Oprah on bipolar and violence

Andrea Petrosky killed her child. On The Oprah Show today, she talks about it, and about her bipolar disorder.

Petrosky is one in a long line of mothers whose untreated or wrongly treated severe mental illness had such a sickening result. In fact, of children killed by a parent, 15.8 percent of defendants had a history of untreated mental illness.

What she has to say about it sounds very familiar.

Andrea says the person who killed her son "wasn't me. It wasn't the real me. It was a very sick me, because I would never hurt him. Never," she says.

Her voice is an eerie echo of many who have been through similar circumstances. Like Naomi Gaines, who killed her 14-month old twins.

"I know how I was feeling that day. I know I was not the same Naomi who got up with my kids a million times before and fed them and bathed them and walked them and breast-fed them and cared for them," she says. "I wasn't that same person. So I know that I would never hurt them if I had had my sanity."

It isn’t the disease that leads to violence, it is the lack of timely and effective treatment for that disease.

People with severe psychiatric disorders are not more dangerous than the general population - if they are being treated. But without treatment, some commit acts of violence because of their delusions and hallucinations. Many of the cases in the news eventually uncover the fact that the person who killed their child was not taking medication. And research shows that the most common reason that people with severe mental illness refuse treatment is because they are too sick to realize they need treatment.

Don’t believe the hype you will hear today from some in the mental health community – that these cases are extremely rare. In Texas just last week, Alysha Green doused her three-, five-, and seven-year old daughters with gasoline and lit them on fire. The three-year-old has since died. Alysha’s husband says his wife had a history of mental illness with a past diagnosis of bipolar disorder. She was prescribed medication. She stopped taking her medication and, her husband reported, her behavior deteriorated in the three weeks prior to the tragedy. That same week, Helen Kirk was found insane in her murder trial in Massachusetts – she told police she believed her son Justin was “the devil” after she strangled him.

Oprah also talks to General Hospital star Maurice Benard and actress Jenifer Lewis from their perspectives as people with bipolar disorder. Benard returns to the issue of violence when he recounts what happened one evening when he was off medication.

“I started yelling. And I told [my wife] if she didn't stop [crying], that I was going to kill her—in my mind I didn't believe I would."

As much as we don’t want it to be true, violent behavior is one of the consequences of failing to treat. Even NIMH gets that now.

Oprah doesn’t delve into the concept of assisted outpatient treatment, which is too bad. The obvious question after a show like this is “how can we help people before they get so sick?” Maybe in a future show, they will include the perspectives of so many who can attest to the importance and value of earlier intervention.

Until then, we call this a good beginning.

Victims of untreated mental illness

Two recent stories at opposite ends of the criminal justice system mirrored those of Andrea Yates, LaShaun Harris, Sherry Sims, Christine Wilhelm, and so many others.

In Massachusetts yesterday Helen Kirk was found not guilty by reason of insanity for fatally strangling her 3- year-old son. Kirk had a long history of mental illness and believed her son was the devil when she strangled him. She will finally be getting treatment in the state hospital where she is committed.

A young mother in Texas faces a capital murder charge. On Saturday, Alysha Green doused her three girls and herself with gasoline and lit them on fire. One of the girls died; two remain in the hospital.

Alysha’s husband says his wife had a history of mental illness with a past diagnosis of bipolar disorder. She was prescribed medication. She stopped taking her medication and, her husband reported, her behavior deteriorated in the last three weeks.

Will Alysha Green someday be committed to treatment as Helen Kirk was? Maybe.
For now four children are victims of untreated mental illness. The mothers are victims too; once they're brought back to reality they must live with something unfathomable.

Plagued by the memories

In Tennessee on Monday, Sherry Sims drowned her 4-year-old daughter. Sims' mother said to reporters: "My daughter is a good mother. She takes real good care of her children. She loves her children. I know if she was still taking her medicine [for schizophrenia], nothing like this would've ever happened."

A news story from New York this week reports that Christine Wilhelm, like Andrea Yates, is "plagued by the memories." Wilhelm also drowned her 4-year-old child, and attempted to drown his brother. She is sentenced to spend the rest of her life in prison.

Will Sims and Wilhelm have more of a chance to get treatment instead of punishment considering the recent Andrea Yates verdict? Possibly. But their children suffered the same fate. And their mothers, once brought back to reality, must live with something unfathomable.

The status quo is unacceptable

It took five terrible years for a jury to decide that Andrea Yates was insane when she murdered her children, despite overwhelming evidence regarding the severity of her illness. She will likely spend the rest of her days in a maximum-security forensic hospital. Eric Clark will spend at least the next 25 years in an Arizona prison, where his family still struggles to ensure he receives adequate treatment. And a story from Pensacola, Florida is the latest in a mind-numbingly long list detailing the terrible conditions the mentally ill face when incarcerated.

The theme running through each of these tragedies is simple: the criminal justice system is a meager substitute for mental health care. Mental health departments across the country are failing in their missions, and are far too willing to abandon the most difficult individuals to jail cells and prisons.

So the next time you read an article about the horrendous conditions in a local jail, or an incident where a family couldn’t get treatment for their son because he wasn’t “dangerous enough yet,” ask yourself, is my mental health department doing all it can to help the most severely ill? Have they implemented AOT? Are they still relying on outdated dangerousness standards for determining who needs care? Are they advocating for change, or simply enforcing the status quo?

We’ve seen the results of the status quo, and they are unacceptable.

Was it worth it?

Andrea Yates has been found not guilty by reason of insanity in the drowning deaths of her five young children. No doubt many pundits, like Andy Cohen of the Washington Post, will find this verdict a victory for both compassion and common sense.

We agree but also ask an additional question – why was this trial necessary at all? The possibility of a capitol sentence was eliminated in the first trial. Hundreds of thousands – if not millions – of public dollars were expended determining whether Andrea Yates would spend her next guilt-ridden years in a jail or a locked psychiatric facility.

How to get into an inpatient psychiatric facility ...

Is the only way to access inpatient treatment for someone who is extremely ill an act of unfathomable violence?

William Bruce will be moved from prison to a psychiatric facilty at least long enough for evaluation - the local sheriff is relieved, noting the prison isn't a good place for inmates with serious mental health conditions. Bruce killed his mother, his family had been trying desperately to help him.

Too often such horrible events spur a call for punishment instead of compassion. Andrea Yates' fate is being decided in the deaths of her 5 children for a second time, but recall that the first time, she ended up in jail. That is where Brenda Drayton is headed as well - for the next 20-30 years, for killing her daughter.

Most often weak state laws make us wait until a crime is committed to help someone ... and then the focus is on punishment, not treatment. People with severe mental illnesses deserve to get real help from the civil treatment system before situations occur that lead them to be punished by the criminal one.

William Bruce, Andrea Yates, Brenda Drayton - if they could have been on an outpatient commitment order long before they committed murder, they might not have gotten so sick to need a hospital bed ... or land in a jail cell.

Yates leaves prison

Andrea Yates will get treatment in a psychiatric facility instead of prison ...

READ MORE: A mother speaks from jail about killing her child (not Andrea Yates) Words from Yates’ mother Better off in a hospital?

Insanity Defense: A True Story

[Lori] Farmer says she knows ... the voices weren't real. God would never urge her to hurt someone -- least of all her 4-year-old son, who loved Batman and used to run around in a cape that his grandma made from an old skirt. Zane was buried in his pretend cape 10 years ago. Farmer killed him.

When you read news reports of Andrea Yates’ new trial, keep Lori Farmer in mind. Farmer was found not guilty by reason of insanity and is now living in a group home, after years of treatment in a secure psychiatric facility. Her story is a rare look at the insanity defense from the perspective of the person charged with a crime.

And if the emotions of her story don’t get you, think about this.

People who are treated at places such as Western State Hospital are much less likely to commit another crime than those who land in prison, according to Bruce Gage, supervising psychiatrist for the hospital's Center for Forensic Services. He said most people released from prison will break the law within three years, while the recidivism rate for people found insane and treated at a specialized psychiatric program is less than 5 percent.

Yates better off in hospital than prison?

Andrea Yates will be moving from prison to a psychiatric facility until her new trial. It is a small win in a story of terrible loss.

Yates’ family had a history of bipolar disorder and depression and she had a history of suicide attempts and hospitalizations. By all accounts, Yates was in a state of continued deterioration in the months before the murders – she would sit and stare into space, she had lost a tremendous amount of weight, she was not showering.

Notes from her April 2001 release from one voluntary assessment say to “contact [the doctor] if danger to self or others.”

On June 18, 2001, her husband said she was still deteriorating and asked that her medication be adjusted. The doctor “told Andrea to think positive rather than negative thoughts.”

On June 20, she drowned her five children.

In interviews after the murders she talked about how her children would “perish in the fires of hell if they were not killed.” She asked for a razor to see if the “mark of the beast (666) was still on her head.” She also mentioned that she had been unable to destroy Satan, so then-Governor Bush would have to do it.

Yes, a psychiatric hospital is a better place for her than prison. How sad that we let the debate reach this point.

MORE: A mother speaks from prison about killing her kids ... Yates’ mother hopes Andrea can get treatment ... Children deserve protection ... Wait until he escalates ... Andrea Yates ... Parents who kill their kids

A mother speaks

There are too many stories about mothers with untreated severe mental illnesses who kill their children – and too few answers to the questions of “why?”.

You rarely hear directly from the mothers themselves, people like Andrea Yates or Lashaun Harris.

An unusual jailhouse interview with Naomi Gaines sheds some light … Gaines threw her 14-month-old twin sons into the river in St. Paul and then jumped in after them. She and one of the babies were rescued.

"I know how I was feeling that day. I know I was not the same Naomi who got up with my kids a million times before and fed them and bathed them and walked them and breast-fed them and cared for them," she says. "I wasn't that same person. So I know that I would never hurt them if I had had my sanity."

Yates’ mother: "I'm hoping that they'll realize [Andrea] was sick”

Andrea Yates’ mother and her ex-husband were both quoted in news stories praising Wednesday’s decision to overturn Yates’ conviction on charges of murdering her five children.

"I would like to see a plea agreement, not guilty by reason of insanity, and have her go to a hospital [said Russell Yates]. I don't know if the state's gonna agree to that or not, but certainly I hope the two sides can come together and reach some common ground so that we don't have to go back to trial and Andrea doesn't have to spend the rest of her life in prison."

Yates’ attorney has said that they will plead insanity in hopes of getting her moved to a psychiatric facility.

While we again watch the mental health community rally around Andrea Yates to spare her a life sentence in prison, remember to wonder where they were when she was desperately ill and in need of help …

Asking "why?": First step in reform

Perhaps looking from almost 2,000 miles away at a mother who ended the lives of her three children allowed the editor of the Texarkana Gazette to gain this thoughtful perspective. Lashaun Harris, as you will recall, threw her three young children to their death off a pier in San Francisco – she was not taking medication for her schizophrenia at the time.

The editor of this Texas paper – a state all too familiar with tragedies like this one – chooses not to finger-point but instead to ask questions about what could have brought a woman and her three sons to the end of that now infamous pier. The answers hold the beginnings of solutions that can bring help instead of headlines to the next Lashaun Harris, Andrea Yates, Dena Schlosser, Julie Rifkin ...

And the main question?

The problem with the benchmark of having to be a danger to oneself or others is that often the damage has been done - tragedy has struck - when the dangerous behavior becomes, at last, recognizable enough to meet that standard. Why can we not make sure people who need medication stay on it?

Children deserve protection

It was a bad week all around.

In Ohio, a man bludgeoned his 13-year old daughter to death – he was not taking his medication for bipolar disorder.

In California, a woman threw her three young children off a pier to their death – she was hearing voices.

By comparison, these stories make this mother from Vermont look lucky – her son was only arrested. But her plea is too familiar.

"I have been trying desperately to get him some medical help but he has been deemed not dangerous enough to be admitted against his will … In the past, when he got appropriate treatment and followed his care plan, he was not having a lot of problems."

Treatment embraced voluntarily is always preferred - but in some cases, the disease may not make that possible. It is time for us to realize that it is just and humane to intervene long before something devastating happens. Did we learn nothing from the Andrea Yates case?

Averting tragedy is not always politically correct. It is not simple, or easy. It often requires family members to petition the court for intervention, and people who are desperately ill to be treated despite refusing treatment. But it works.

MORE: what is it like to hear voices? * help for overwhelmed family members * state laws