I haven’t been writing about Andrea Yates’ retrial thus far because, to be honest, it gives me a heavy heart. I feel such sadness for those children, and such sadness for Andrea. But, as the jury considers her fate, I thought I’d share with you what seems to be a major obstacle in Andrea’s way when it comes to being found not guilty by reason of insanity.

At the Postpartum Support International Annual Conference this year, Dr. Margaret Spinelli, Director of Maternal Mental Health at the New York State Psychiatric Institute and author of an award-winning book on infanticide, explained that most U.S. states use one of two different laws concerning the insanity defense. The first is called the M’Naghten rule, and is also known as the "right or wrong" test. Did the defendant suffer a mental disease that caused her to not know right from wrong or to fail to appreciate the nature of her actions? This is the law Texas uses. From the Encyclopedia of Everyday Law at Enotes.com:

"The M’Naghten rule states: ‘Every man is to be presumed to be sane, and . . . that to establish a defense on the ground of insanity, it must be clearly proved that, at the time of the committing of the act, the party ACCUSED was laboring under such a defect of reason, from disease of mind, as not to know the nature and quality of the act he was doing; or if he did know it, that he did not know he was doing what was wrong.’

The test to determine if defendants can distinguish right from wrong is based on the idea that they must know the difference in order to be convicted of a crime. Determining defendants’ ability to do so may seem straightforward enough, but in practice in cases in which the M’Naghten standard is used dilemmas often arise. One of these is what constitutes the defendants’ ‘knowledge.’ Some questions concern defendants’ knowledge that their criminal acts are wrong and their knowledge that laws exist which prohibit these acts.

Criticism of the M’Naghten test focuses on the test’s concentration on defendants’ cognitive abilities. Then, too, questions occur about how to treat defendants who know their acts are against the law but who cannot control their impulses to commit them. Similarly, the courts need to determine how to evaluate and assign responsibility for emotional factors and compulsion. Finally, because of the rule’s inflexible cognitive standard, it tends to be very difficult for defendants to be found not guilty by reason of insanity. Despite these complications, M’Naghten survives and is currently the rule in a majority of states in regard to the insanity defense …" (note: the highlights are my emphasis)

Other states use the Model Penal Code, which considers both the cognitive and volitional states of the defendant. Did she know right from wrong, but also did she suffer from a mental disease that caused her to lack capacity to appreciate the criminality of her conduct or fail to conform her conduct to the requirements of the law? From the Encyclopedia of Everyday Law at Enotes.com:

"In response to the criticisms of the various tests for the insanity defense, the American Law Institute (ALI) designed a new test for its Model Penal Code in 1962. Under this test, ‘a person is not responsible for criminal conduct if at the time of such conduct as a result of mental disease or defect he lacks substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law.’

The penal code test is much broader than the M’Naghten Rule … It asks whether defendants have a substantial incapacity to appreciate the criminality of their conduct or to conform their conduct to the law rather than the absolute knowledge required by M’Naghten and the absolute inability to control conduct required by the Irresistible Impulse test.

The ALI test [Model Penal Code] also requires that the mental disease or defect be a medical diagnosis …"

If Andrea lived in a state that used the Model Penal Code, I believe she would be found guilty by reason of insanity and sent to a mental institution rather than prison. She may have called 911, indicating knowledge of right from wrong, but from what I understand there is enough data to show that she was delusional. According to this 2003 article from the Dallas Morning News:

"Mrs. Yates’ mental health almost immediately was at issue. Her husband told of years of mental illness, beginning with a severe bout of postpartum depression after the birth of their fourth child.

Medical records released two months after the deaths detailed two suicide attempts and four hospitalizations in mental health facilities. Mrs. Yates’ most recent hospital stay ended less than a month before the drownings, even though she was rarely sleeping and eating, and showing other signs of severe mental illness. In an outpatient visit two weeks before, her doctor took her off Haldol, a powerful antipsychotic drug that had helped her in the past.

In her confession to police, and in interviews with psychiatrists, Mrs. Yates said that she killed the children to spare them from Satan. At times she said she was Satan herself and that the only way to keep her kids from going to hell was to kill them when they were still young so that God would have mercy on their souls. She also told of vivid hallucinations, such as receiving messages from television and seeing the devil in her jail cell."

Did you know that her father and brother are bipolar and her mother suffers from depression? It is such a shocker to look at her heredity, and her medical history, and come up with the conclusion that she was mentally ill? And for anyone reading this who thinks being found not guilty by reason of insanity means a walk in the park for Andrea Yates, they should read this recent article from the Associated Press on what it means to be committed to a mental institution.

This whole event and everything following from it causes me such sadness and distress. Those children should be alive — they, and their mother, were let down by the medical community, insurance companies, child protective services and so many more. What should come of their death is a renewed vigilance among all parties to prevent this from ever happening again. Postpartum psychosis is a serious and dangerous psychiatric emergency that should be properly diagnosed and treated with the utmost in care by parties well-trained in the arena of reproductive psychiatry.

postpartum psychosis postpartum depression Andrea Yates insanity defense