he was doing and that it was wrong.

Yates's Depression and Post-Partum Psychosis: When "Good People" Kill

Andrea Yates was (and is) a very sick person. No one in the case has disputed that. The delusions from which she suffered distorted her reality almost beyond recognition. She had loved her five children - as every witness who knew her and knew her relationship with her family confirmed. She had not physically or mentally abused her offspring, nor had she neglected their needs. Until she came under the spell of the belief that they had to die, she had adored them and treated them with affection, kindness, and love.

When she killed her children, Andrea Yates suffered from two kinds of mental illness: post-partum depression and post-partum psychosis. Both of them are painful, frightening, and crippling. Though she had suffered from these conditions after giving birth to her fourth child, she and her husband nonetheless proceeded with a fifth pregnancy.

According to Andrea's husband, Rusty Yates, he had brought her to a psychiatrist several days before she killed their children. The psychiatrist, Rusty claims, refused to put Andrea on Haldol, an anti-psychotic medication that had worked for her in the past. As an alternative, the doctor adjusted the dosage of her anti-depressants and told Andrea to think positive thoughts. Had he instead prescribed Haldol, the tragedies that ensued might have been averted.

Andrea and her husband, like the surrounding society, underestimated the power of mental illness. They thought that since Andrea was a good person, she would never harm her beloved children. Strangers have now embraced the converse inference, believing that since Andrea killed her children and did so methodically, she must never have been a good person or a loving mother in the first place.

The shared assumption underlying both these beliefs is the notion that mental illness cannot affect one's essential nature: A good person cannot be compelled by psychosis to do bad things. Unfortunately, this assumption is false.

Yates did not rant and rave like a Hollywood portrayal of a mentally ill woman, nor did she mistake her own actions for something other than homicide. She believed, however, that her children had to die or they would suffer the fires of hell. We do not know what put such an idea into her head. She had apparently been close with a traveling preacher, a spiritual mentor who told Andrea that she was evil, that her children were damned, and that only death could save her. Perhaps this played some role in the particular shape that her pathology took, though we may never know.

However it got there, the idea possessed her consciousness. To understand how she felt, one might try to imagine the motives of Jewish women whose children were about to be discovered in their hiding places during World War II. Knowing that their children would otherwise be taken to Auschwitz, some mothers might have given them cyanide and done so out of love.

In Andrea's case, of course, Nazis were not pursuing her family, and neither - so far as we know - was Satan. Her children could have been safe and happy if she had not brutally snuffed out their lives. Because of mental illness, however, Andrea experienced an urgency that misguidedly and insanely could have led her to feel as strongly as the mothers facing Nazis that what she was doing was in the best interests of her children. Indeed, the prosecutors themselves acknowledged that this might well have been the case.

Yates's was not a rational point of view. It was an obsessive, psychotic delusion. It was, in a word, insane. The law, and our society, should have counseled the Texas jury so to find, and Yates should now be provided with treatment, not consigned to a prison term.

A Different Approach to Infanticide

As we contemplate Andrea Yates's fate, we should consider for a moment how other Western nations have dealt with similar cases. Infanticide statutes in at least 30 countries rule out murder charges and usually impose sentences of probation and counseling instead. These statutes reveal an understanding of the reality of post-partum mental illness, and a willingness to presume that sickness, rather than malevolence, explains most such cases.

Andrea Yates, by contrast, will spend the next forty years in prison and could legally have been sentenced to be executed in the State of Texas. It is time for the United States to cultivate more of the compassion and enlightenment that other countries have exhibited in responding to the ravages of what we sometimes call "insanity."

Sherry F. Colb is a visiting professor at University of Pennsylvania and a professor at Rutgers Law School. She teaches and writes about mental health law, among other subjects.

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