A recent news report tells about a mother who killed her 3 young children. She then attempted suicide and ended up in a hospital. She is charged with 3 counts of premeditated murder.
Why would any mother kill her own children? In the case mentioned, the mother suffered from post-partum psychosis and was treated with multiple medications over a number of months in an attempt to manage her psychosis.
As is too often the case, the legal system is treating this as a murder case rather than a mental health emergency.
So, why do mothers (and fathers) ever kill their children? Filicide is the technical name for a parent killing their own child. A famous forensic psychiatrist, Phillip Resnick, MD did a study years ago and found that there were 6 reasons why this happens.
1. Altruism: The child is killed to relieve suffering that the parent believes the child has.
2. Acute psychosis: Often, the psychosis includes hallucinations telling the parent to kill the child. This is often accompanied by a delusion that the child is possessed by an evil spirit and will go to hell for eternity unless the parent releases the child’s soul by killing the child. That is, the parent is trying to save the child.
3. Accidental (unintended) due to child abuse or neglect: Examples include a child who dies as a result of a beating given as punishment for some reason, and the child dies, but that was not what was intended. Or a child may die of dehydration due to a parent’s neglect by not giving the child enough fluids.
4. Child is unwanted: The parent resents the child for some reason and kills the child. An example might be a child, resulting from a rape and who has a mental disorder, and constantly disrupts the household.
5. Get revenge on a spouse: A parent who is enraged at their spouse kills their child to get revenge by taking away what the spouse most loves, the child.
6. Resulting from the killing of the whole family: In this case the parent kills everyone in the family including the children. Killing one’s own family is called, familicide.
Attempting suicide after killing one’s own child is common. Even if the killing was for an altruistic reason or due to a psychotic delusion, the parent often no longer wants to live. This is especially true when the parent has significant depression as part of an underlying mental disorder.
One cause of psychosis that results in filicide is post-partum psychosis. On the face of it, this is the most likely reason for the case mentioned at the start of this blog. If so, the correct response is psychiatric care, not legal proceedings.
While post-partum depression is common, post-partum psychosis is uncommon. There are underlying psychiatric illnesses that are the cause of the psychosis. The most common one is bipolar disorder with depression; it may not have been identified before the baby’s birth. A second cause is a major depressive disorder with psychosis. Other diagnoses are less common.
Filicide is uncommon. When it does occur, many people are outraged and baffled. They find it unfathomable that a parent would kill their own child. It is important to identify the specific reason in each case before passing judgment.
Peter M. Hartmann, MD
Family Medicine & Psychiatry
