Who Should Be Punished When Maternal Mental Illness Kills Children?

In 2014, a young mother who had been evaluated and given prescription medication for a mood disorder killed her two young children (as described in http://www.oxygen.com/blogs/mom-suffocates-her-two-kids-to-death-with-plastic-bags-and-duct-tape; see also Lynh Bui, “Mother who suffocated children with plastic bags and duct tape sentenced to 45 years”, Washington Post, June 7, 2017). She had initially threatened to kill herself and her daughter, and her own mother called the police, who took the younger woman to a hospital for a mental health evaluation. Against her mother’s objections, the young woman, Sonya Spoon, was released with a prescription for antidepressants four days later. Hospital staff apparently did not have information about her threats to the children. A day and a half after that, Sonya Spoon killed her 3-year-old and 1-year-old children by suffocating them, and put the same plastic bag and duct tape around her own head, but then went to get her mother to help remove the suffocating material. The children were unconscious and died later. Sonya subsequently said she did not know what was wrong with her and apologized to her dead children.

Arguments about mitigating circumstances for Sonya Spoon’s actions included the off-base claim that she suffered from an attachment disorder because of having been abandoned as a young infant by her Russian biological family, spending several years in an orphanage, and finally being adopted to the United States. This experience, although very sad and distressing , might well have interfered with her cognitive and language development, but attachment disorder is less likely and in any case would not make her likely to be either suicidal or harmful to others. A factor with a more probably connection to her behavior was a traumatic brain injury from and accident when she was 18—an event likely to interfere with her cognitive abilities and possibly to produce post-traumatic stress disorder. At least one of her children was fathered by an abusive man, who wanted custody, which she resisted. Either in addition to or because of these experiences, Sonya Spoon had perinatal mood disorder—often called post-partum depression, but sometimes continuing well after the post-partum period.

Shifting and negative moods are typical of the days soon after childbirth, but most women experience only “baby blues” in which they feel easily overwhelmed and ready to cry. Many traditional cultures have made sure that new mothers are honored, cared for, and petted during these days, which do not last long. A small number of women experience much more profound anxiety and depression, often focused on whether there is something wrong with the baby, and this may not begin at once. Whenever depression and anxiety are in the picture, suicidal thoughts and actions are very possible, and these may be part of the more severe perinatal mood disorders. Finally, a very small proportion of women experience a post-childbirth period of psychosis which again may not begin at once. They may have delusions of hearing voices that tell them to harm themselves or their children, and some obey. In the famous Andrea Yates case of some years ago, Yates drowned her five young children in the bathtub in obedience to “voices”; she also gave the rationale that she felt they should die and go to heaven at once rather than risking the sins of childhood and adulthood.

Andrea Yates had experienced perinatal mood disorders with each of her five children, but her husband was said to have encouraged further pregnancies. She was found competent to stand trial, a very low bar for which it only had to be shown that she could understand the charges and could work with her lawyer, but she was eventually found not guilty by reason of insanity (the death penalty had been sought). Sonya Spoon was also found competent to stand trial and convicted; the judge said some of her actions had been “selfish”.

Yes, it’s true that the children did get the death penalty, and their terror and pain as they died hardly bears thinking about. But who is really in the wrong here? Does Sonya Spoon deserve 45 years in prison, but the child’s father who did not pay attention to her state of mind is not to be punished? How about hospital staff who did not explore her situation far enough to know that she had threatened the children? For that matter, what about insurance and other regulations that limit the amount of mental health care available even to those who desperately need it? And what about a judge who brought a trivial view of the human mind to the trial by declaring Sonya Spoon “selfish” because she asked her mother to release her from the suffocating bag before seeing to the children? Just like Andrea Yates’ husband and family, these people contributed much to the tragedies, but punishing mentally ill mothers alone is a fine old tradition that apparently must be kept up.