Monday, November 10, 2008

It's An Outrage

by Lucy Puryear, M.D.

"Woman Who Cut Off Baby's Arms to be Released," Houston Chronicle, November 7, 2008. Dee Schlosser was arrested in Dallas, in November of 2004 for cutting off her daughter Maggie's arms, resulting in her death. In the aftermath of the Andrea Yates case in Texas, several women have been found not guilty by reason of insanity after killing their children. All of these women, including Schlosser, were psychotic at the time of the killings. Schlosser believed that by cutting off her daughter's arms she was making a more perfect offering to God. The police came to her home and found her soaked in blood humming along to a hymn.

Schlosser was sent to a state mental hospital where she received treatment and continued to be under the jurisdiction of the court. According to law, persons found NGRI (not guilty by reason of insanity) must remain in a state mental hospital indefinitely until it is determined by their psychiatrist that they are no longer a danger to themselves or others and can be maintained in outpatient treatment. Schlosser will be released into the community where she will be mandated to meet with a psychiatrist weekly. She will no longer be allowed to have contact with her other two children, and may not be in close proximity to any other children. It is unknown where she will live when released. She will remain under the jurisdiction of the court permanently and will be forced to return to the hospital if she again becomes dangerous.

Understandably the prosecutors of Collin County are unhappy with her release and wish the laws were different. Understandably the citizens of Dallas are unhappy that she may released into their community. Understandably there may be some renewed talk about having the laws changed. Maybe Dee Schlosser should have been committed to a state psychiatric facility for the rest of her life? It is an outrage that a mother who killed her children is free to walk the streets.

I am going to ask you to believe that Dee Schlosser should be released and be free to live what ever kind of life she is able to piece together for herself. She is no longer psychotic, she is on medication, she will be monitored by a psychiatrist to make sure that she remains well. So why should she remain in the hospital; just so our sensibilities are appeased? That's a waste of money. Her being in the hospital does not protect you or your children. Dee Schlosser has no intention of coming to your house to cut off the arms of your child.

Many of you would say she should be in jail, or even executed for what she did. That would solve the problem. She did something bad and she should be punished. Does it matter that her brain was malfunctioning? That the blood flow to certain areas of the brain were increased where they shouldn't have been and decreased to other parts? Was this happening to her because she chose to be crazy or decided that hearing voices and was a good idea?

Let me ask you to fantasize for a moment. What if you had a hundred and four degree fever and you became delirious. You were hearing someone walking into your room in the middle of the night and when you looked up you saw a masked man carrying a gun. You reached for your gun on the bedside table and shot. Only later when your illness was treated were you aware that you had shot your husband. Death penalty? Think that's not possible? Hallucinations happen all the time with high fevers and brain infections. Your brain is malfunctioning.

Let's speculate again. You are driving in your car and have a heart attack. You swerve off the road and plow into a group of people standing on the corner of the street. A mother and her young child are killed. Death penalty? Clearly you didn't do this on purpose. Your heart was malfunctioning and caused behavior that was out of your control. Let me go a little further. What if you knew you were at risk for heart disease but declined diet and exercise and didn't take your heart medication because you didn't like the side effects. Death penalty? Surely you knew you were at risk for a heart attack. In fact you doctor warned you on numerous occasions. The fact that you had a heart attack isn't all that surprising. Are you responsible for those deaths?

Mental illness is a brain disorder. The symptoms are behavioral, and often the symptoms are horrific. No one wishes to be mentally ill, anymore than someone asks to have diabetes or heart disease or meningitis. And untreated the symptoms of mental illness can be deadly, just like any other medical illness. Not just for yourself, but as I described above, for others. Why do we treat the mentally ill as criminals?

Dee Schlosser will never live a care free life. She must live with the knowledge and memory of killing her child. She will no longer be able to care for or have contact with her other children, and her marriage ended in divorce. What kind of life will she have? Can you imagine waking up every day to that horror? As a matter of fact, most mothers who have killed their children eventually end up killing themselves.

Let me let you in on a secret. Every single one of you reading this has a mental illness, has a family member with a mental illness, or knows someone who has one. And if you don't know someone who does that's simply because they don't talk about it. The stigma of mental illness is so great that we can't face admitting that we are all affected. This is not unlike epilepsy in earlier times. Until the cause of and treatment for epilepsy was discovered family members were hidden in asylums, attics, and weren't allowed to marry into good families. That is where mental illness is today.

Dee Schlosser deserves to be released if she is no longer suffering from her symptoms. She is medicated and no longer poses any danger to anyone. Don't worry, if you feel the need for her to be punished she already has been. She will continue to suffer every day of her life no matter where she is living. She needs our prayers. And we need to pray that some day we can find the cause of and a cure for mental illness so that no one kills their child because they're sick.


Anonymous said...

I do agree with the fact that we all either have a mental illness or have a family member or know someone with it. But, I have a news flash for you, some of these people need to be locked up but haven't been because they haven't done anything to justify it - yet. It is just a matter of time for a lot of them.

The problem with Schlosser, as I see it, is that we all know that mentally ill people very often stop taking their meds. So, is she going to be subjected to freqeuent blood tests to determine if she is indeed taking her meds, or are her physicians just going to take her word for it? Maybe she is going to suffer for the rest of her life, but she can just as easily do that in a mental institution.

Mental illness is very different from other illnesses that only affect the person with the illness. They don't put society at risk. I don't think that mentally ill people ought to be sent to prison, but they do need to removed from main stream society. To me we are taking the same chance letting a mentally ill person free from an institution as a violent convict out on parole. Just because we can all understand and sympathize with a mentally ill person rather that a violent offender doesn't mean they should be free.

Lucy Puryear MD said...

Most people with mental illness don't commit violent crimes. Locking up someone for a crime that was caused by a brain disorder makes no sense, anymore than locking up the person who had a heart attack and killed the young mother on the street corner as in my example.

And as a matter of fact, most people don't take their medication as instructed, not just those with mental illness. Again as in my example of the heart attack victem; they knew they were at risk for a heart attack but didn't take their meds because of side effects. Should they be kept in the hospital after their heart is better, just in case they might throw their meds out the window and stop at the Dairy Queen on the way home?

The issue I think you are struggling with, is that when on medication most people with mental illness are just like you and me. Yes, that means Dee Schlosser and Andrea Yates. They act and seem completely normal when they are on medication and their brain is functioning normally. You wouldn't know that they were sick.

And no, you don't take someone's word that they are taking medication. That's why she will be monitered by a psychiatrist. Believe it or not, we can tell by talking to someone and noticing other behaviors whether or not someone is seriously ill.

I do agree however that there are some persons who would benefit from what used to be called "institutionalization." There are a few who are unable to care for themselves and take medication unless they are living in a supervised setting. Because of the civil rights movements in the 60's that's not allowed any longer. That's been both good and bad.

Sorry for my long response!

Jodi Scaife said...

I don't think that paying for Dee Schlosser to be locked up in a mental hospital for the rest of her life if she can be safely monitored on the outside is a viable use of tax payer dollars. Did she commit a horrible act of violence? Yes. Has she been held responsible for it? To the extent that she was capable of understanding it at the time, yes. Is she ever going to forget what she did? No. She will have to live with the knowledge that she killed her child because she had not taken control of her mental health. That's a heavy thing to live with now that Dee has her psychoses under control.

Anonymous said...

Leah your comment tells me that you know next to nothing about mental illness and you know no one with mental illness. If it was up to someone like you we would be rounding them all up and putting them on an island not unlike what people wanted to do with persons with leprosy.

Anonymous said...

You would be wrong about that Rosie. I have dealt with a grandmothe, an aunt and currently a cousin with mental illness. Do you know how hard it is to get anyone committed before they commit a crime or hurt themselves?

I don't understand the correlation between a person that MIGHT have a heart attack versus a person who has already killed. I understand they are both ill, but that is comparing apples and oranges.

Anonymous said...

I am sorry to hear you have had troubles with family members with very severe mental illnesses.

What got me going was when you wrote: I don't think that mentally ill people ought to be sent to prison, but they do need to removed from main stream society.

Give that you have a right to your opinion, this groups all mentally ill people together, as if all of them cannot function in society. There are many forms of mental illness, and many of them are not the type where the ill person is a danger to society.

Yes, I do know how hard it is to get someone committed, as I had an aunt with major problems. I also know that not everyone with a mental illness is in need of being sent to a facility because of their illness.

Lucy Puryear MD said...

Thanks all for the great conversations. It is hard to get someone committed even when you know they are at risk. The law says they must be in IMMEDIATE danger of hurting themselves or others. In general protecting someon's civil liberties is a good thing, however sometimes it makes it very hard to get help for those who need it.

The correlation between heart attack and mental illness was about both being capable of harming another (plowing your car into a group of people, hearing voices telling you to stab someone), but both of those killings being related to a persons medical illness not because it was something they intended to or wanted to do. I think because mental illness is in our brains, we have a hard time believing we don't have ultimate control over our own thoughts. Believe me, we do not when the temporal lobe is activated by an internal mechanism, not be an external person actually talking to you. The person "hearing" the voice "hears" it the same as if there really was someone there. The brain can not tell the difference, neither can you.

Anonymous said...

Your argument about the heart attack is compelling, but there's still a fundamental difference. The majority of people with mental illness do not kill other people.

This woman's brain made a choice to kill; in the heart attack case there was no decision to do so. It doesn't matter that it was malfunctioning - the same malfunction could happen again. If the heart attack case is let go and suffers the same incident, the odds are that nobody will be hurt (i.e. they may not be driving this time). If this woman is let go and suffers the same incident, the odds are that someone will be hurt.

Losing control of a car and deliberately maiming someone are not comparable at all. It doesn't matter that it "wasn't her" - her decision making organ has proven itself capable of a malfunction that resulted in the torture and death of a small child. And we're going to risk letting this complex, not-fully-understood organ go free?

Anonymous said...

Rosie, I think it's possible that Leah meant that violent offenders who are mentally ill should be removed from mainstream society. At least, that's what I hope she meant, otherwise, I'd have to strongly disagree with her. I've known mentally ill people who functioned well with medication and treatment. It depends on the circumstances, the severity of the illness, and a multitude of factors. But, rounding them all up and socking them away in institutions? No way.

Anonymous said...

I correlate mental illness in this case more with the alcoholic/drug addict that knows he can't use but does so anyway and someone gets hurt. Both the alcoholic and the person hearing voices are making a choice. The person having the heart attack isn't.

My issue with instutions is that they sometimes do what prisons do when they get overcrowded - they let the person least likely to reoffend free. Institutions also do it when a person is functioning normally and the institution has nothing left to offer them in the way of treatment. That is fine if they aren't murderers. There are some individuals in both prison and institutions that don't need to be free in our society. As far as wasting tax payers money, we are paying for it one way or another. Does Dee have a means of support and her medical care after she is released?

Anonymous said...

If she's no longer mentally ill, then why restrict her from being around children?

There's a lot of mental illness, but like other commenters here, most don't dismember innocent babies. So it's your professional opinion that she'll never snap again, that despite proof of a horrid and extremely painful act during her temporary lapse of sanity, she'll never commit another extreme crime of humanity during another temporary lapse of sanity?

As far as being monitored, we regularly see how well that works when previously convicted pedophiles strike again while supposedly being monitored.

And perhaps this woman truly was insane at the time she committed this heinous act, but how many others get away with false claims of insanity.

No, she shouldn't be allowed to move freely in society. Her insane moment has proven her to be an extreme risk to weaker beings during her insane time/s.

Anonymous said...

Much as we would like to think so, not every mother who kills her children is mentally ill. I know that it is easier to rationalize such inhuman behavior by passing it off as an illnes. All murdering mothers aren't hearing voices or suffering from post partum depression. Sometimes they are evil narcissists who see their family as just in the way of something that they want. Some people can't be made better. That is who they are and that is who they will always be... a danger to other people. I haven't met any of the women mentioned in the article or comments, so I can't judge their mental health. But, believe me, I've met that other woman in spades. I've looked evil in the eye and I know that she needs to be kept away from other people for the rest of her life. Is saving the taxpayers' money worth the risk of letting a monster loose to kill again? Tell me your opinion when it's your child or grandchild that stands in her way.

Lucy Puryear MD said...

Not every mother who her child is isane. As a matter of fact most aren't. Leah and anonymous, I am going to take umbrage with your sense that people who have mental illnesses have choices to be ill or not. You are holding someone with a psychiatric illness to a standard higher than you would hold yourself. If your BRAIN is not functioning, you LOSE the ability to make rational, sensible, logical, unbiased decisions. People with mental illness are not BAD people, or somehow different from you and me. By the grace of God or good genes have you and I been spared what afflicted Dee Schlosser.

As for monitoring someone who'd ill, it's what I do everyday. It's just like any other doctor who moniters blood pressure or blood sugar or weight.

The most frustrating thing to me about this issue is the inability for people to accept and understand that psychiatric illness is no different that any other disease that any of us have or could have. And the people that it affects is all of us.

Anonymous said...

I agree with your clinical assessment that mental illenss is like any other medical standards and definition. But the symptoms and the affects of certain mental illness are not the same as epilepsy, diabetes, heart disease or meningitis. And you aren't prescribing the same types of drugs to treat all these diseases.

I don't believe Dee or Andrea should be sent to prison specifically because of their mental illness - insanity at the time of the crime. I also don't believe, as you stated, that they choose to be mentally ill. But, I don't see what that has to do with anything. I hope you are accurate in your assessment of Dee and that she can be a productive citizen because, as you have already gleaned, there is a long line of people waiting to say "I told you so". And because I am certain that Dee is only the beginning of what is to come.

Anonymous said...

Mental illness is to cardiovascular disease as kites are to jet aircraft. It is an illogical comparison. Just like drinking milk as an infant does not lead to substance abuse as an adult.
Febrile induced visual hallucinations are self limited acute events that cannot be compared to the chronic psychotic whose delusions are merely tempered with psychotropic Rx's and never "cured" per se.
Irresponsible behavior,regardless of the mental capacity of the perpetrator, is a threat to society and should have consequences. Consequences must be reasonable under the circumstances and not arbitrary or hypothetical.
Statistically, those individuals afflicted with psychiatric disorders taken as a whole are not more likely then the general population to commit violent crimes. However, once that criminal threshold is crossed, aberrant synapses notwithstanding, punishment should be equally meted out.
This "mentally challenged" individual is no longer a potential threat she is a real threat and the future risk to society outweighs this individual's right of freedom to roam our streets with marginal supervision. Mental Illness is not the exact science you allude it to be and non compliance issues inherent in this group of patients inter alia will have dire consequences.

Anonymous said...

My problem with this issue is the opposite of Leah's. Many people assume that if a mother kills her children she is ill. That isn't assumed if the murderer is the father.

When people read that my daughter-in-law smothered her two small children last year and then hacked my son to death with a sword, they immediately ask what many of you are probably thinking, "What did he do to make her do that?" The second thing they ask is if she is mentally ill. Would they ask those things if she was lying at the top of the stairs in a pool of blood and he had the sword in his hand? I greatly doubt it.

Our society usually assumes that women are always nuturing, always innocent and always the victim. That isn't true. Men and women alike can be cruel or kind, loving or hateful. The fact that a few cases of mental illness are sensationalized across the nation gives many people the idea that their cases are typical. That's a disservice to innocent victims.

And by the way, people HAVE asked me to my face what my son did to deserve to be murdered. Many times. I learned for the first time at a hearing yesterday that he was stabbed 97 times, so this is a sensitive subject for me today. I apologize if I have gone overboard.

Anonymous said...

Dr. Puryear:

How prevalent is violence among people with borderline personality disorder?

And why is BPD so hard to diagnose?

Thank you for your opinions and for your writing. I enjoy your posts.

Anonymous said...

I would like to know if you can guarantee that she will never commit another act of violence as long as she is free. I would also like to know if you [I am assuming you are her psychiatrist] are going to be held accountable if she does, and if so to what extent. I feel like it is unfair of you to ask us to welcome Dee back into society and believe that nothing but good can come of it if you can't.

Anonymous said...

It took me a while to find out that:

[1] Dee's real name is Dena.
[2] When she killed her baby she had stopped taking her meds.
[3] Her last phychotic episode was less than two years ago and
[4] According to the Dallas Morning News, Sat. 8 Nov 08, this is a statement by a professional named Mr. Dix: "There is no typical period of institutionalization in cases such as this. Most mental health professionals agree that once a patient reaches "maximum receptivity" to treatment, they should be released".

Anonymous said...

It doesn't seem right that she should go free, but it is the law in Texas at least

Anonymous said...

To Jan:
I don't think you went overboard. Of all the comments, yours make the most 'sense' to me.


p.s. And, while I'm 'talking' to you,' I just want to say that I think you have a great blog. I discovered it last week and read it cover to cover and will check it often. I have also sent the link to a friend whose daughter was murdered by her boyfriend.

Anonymous said...

I am the anonymous commenter being addressed in this quote:

"I am going to take umbrage with your sense that people who have mental illnesses have choices to be ill or not. You are holding someone with a psychiatric illness to a standard higher than you would hold yourself. If your BRAIN is not functioning, you LOSE the ability to make rational, sensible, logical, unbiased decisions. People with mental illness are not BAD people, or somehow different from you and me"

I never said she was a bad person, nor did I say she should be in prison. But, she is a proven danger to society, even if it's not by choice.

Rabies is a medical condition, not a chosen behavior by the infected animal. They probably weren't "bad animals" prior to becoming infected. But they should still be isolated from other beings because of the danger to others. Rabies was the only medical condition I could think of, but it doesn't mean I think psychotic people should be put down just because rabies animals are (you seem to be VERY sensitive).

Just because "professionals" can't come up with any more solutions for psychotic people that have performed heinous acts shouldn't mean that they should be released to the general public.

As far as monitoring, in addition to my pedo analogy, I once worked with a woman who had a schizophrenic client -- she made a lot of money off him, and he considered her one of his friends. All went well with this, until he either decided he didn't want to take his meds any longer, or just forgot. He failed to check in with his monitor person, who showed up at our place of business in the hopes that my coworker had seen him. She hadn't seen him in some time. The monitor person gave the coworker the contact info for when coworker finally saw him. It was weeks before he showed up; he was just confused and no harm to himself or others. But, it proves to me monitoring systems aren't reliable and rely on luck that when the monitored person snaps or goes off meds that they don't harm others because their reality is different (not because they're bad).

Anonymous said...

Leah, you're an idiot

Anonymous said...

Idiots should be either removed from mainstream society altogether or sterilized as soon as they show the classic symptoms of being an idiot.

Anonymous said...

I am from the uk and am so incensed
with this article. Another do gooder
thinking this women should not be punished any more SHE CUT OFF HER CHILDS ARM FOR GODSAKE,
Recently in England we have had a terrible crime committed against a poor innocent child of 17 months. Do gooders thought he should stay with his mother even though he had numerous injurys he finally died in a blood spattered cot. Common sense does not prevail amongst some so called experts. sbyunadgygthe acocent oiainnimm3 arch/ilrIn writeen uccomments tn