PSI Statement on Tragedies Associated with Psychosis
Postpartum Support International (PSI) PSI is the global champion for perinatal mental health (PMH), connecting individuals and families with the resources and support needed to give them the strongest and healthiest start possible. For 35 years, PSI has led the effort to address PMH disorders, working with experts and families to strengthen scientific knowledge and emotional understanding to develop and deliver effective interventions for all perinatal individuals and families.
Postpartum psychosis occurs after childbirth in approximately 1-2 out of 1000 births, although occasionally psychosis may begin during pregnancy or after a pregnancy loss. Of that number, 4% of those involved infanticide. Symptoms of postpartum psychosis usually begin within the first 2 weeks after birth, and may include delusions, hallucinations, delirium, and paranoia. Sometimes people lose complete touch with reality. Psychosis is a medical emergency that requires immediate care and thorough assessment, intervention, and treatment. Although the symptoms of psychosis are severe and carry significant risk, perinatal psychosis is treatable and individuals are capable of full recovery. Perinatal psychosis is a temporary illness that needs to be viewed differently than chronic psychiatric disorders. This distinction must be understood as individuals are assessed, defended, and evaluated for alleged crimes committed during a temporary and treatable delusional state. Definitions of legal insanity can be misleading, as the individual experiencing postpartum psychosis may at times be able to distinguish right from wrong, but in the delusional state is influenced by strong compelling beliefs, hallucinations, or order that may teach them to hurt their baby.
In a very small percentage of cases, individuals experiencing severe symptoms of perinatal psychosis act out delusions that result in harm, neglect, or infanticide. Perinatal psychosis is too often unrecognized, ignored, or inadequately treated. PSI advocates for a complete mental health evaluation and clinical evaluation when an individual is suspected of having committed a crime during pregnancy or postpartum. While many countries provide compassionate trials and laws, in the United States individuals often face long and sometimes life imprisonment. PSI aims to promote positive change and justice, and to promote improved knowledge among lawyers, judges, law enforcement, health care providers and the public about perinatal mental health disorders including psychosis, and to help change outdated legislation if possible. PSI works to increase public and professional understanding that perinatal psychosis, while it presents serious and immediate potential for harm, is treatable and temporary.
PSI cannot provide psychiatric or legal evaluations in individual cases. We have resources available for affected individuals, families and professionals. Here are some resources:
Through education, advocacy, and providing resources for prompt and proper treatment, PSI strives to prevent the crises associated with perinatal psychiatric illness and the risk of tragic outcomes. We strive to increase informed mental health coverage on these topics, including fair and equitable coverage for all individuals and families.
