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STATE OF TEXAS v. ANDREA YATES

Exhibits to the testimony of Park Dietz, MD, PhD. STATE OF TEXAS v. ANDREA YATES. SPECIALIZED EXPERIENCE. Experience in the Forensic Evaluation of Criminal Responsibility. Hundreds of evaluations of this issue since 1977, for courts, defense attorneys, and prosecutors

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STATE OF TEXAS v. ANDREA YATES

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  1. Exhibits to the testimony of Park Dietz, MD, PhD STATE OF TEXAS v. ANDREA YATES

  2. SPECIALIZED EXPERIENCE

  3. Experience in the Forensic Evaluation of Criminal Responsibility • Hundreds of evaluations of this issue since 1977, for courts, defense attorneys, and prosecutors • Teaching and lecturing on techniques of evaluation at universities and professional conferences in the U.S. and other countries

  4. Experience in the Forensic Evaluation of Criminal Responsibility • Wrote reports about 30 other defendants pleading insanity since 1994 • Found 9 of 30 insane (30%) • Retained by prosecution in 7 of the 9 cases found insane

  5. Maternal Filicide Forensic Experience • Evaluated 14 cases from 1996-2006 • Reached opinions about criminal responsibility in 7 cases: 3 sane, 4 insane • Working for prosecution in all 7

  6. Research on Maternal Filicide • FBI research project • 175 mothers who killed their children

  7. Retention • Contacted July 6, 2001 (16 days after drownings) • Requested all records and exam ASAP • Notified September 26, 2001, that Court had authorized exam

  8. SOURCES OF INFORMATION

  9. Interviews • Mrs. Andrea Yates, 11/6/01 and 11/7/01 (videotaped and audio taped) • Melissa Ferguson, M.D., 11/6/01 • Debra M. Osterman, M.D., 11/7/01 • Mr. and Mrs. Robert Holmes, 11/8/01 • Mr. Russell Yates: requested but refused • Mrs. Dora Yates: requested but refused

  10. Videotaped Interviews by Others • Interview of Russell Yates, 6/21/02, Channel 13 • Recorded portion of the examination by Phillip Resnick, M.D., 7/14/01 • Recorded portion of the examination by Lucy J. Puryear, M.D., 7/27/01 • Recorded portion of the examination by Lucy J. Puryear, M.D., 8/10/01 Cont.

  11. Videotaped Interviews by Others (cont.) • Examination by Phillip Resnick, M.D., 11/3/01 • Excerpts of an interview of Russell Yates, undated, broadcast on 60 Minutes, 12/9/01 • Examination by Lucy J. Puryear, M.D., 2/4/02

  12. Videotaped Interviews by Others (cont.) • Birthday party • Examination by Michael Welner, M.D., 5/3/06 and 5/4/06

  13. Testimony from Prior Proceedings • Mohammad A. Saeed, M.D. • Phillip J. Resnick, M.D. • Lucy J. Puryear, M.D. • Melissa A. Ferguson, M.D. • Steven Rosenblatt, M.D.

  14. Testimony from Prior Proceedings • Ellen Allbritton, M.D. • Earline Willcott, LMSW • Harry Wilson, M.D. • Park Dietz, M.D., Ph.D.

  15. Educational Records re. Defendant • Transcript from Houston Independent School District • Milby High School Yearbook, 1982 • University of Houston records • University of Texas Health Science Center at Houston records

  16. Employment Records re. Defendant • Employment records, M.D. Anderson Hospital and Tumor Institute

  17. Social Service Records re. Defendant • Harris County Child Protective Services records re. Andrea Yates

  18. Medical Records re. Defendant • Ben Taub Hospital Emergency Room, 6/17/99 • Methodist Hospital, 6/18/99 – 6/24/99 • James P. Thompson, Ph.D. • Starbranch Psychiatry Associates, 7/1/99 – 4/3/01 Cont.

  19. Medical Records re. Defendant (cont.) • Spring Shadows Glen Hospital, 7/21/99-8/10/99 • Samaritan Center for Counseling and Education, 8/26/99-2/24/00 • Earline Willcott, LMSW, 5/16/00 – 03/06/01 • Devereux Texas Treatment Network, 3/31/01–4/12/01 Cont.

  20. Medical Records re. Defendant (cont.) • Devereux Texas Treatment Network, 5/04/01–5/22/01 • Mohammad A. Saeed, M.D., 4/19/01 – 6/21/01 • Harris County Jail medical records, 6/20/01 – 12/19/01 • Portions of the medical and psychiatric treatment records from 2002-2006

  21. Investigative Reports • Complete Houston Police Department investigative file • Tape of 911 call by Andrea Yates • Police crime scene photos • Crime scene videotape 

  22. Statements • Statement of Andrea Yates, 6/20/01 (tape and transcript) • Statement of Russell Edison Yates, 6/20/01 (tape and transcript) • Statement of Dora Yates, 6/20/01 (tape and transcript)

  23. Medical Examiner’s Office Investigation • Medical Examiner’s Office crime scene photos • Autopsy report re. Mary Deborah Yates, age 6 months, by Patricia J. Moore, D.O. • Autopsy photographs of Mary Deborah Yates • Autopsy report re. Luke David Yates, age 2, by Harminder S. Narula, M.D. • Autopsy photographs of Luke David Yates Cont.

  24. Medical Examiner’s Office Investigation (cont.) • Autopsy report re. Paul Abraham Yates, age 3, by Harminder S. Narula, M.D. • Autopsy photographs of Paul Abraham Yates • Autopsy report re. John Samuel Yates, age 5, by Patricia J. Moore, D.O. • Autopsy photographs of John Samuel Yates • Autopsy report re. Noah Jack Yates, age 7, by Harminder S. Narula, M.D. • Autopsy photographs of Noah Jack Yates

  25. Forensic Evaluation Records re. Defendant • Report by Steven Rosenblatt, M.D., 6/25/01 • Report by George M. Ringholz, Ph.D., M.D., undated • Report by Phillip J. Resnick, M.D., 02/27/02

  26. Legal Documents • Texas Penal Code, Section 8.01 re. Insanity • Notice of Intent to Offer Evidence of the Insanity Defense, 7/30/01 • Various Motions

  27. Miscellaneous Documents • March – June 2001 Chronology prepared by Debbie Holmes • The Perilous Times, Series: 2000-1J • Various letters to and from Mrs. Yates • Scientific studies of maternal filicide, postpartum illness, haloperidol, and benzodiazepine-induced amnesia

  28. REPORT

  29. Report • Peer-reviewed by Daryl Matthews, M.D., Ph.D., Bennett Blum, M.D., and Daniel Martell, Ph.D. • 103 pages (single spaced) + 144 pages of complete examination transcript (single spaced) • Submitted 2/25/02

  30. REFERRAL QUESTIONS

  31. Referral Questions • Did Andrea Yates have a mental disease or defect on June 20, 2001? • What was her mental state during the time she drowned her children? • During that time, did she know her conduct was wrong?

  32. DID ANDREA YATES HAVE A MENTAL DISEASE OR DEFECT ON JUNE 20, 2001?

  33. Various Doctors’ Diagnoses of Mrs. Yates at Her Worst • Major Depression with Psychotic Features • Schizophrenia • Schizoaffective Disorder • Postpartum Psychosis • Bipolar Disorder + Schizoid Personality Disorder Any of these can be a severe mental disease

  34. Effects of These Mental Diseases • Any of these diseases may cause delusions, hallucinations, or some degree of cognitive impairment in some people, some of the time • People with a particular disease do not all have identical signs and symptoms • A person with a mental disease may have different signs and symptoms at different times

  35. Effects of These Mental Diseases • Sometimes, individuals with each of these diseases kills someone • When someone with a mental disease kills another, it may or may not be at a time when because of delusions, hallucinations, or other psychotic symptoms, that person does not know that killing is wrong • No mental disease causes every killer with the disease to not know what he or she is doing is wrong

  36. The Question of Postpartum Onset • DSM-IV-TR requires onset within 4 weeks of delivery • Some doctors believe the definition should be changed to 3 months or even one year • Changing the definition changes which cases are classified as postpartum onset

  37. The Question of Postpartum Onset • DSM-IV-TR says the symptoms do not differ from those of mood disorders without postpartum onset • Some doctors believe there is a unique condition of postpartum psychosis with hormonal causes, additional symptoms, and faster recovery

  38. The Question of Postpartum Onset • Whether onset was postpartum is not related to the severity of Mrs. Yates symptoms at the time she drowned her children • Whether onset was postpartum is not related to whether Mrs. Yates knew her conduct was wrong when she drowned her children

  39. Timing of Defendant’s Symptom OnsetAfter Luke’s Birth • Depression began 6-8 weeks after Luke’s birth (2/15/99), while living in the bus and home schooling • Psychosis was suspected in July (Dr. Starbranch) • The first clear psychotic symptom (delusion of cameras in the house) was in August

  40. Timing of Defendant’s Symptom OnsetAfter Mary’s Birth • By most accounts, Mrs. Yates’ depression began more than 3 months after Mary’s birth (11/30/00) and after Mrs. Yates’ father’s death (3/12/01) • Unknown when delusions began • Floridly psychotic only after she was in jail

  41. WHAT WAS MRS. YATES’ MENTAL STATE DURING THE TIME SHE DROWNED HER CHILDREN?

  42. Mental Disease vs. Mental State • Mental disease: a serious mental disorder with a known set of signs and symptoms that may fluctuate in severity over time • Mental state: the condition of a person’s mind at a particular time, such as the time of the drownings

  43. Signs and Symptoms Change as Mental State Changes • Mood, affect, energy, and appetite may vary • Cognitive functioning may vary (e.g., consciousness, memory, orientation) • Hallucinations may be present or absent • Delusions may be present or absent

  44. Some of the Factors Influencing Mental State • Natural history of any mental disease • Life events (ordinary, stressful, and traumatic) • Fatigue • Lack of sleep • Medications and other treatment

  45. Some of the Life Events Affecting Mrs. Yates Before Her 1999 Episode of Illness • Giving up her career • Giving up her possessions • Changing her faith • Giving up her identity (according to others) • Allowing her husband to make all decisions • Relative social isolation • Five pregnancies (four births and a miscarriage) • Living in an RV and a bus • Home schooling her children

  46. Treatment Delayed and Refused in 1999 • Feeling depressed and overwhelmed, she asked her husband for help, but got medical attention only upon taking an overdose (June) • Flushed Zyprexa (July) • ECT recommended by Drs. Thompson and Rios; Mr. and Mrs. Yates refused (August) • Against medical advice, secretly went off all medication (November)

  47. Medical Advice Disregarded in 2000 • Against medical advice, became pregnant (February) • Against medical advice, failed to take medication during pregnancy • Against medical advice, failed to take medication after Mary’s birth (November 30)

  48. Evidence of Mrs. Yates’ Mental State 11/30/00 – 3/12/01 • Mrs. Yates said she had a reasonably normal Christmas • Resumed fitness routine of morning swim for 2-3 months • According to Mr. Yates, she “was fine” • According to Ms. Willicott, she was not psychotic but rather a devoted, perfectionistic mother worried about her father’s declining health in early March • Kept a detailed journal of home schooling until 3/12/01

  49. New Stressors in 2001 • Mrs. Yates’ father fell (January) and declined in health • Mrs. Yates’ father died (March 12th) • Felt guilty about not doing enough for her father • Separation from her family during admissions to Devereux (March and May) • Felt guilty about not attending to her children as she wished • Worried about her children bonding with Dora and not coming to her • Worried about her children being taken away

  50. Medical Advice Ignored and Delusions Hidden in 2001 • Dr. Saeed told Mr. Yates that someone must be with his wife at all times (April) • Dr. Saeed recommended ECT; Mr. and Mrs. Yates refused (May) • Mrs. Yates denied delusions or hallucinations countless times when asked by MDs • Two delusions (cameras and television)—known only to Mr. and Mrs. Yates—were kept secret from all doctors (August 1999-June 2001) • Mrs. Yates was left alone with the children for an hour (June 20, 2001)

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