PSI Position Statement on Perinatal Psychosis related Crimes
Postpartum Support International (PSI) is an organization dedicated to the mental health of mothers and fathers and the well-being of families around the world. PSI advocates for screening, treatment and prevention of mental illness in pregnant and postpartum women, and for access to informed healthcare providers.
In rare cases crimes, including infanticide, are committed by women with perinatal psychosis, which is too often unrecognized, ignored, or inadequately treated. PSI advocates for a complete mental health assessment when crimes are committed during pregnancy or postpartum. While many countries provide compassionate investigation and legislation, in the United States women often face lengthy and sometimes lifelong incarceration. It is the intent of PSI to promote positive change and advocate for improved knowledge among attorneys, judges, law enforcement, health care providers and the public about perinatal mood disorders including psychosis, and to help change outdated legislation where possible.
Postpartum psychosis occurs after childbirth in 1-2 mothers out of 1000 births, although occasionally psychosis can begin during pregnancy. The symptoms most often begin within the first 2 weeks postpartum, and can include delusions, hallucinations, delirium, and paranoia. At times the woman loses complete touch with reality. Psychosis is a medical emergency that requires immediate and thorough assessment, intervention, and treatment. Although the symptoms of psychosis are severe and present great risk, perinatal psychosis is treatable and women are capable of full recovery. Perinatal psychosis is a temporary illness that needs to be looked at differently than chronic psychiatric disorders. This difference must be understood as women are assessed, defended, and evaluated for crimes committed during a temporary delusional state. Legal insanity definitions can be misleading because the woman may at moments be able to differentiate right from wrong, yet in the delusional state be influenced by extreme compelling thoughts, hallucinations or commands which instruct her to harm her baby. PSI works to increase public and professional understanding that perinatal psychosis, while it presents a serious and immediate potential for harm, is treatable and temporary.
While PSI cannot provide psychiatric or legal evaluation in individual cases, we can provide compassionate understanding to confused or grieving families, and support to incarcerated mothers through our Pen Pal Network for Incarcerated Women. Further, we can help legal and health care providers better understand perinatal mental illness and provide adequate care. We can assist those who are supporting individual cases by sharing information, data, and rationale for just and fair treatment. And we can provide resources to psychiatric and legal professionals who are knowledgeable in the field of Perinatal Mood Disorders.
Through education, advocacy and providing resources for prompt and proper treatment, PSI endeavors to prevent perinatal psychiatric illness and the risk of tragic results that may occur as a result.