The Andrea Yates Case: Post-Partum Psychosis and the Insanity Defence
Introduction
This article will examine the case of Andrea Yates. This infamous case broke international headlines in 2002, as the world struggled to grapple with the news of the mother who drowned five of her young children with her bare hands. Due to the extensive media coverage of this case, Andrea Yates was vilified by the media. As a result, the harrowing question arose about whether a caring and loving mother other is capable of committing filicide by reason of insanity. This article intends to outline how the societal views in Texas, and the limited information and research available at the time regarding postpartum psychosis, had an influential impact on the verdict in the Yates trial. This article will also discuss the opposing and contrasting perspectives provided by the expert witnesses on the behalf of the prosecution and the defence, while simultaneously tracing the evolution of societal attitudes and developments in Texas case law, involving mothers who commit acts of infanticide when experiencing extreme levels of psychosis and postpartum depression.
Facts
Andrea Yates suffered from a variety of psychiatric disorders such as postpartum depression and psychosis. Many members of her family also suffered from depression and bipolar disorder. However, throughout her childhood and teenage years, Andrea excelled in school and graduated valedictorian of her high school class, before deciding to pursue a career in nursing. Eight years after getting married to her husband Rusty, she began to experience several bouts of postpartum depression which were amplified after the birth of each child. On 20 June 2001, Andrea resorted to drowning her five children, all of whom were under the age of seven. In the Yates Case, renowned psychiatrist Dr. Park Dietz, who had previously testified in the Hinkley and Dahmer case, provided testimony as an expert witness for the prosecution. A multitude of different psychiatrists testified as expert witnesses for the defence, most notably, psychiatrist Dr. Philip Resnick. In 2002 the Yates trial was held in Houston, Texas and the jury returned a verdict of guilty of murder in the first degree. The jury in the first trial was death-qualified, however, they decided that Mrs.Yates would receive a sentence of life imprisonment instead of being executed.
This ruling was overturned by an appeal in 2006, upon the discovery that Dr. Dietz had made an erroneous statement during cross-examination which was referred to by the prosecution during cross-examination of defence witnesses and in the closing statements. As a result, the defence were able to utilise this opportunity to present Andrea’s case to a jury once again by applying the insanity defence. On this occasion, the jury were persuaded by the evidence put forward by the defence and returned a favourable verdict of not guilty by reason of insanity.
The Insanity Defence:
The central forensic issue in the Yates case was to determine whether Andrea Yates could be considered legally sane or whether she should be acquitted of first-degree murder by reason of insanity (NGRI). The defence had an arduous task of legitimising the NGRI defence to the jury. The use of the insanity defence has often been met with an onslaught of criticism by society. It has been frowned upon since it was first introduced in the M’Naghten Case in 1843. There still remains a considerable amount of controversy surrounding the definition of insanity and which legal standard should be adhered to in criminal cases.
As a result of the public outcry concerning the M’Naghten verdict, a strict legal standard was devised in order to test the insanity defence. The two main principles pertaining to the defence of insanity in the United States are the M’Naghten test and the American Law Institute (ALI) test. The most notable distinction between the two standards is that the M’Naghten legal standard is far more stringent as it is a purely cognitive test: the defendant was unaware of what he/she was doing when committing the act or was unable to distinguish between right and wrong. Conversely, the ALI test is quite lenient in comparison, as it contains a volitional limb which provides that even if the individual was aware that the act being committed was morally wrong, the individual was nonetheless incapable of controlling him/herself due to his/her mental illness.
Texas and the Insanity Defence
It is important to note that the State of Texas executes more defendants than any other state (McLellan, F. 2006). The Yates trial was held in Harris County, Tx which is also notorious for executing more people than any other county within the state of Texas. (McLellan. F, 2006). Similar to other states with the US, there is no particular law pertaining to infanticide in the Texas penal code which contrasts with other common law countries such as the UK, (British Infanticide Act 1922). The complexity and ambiguity of the legal statute pertaining to insanity in Texas significantly reduced the likelihood that Mrs. Yates would be found not guilty by reason of insanity.
Texas employs one of the most stringent legal standards when adjudicating cases of insanity. This element makes it extremely difficult for the defendant to plead not guilty by reason of insanity. Based on recent statistics, less than 1 in 400 defendants are found NGRI in the US. Similarly, the NGRI defence is often only invoked in 1 percent of all criminal trials (Lewis. S, 2020). Historically, Texas first applied the M’Naghten test in cases dealing with insanity and subsequently adapted the statute to conform with the ALI test for insanity. However, upon narrowing the legal test for insanity, due to public demand following the Hinkley Case, a stricter M’Naghten test was reestablished in Texas.
According to the Texas Penal Code 2006, §8. 01(A), “It is an affirmative defence to prosecution that, at the time of the conduct charged, the actor, as a result of severe mental disease or defect, did not know that his conduct was wrong.” However, a definition has not been provided by the statute to determine how to interpret the term ‘wrong’. This makes it difficult to decipher whether the term should be understood from a legal or moral point of view. This is referred to by Professor William Winslade, who concedes that this Texas statute is flawed. He notes that the statute is too ambiguous to be interpreted correctly and this will lead to incorrect determinations being formulated and miscarriages of justice taking place (Winslade.W, 1983).
(i) Widespread Misconceptions
The Yates case is a prime example of society’s reluctance to accept a NGRI verdict. This is due to several misconceptions which have over time, become incorrectly acknowledged as universal truths and imbedded within the public vernacular. Firstly, it is widely believed that a NGRI verdict is more desirable than a prison sentence. However, most defendants who are acquitted by reason of insanity often spend a longer period of time in a psychiatric hospital than they would have spent in prison if they been found guilty of the crime (Perlin, 1998, Lilienfeld, S., et al., 2010).
The insanity defence is often perplexing for jurors, due to the fact that a mentally disturbed individual can commit a heinous crime and not be held criminally responsible. Many find his notion counterintuitive to the pursuit of justice in criminal cases, especially for the victim(s). Some also believe that the insanity defence is utilised as a legal loophole which makes a mockery of the judicial system. Statistics reveal that only a third of jurors believe it is wrong to punish those who are found legally insane (Hans, 1986). Furthermore, many jurors believe that if a defendant refuses to take their medication and then commits a crime such as infanticide, the defendant is blameworthy (Finkel, 1995).
(ii) Psychopathology: Andrea Yates
(i) Factors
In order to fully comprehend how a mother could succumb to committing such an unthinkable act, one must trace the origin and progression of her mental illness. In order to achieve this, it is imperative to analyse the risk factors which Andrea was exposed to over the course of her life. It is evident that several factors contributed to Andrea’s downward spiral. Most notably, static risk, dynamic and long-term factors. In contrast to her mid-thirties, her early adulthood was filled with personal achievements and academic excellence. Until the birth of her first child, Andrea Yates lived a very fulfilling life. The birth of her children amplified and exacerbated her genetic predisposition to experiencing depressive episodes.
A. Static Risk Factors
Andrea Yates was genetically predisposed to depression, due to her family history. Andrea and her siblings all inherited this genetic predisposition, many of whom suffer from bi-polar disorder or depression. In this case, the birth of her Andrea’s first child acted as a catalyst for her postpartum depression.
B. Dynamic Factors
Dynamic Factors also increased the likelihood that Andrea would develop postpartum depression and psychosis. Such factors include: the sudden illness and death of her father and her resignation from work at the behest of her husband. Andrea also lost her sense of purpose and freedom.
Increased levels of stress also played a role in her mood swings and altered state, as child-bearing and raising children by herself without support from her husband was very demanding and took an emotional toll on Andrea’s well-being. Environmental changes also had an adverse effect on Andrea’s behaviour. Despite her husband’s impressive financial earnings from his work as an engineer at NASA, he was very frugal with his money. He was also a religious fanatic and believed that it would be much healthier for his family to live a simple lifestyle, by deciding to sell their house and live in a small, cramped trailer. (McLellan. F, 2006).
Static- risk Factors such as her genes and dynamic factors such as the birth of each of her children, combined to form long-term risk factors. This is due to the fact that it is widely acknowledged that each birth considerably increases the likelihood of a mother developing and experiencing psychotic episodes. This also becomes significantly worse over time, especially if a mother has a history of depression. Therefore, Andrea found it more difficult to maintain control over her actions and impulses after the birth of her fifth child than after her first.
C. Postpartum Depression and Psychosis
Following childbirth, a mother may experience psychiatric disorders which can be categorised into postpartum psychosis, postpartum depression and the maternity blues, the latter being the least serious (Manfredi et al., 2005). In contrast to postpartum depression and postpartum psychosis, the baby blues is not rooted in psychopathology and is less severe as the mother is still able to function and carry out her parental responsibilities (Clay & Sheeheusen, 2004). The prevalence of postpartum depression is estimated to be present between 10- 15% of women who have given birth (Bloch, Karen & Klein, 2005). This form of depression usually occurs within the first twelve weeks after childbirth.
Dr. Starbranch, who acted as Andrea’s psychiatrist several months before the incident occurred provided the court with some of the medical notes that were recorded during several psychiatric evaluations carried out on Mrs. Yates. Dr. Starbranch urged both Andrea and her husband to refrain from having any more children. In August 1999, one note stated, “ Patient and husband plan to have as many babies as nature and god will allow...this will surely guarantee future psychotic depression.”
Clay & Sheehusen(2004) note that women experiencing postpartum depression may show symptoms such as feeling worthless and suicidal thoughts, which Andrea similarly experienced. In addition, Clay & Sheehusen (2004) note that according to the DSM-IV, the diagnostic criteria for postpartum depression correlates with major depressive disorder, bipolar disorder or brief psychotic disorder beginning within four weeks of childbirth.
Andrea Yates experienced these types of symptoms upon the birth of her first child. Clay & Sheehusen also note that mothers who are not adequately treated for postpartum psychosis are more likely to commit filicide or infanticide by 4%. In Andrea’s Case, her former psychiatrist Dr. Saed who was the last professional psychiatrist to treat her before the incident occurred, discontinued her Haldol prescription as he did not belief that she was suffering from any form of psychosis. Two days later she drowned her five children.
Expert Witness Testimony
(i) Trial Yates v. Texas, 2002
The court was interested to know Andrea’s mental state during the course of the trial, not when the incident occurred. However, when making a clinical-forensic examination of an individual for an insanity evaluation, the most important time frame is when the act transpired which is a ‘retrospective diagnosis’ (Miller, 84).
Dr. Park Dietz and Dr. Philip Resnick were both in agreement regarding several aspects of Andrea’s mental state on the day the drownings took place. Both of the expert psychiatrists held that Mrs. Yates had a severe mental disease on June 20, 2001, she was aware that drowning her children was against the law in Texas and believed that ending the lives of her children were in their best interests.
Dr. Resnick’s diagnosis of Mrs. Yates was that she suffered from a,“psychosis schizoaffective disorder.” based on several major depressive episodes, paranoid delusions and auditory and visual hallucinations (Resnick, 2007 p. 150). In contrast, Dr. Dietz did not formulate any psychiatric diagnosis after evaluating Mrs. Yates. Both expert witnesses differed on their determination of whether Andrea Yates thought that her actions were 'right or wrong’. Dietz opined that Yates knew that killing her children would be condemned by society and by the law in Texas. However, Resnick stated that that due to her psychiatric illness, this impaired her ability to differentiate between right and wrong on June 20, 2001.
Resnick based his opinion on the following:
1) Yates believed that the minds of her children were going to be poisoned by Satan and would never live a life of ‘righteousness’ which was extremely important to her and her religious beliefs.
2) Yates was willing to be executed in forfeit for having saved the souls of her children in order to kill satan who resided within her.
3) She attempted suicide several times to protect her children before resorting to drowning.
4) Mrs. Yates never wished to conceal her crime and contacted the police immediately.
5) There appeared to be no financial motive or personal gain of drowning her children other than the
rationale of her psychotic beliefs that it was the only way to protect her children.
Conversely, Dr. Dietz testified at the Yates trial that she was fully cognisant of her wrongdoing and by methodically drowning each of her children (Resnick, 2007).
1) Mrs. Yates knew that she would be judged by society and by god as a‘bad’ individual.
2) Andrea Yates was aware that her action was sinful.
3) She had gotten the idea to kill her children by drowning them, after watching a recent episode of law and
order about a similar situation where a mother was acquitted of first degree murder for the drowning of
her children by reason of insanity.
4) Andrea Yates deliberately decided not to disclose her thoughts about Satan’s presence to her family and
friends or the impact this had on her decision-making abilities.
There are many reasons why the NGRI defence failed in the first trial: The captivating expert testimony of Dr. Dietz, the conservative societal views towards the insanity defence in Texas and the shortcomings of the expert witnesses for the defence.
In the first trial, there was nothing solid to refute the testimony given by Dr. Dietz. Everything in the case hinged on his findings. It is also evident that the defence expert witnesses may have unintentionally had an adverse impact on Andrea’s likelihood of success in the first trial. Firstly, the defence psychiatrists did not emphasise her family history of depression and psychiatric disorders, despite the fact that women have a predisposition to postpartum depression if there is a family history of mental disorders (Freeman, et al., 2005). It is highly probable that if this aspect had been explored in depth and presented to the jury clearly and succinctly, this form of concrete evidence would have been highly persuasive. It would have also demonstrated that Andrea’s predisposition to experiencing a mental illness was linked to the fibres of her own DNA and would have negated Dietz’ testimony that Mrs. Yates had control over actions. Therefore, the defence experts erred in this regard.
Similarly, in the first trial, numerous defence psychiatrists testified in the case and referred to different and often, contradicting findings. From the perspective of the jury, this was extremely confusing and made the fact-finding process very complicated in order to ascertain the truth about Andrea’s clinical diagnosis, as the different testimonies lacked any sense of uniformity or coherency. Therefore, the single testimony provided by Dr. Park Dietz for the prosecution, appeared to be more coherent and congruent in comparison to the defence. It would have been more advantageous and in the interests of the defence to have provided one single testimony from Dr. Philip Resnick, being the most experienced psychiatrist in this field who testified for the defence.
Trial Yates v. Texas, 2006
Dr. Resnick served as a rebuttal witness following the testimony provided by Dr. Dietz in the first case.
Dr. Resnick stated that he believed Mrs. Yates killed her children in order to protect their souls from being destroyed by Satan and would ultimately defeat Satan. In addition, Dr. Resnick conceded that the reason she did not openly discuss the presence of Satan was done in order to disallow him from using her words against her.
In addition, Resnick testified that Andrea Yates knew that drowning her children and committing suicide were sins. Yet, in her opinion, allowing her offspring to lead an unrighteous life was far worse. Therefore, in her psychotic state, the most ‘rational’ solution was for her was to drown her children as it was in their best interests, “ Mrs. Yeats chose the lessers of evils.” (Resnick, 2007 p. 157).
Resnick also noted that Andrea Yates, although was aware that what she had done was ‘wrongful’ in the eyes of society, Mrs. Yates also knew that no one else was aware of the dreadful fate which awaited her children at the hands of Satan if she allowed them to live. It is important to note that after several months of anti-psychotic treatment following this incident, Mrs. Yates could not recall that she was, “fulfilling a biblical prophecy.” This demonstrates the severity of her psychosis at the time of the drownings (Resnick, 2007, p. 152).
It is also evident that Dr. Resnick’s findings are more robust than those proposed by Dr. Dietz. For example, Andrea suffered from auditory command hallucinations which would correlate with Resnick’s findings of a schizoaffective disorder as these types of hallucinations are quite frequent among individuals suffering from this type of disorder, which may be potentially harmful for the individual or others (Miller. L, 2013). In addition, Mrs. Yates tried to battle her persecutory delusions and command hallucinations by attempting to commit suicide twice in order to protect her children and liberate herself from her demonic inner turmoil.
Research has found that many individuals often try to resist such commands in the beginning (Miller. L, 2013 p.86). This would also uphold Dr. Resnick’s opinion that Andrea was suffering from a severe form of schizoaffective disorder and postpartum depression which impaired her ability to control her own actions.
In addition, Dr. Resnick has experience carrying out forensic psychological evaluations on women suffering from postpartum depression and psychosis, whereas Dr. Dietz did not.
Fundamental Issues with the Testimony provided by Dr. Dietz
Dr. Dietz and the prosecution, depicted Andrea Yates as a cold and calculated killer, who methodically killed her children and displayed no remorse. However, the testimony provided by Dr. Dietz has been subject to severe criticism from the scientific and legal community.
Firstly, his evaluation was based solely on his interaction with Mrs. Yates which was conducted several months after the incident took place. Conversely, Dr. Resnick conducted his evaluation in the early stages following her arrest. The danger of conducting a forensic psychological evaluation after such an extended period of time is that the demeanour and behaviour of the subject will have evolved and changed dramatically. Findings will differ significantly from moments shortly after the incident compared to several months. Therefore, Dr. Resnick’s evaluations are more accurate and credible due to his early exposure to Andrea’s psychotic behaviour compared to the evaluation conducted by Dr. Dietz several months later.
For example, several parallels can be drawn between Dr. Dietz and Dr. Michael West, a notorious forensic odontologist, who has testified in hundreds of criminal cases on behalf of the prosecution. Dr. West was recently exposed in an investigative report in 2019, that his unconventional and unorthodox practices have led to several wrongful convictions such as the Brewster and Johnson Case. Neither Dr. West nor Dr. Dietz have faced any significant repercussions for the actions, even though some of their errors almost cost the lives of innocent individuals.
Dr. Dietz also made the monumental mistake of introducing false evidence during his oral testimony about a Law and Order episode which ‘supposedly’ aired on television before the incident. Dietz was a consultant for the show and told the jury that he asked Mrs. Yates about the show throughout the course of his forensic psychological evaluation and discovered that she watched the programme regularly. However, such an episode never existed. It could be surmised that Dietz attempted to sow a seed into the minds of the jury that Mrs. Yates had concocted a plan to drown her kids and used the show as a ‘blueprint’ for the crime.
Furthermore, Dr. Dietz did not have experience in postnatal disorders and stopped treating patients in 1982. The last patient he evaluated for postnatal depression was thirty-five years before the Yates Case was brought to trial and he was also unable to verify during the trial whether he had ever dealt with a case which involved psychosis.
Contrast between the First and Second Trial
The Defence was once again faced with the laborious task to challenge any of the jurors preconceived ideas about defendants who plead not guilty by reason of insanity. However, the second trial was successful despite the fact that both Dr. Dietz and Dr. Resnick testified as expert witnesses. When asked in an interview in 2006 about the overturned decision, Judge Belinda Hall, the former presiding judge acknowledged that, “People were more sensitive to the issue.”of postpartum depression and psychosis.
In addition, there had been significant developments in Texas case law pertaining to mothers who commit acts of infanticide since the trial in 2002. In the Deanna Laney Case (2003), a mother stoned two of her children to death and severely injured another. Ms Laney was an extremely religious woman who homeschooled her children. Laney, like Mrs. Yates, suffered from psychotic delusions. A psychiatrist testified in the trial that the defendant was under the impression that she had to kill her children as a testament of her faith. Surprisingly, she was found NGRI and committed to a state mental hospital. This development is highly significant and played a role in securing Andrea’s acquittal in 2006. It is also interesting to note that after one year following the Yates trial, cultural attitudes in Texas had quickly begun to change.
Moreover, following the Yates v. Texas case, clarification on postpartum depression and psychosis was requested to help educate and inform future mothers and the medical community about the potential risks that come with childbirth, especially if the mother in question has a family history of depressive disorders (Spinelli, 2004).
Conclusion
Juries have the important role of acting as fact-finders during the criminal adjudicative process. They often rely upon the expertise of witnesses called upon by the defence and prosecution to fill in the essential psychological and psychiatric missing pieces of the judicial puzzle. It is clear that Dr. Resnick was experienced in the area of postpartum depression and psychosis. His findings and opinions were based on robust and solid evidence which could be analysed and examined. In contrast, the testimony provided by Dr. Dietz as an expert witness, was loosely based on mere speculation and was often ill-founded.
For many years, Andrea Yates was considered the most reprehensible woman in the United States. However, shifting attitudes regarding infanticide cases and postpartum depression improved over time. Society became more tolerant of these acts and also more willing to accept a NGRI verdict.
The Yates case makes reference to the vigorously debated issue about whether the long-established tradition of using expert witnesses in criminal trials should be reformed or dissolved in order to ensure that justice is being administered fairly. Dr. Dietz’s testimony highlights the danger of juries over-relying on expert witness testimony in criminal cases. As Denno (2006) notes, the storytelling process of the expert witness in criminal trials is often unregulated, enabling ample opportunity for misuse and abuse of power. Therefore, it is advised to err on the side of caution when analysing expert witness testimony in criminal proceedings.
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Websites:
Cassel. E (2002). “The Andrea Yates Trial: Did the jury do the right thing?” CNN, https://edition.cnn.com/ 2002/L AW/03/columns/fl.cassel.yates.03.18/
Lewis. S (2020). “Not Guilty by Reason of Insanity: What It means to be insane according to the law.”https://www.psychologytoday.com/ie/blog/law-disorder/202002/not-guilty-reason-insanity
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