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Mum should've been hospitalised for 'severe' depression- expert

Author
Anna Leask,
Publish Date
Tue, 8 Aug 2023, 1:18pm

Mum should've been hospitalised for 'severe' depression- expert

Author
Anna Leask,
Publish Date
Tue, 8 Aug 2023, 1:18pm

WARNING: This story contains graphic and sensitive content.

Three months to the day Lauren Dickason killed her three little girls she told a psychiatrist she was “missing the kids a lot” and waking every morning was “like a kick in the guts” and she “just wanted to die”.

She cried a lot, admitted struggling and said her mood was “lower than it had ever been”.

Dickason later told the expert she wanted to go back to South Africa and die so she could be reunited with her children - who are buried there.

Forensic psychiatrist Justin Barry-Walsh said it was clear to him Dickason’s fatal actions were motivated by her “severe” and increasing depression and he refuted claims made by other experts that she killed her children out of anger or a need to control her family.

“There is not enough evidence of the extraordinary level of anger required to act in such a way,” he said.

“She didn’t just lash out... in an appalling methodical way, she killed all three (children). This woman was depressed and she was getting more depressed and as she got more depressed she got to a position where she could not see any way of going on.

“She got to a position where she decided she had to suicide... she also decided that her children would be better off dead and that was that apparent logic that drove her to commit this act.

 “In my view, it was more than likely - because of her depression - that she acted in the way that she did.”

Barry-Walsh said if he had seen her the day of the alleged murders and taken her history and considered her lack of support in New Zealand he would have admitted her to a psychiatric ward.

“And if she declined treatment I would have thought she readily met the criteria for compulsory treatment under the Mental Health Act,’ he said.

“Her motive for killing the children was as part of her suicidal thinking she also felt that the children were better off dead... she was in the grips of rapidly worsening depression... not only overwhelmed by viewing the world through a negative lens... she believed killing the children was morally correct at the time.

“In that mental state she was unable to reason as to the moral wrongfulness of her actions… and beyond that would seem to believe her actions were morally correct.

“The weight of evidence is sufficient to sustain the defence that Mrs Dickason was not guilty by reason of insanity.”

Dickason does not deny killing Liane, 6, and 2-year-old twins Maya and Karla in September 2021.

But she has pleaded not guilty to murder, claiming she was severley mentally disturbed at the time and did not know what she was doing was morally wrong - and that she should not be held criminally responsible.

Liané Dickason. Photo / Facebook

Liané Dickason. Photo / Facebook

Over the last three weeks the jury has heard extensive evidence about Dickason’s life - her upbringing, marriage, the gruelling fertility treatment she underwent to have children and her long battle with anxiety and depression.

Jurors also watched footage of police interviews with Dickason and her husband Graham - who found his children dead in bed and his wife in need of medical attention when he returned from a work function.

Expert witnesses are now giving evidence about their assessment of Dickason and her mental health and whether they think hers is a case of insanity or infanticide.

Barry-Walsh said Dickason described feeling “a period of numbness” for about five weeks after she killed the children and when “the feeling started to come back” she had “terrible guilt”.

She had a high level of distress which she said was due to “all the hurt I have caused”.

Dickason spoke to Barry-Walsh about the time her family spent in New Zealand.

She described everything looking “black and negative” and she “felt she was on auto-pilot”.

She “considered herself a winner if she achieved changing the nappies or feeding the children”.

On the day of the alleged murders - after she made the decision kill the girls and take her own life - she felt like she was “in a dream.

“She said she felt she could not do this anymore she said: ‘I wanted it to be quiet, I did not want to leave them behind, I felt like I would be abandoning them.

“She spoke about how unsettled their lives had been, she felt like they had ‘been putting (the girls) through torture with the shift to New Zealand... they were asking when they could see their grandparents and their friends... asking why they had moved somewhere so cold.

“She could not see a way out of it... killing the children felt right... she was concerned about the future.... she thought the children were better off dead.”

Lauren Dickason during her police interview. Photo / Pool

Lauren Dickason during her police interview. Photo / Pool

Barry-Walsh said when he first saw Dickson in October 2021 she was still greatly affected by the incident and while he interviewed her he did not canvass the killings.

He said he did not feel it was “humane” and chose to speak to her about the specifics of the alleged murders at later interviews.

She eventually told him that the day the girls died she had been asked for additional information from the family’s immigration advisor including about her mental health.

“It was the straw that broke the camel’s back,” said Barry-Walsh.

“She knew she would not pass the psychiatric assessment due to her mental state… she just cracked.

“She said ‘it came to me... I cannot go through any more, I cannot do another day of this, I had nothing left in my tank.”

She felt “so overwhelmed”, felt “the world was such a mess” and “wanted to die so badly”.

“I was not prepared to leave the kids… didn’t want them to not have a mother, didn’t want to leave Graham with the burden,” she told Barry-Walsh.

“It seemed like the logical thing to do... it felt like it was right.”

Dickason disclosed as she killed the girls she felt “no emotions” and it was like “an out of body experience”.

She then tried to kill herself and said her plan was to “climb into bed so that when she was found it would look like she was sleeping.

“When she woke she could not believe she was still alive,” said Barry-Walsh.

“She saw a police officer... she had not thought through the consequences... she did not intend to wake up.”

She said at that stage she “didn’t change her mind about the children dying” and still “felt she was right” and that “the biggest mistake she made” was coming to a country she had never seen before.

“She said she wished she had stayed in South Africa.”

Dickason claimed she told at least 15 people before leaving her home country that she was “not ok”.

While in hospital she was told that her three children were dead and her thought was “at least they are free of all the frustrations in the world.

“She wished she could go back 12 weeks... but she still thought they were better off dead, she felt guilty for what she’d done... that she was probably going to hell.

“She did not care about what happened.”

The Dickason children. Photo / Supplied

The Dickason children. Photo / Supplied

Dickason later told Barry-Walsh that she “prayed every night she would not wake up in the morning.

“She said she just wanted to go home and die... she said it would be easier on her family and she could be ‘with my girls’ whose remains are in South Africa,” she said.

“That is the final thing to happen in this nightmare.

Dickason said it was “horrible and ugly dealing with the court case” which “led to it all coming up”.

She told Barry-Walsh: “I am missing my girls so much”.

She said she “would give everything” to change what happened but sometimes still felt the little girls were “better off” dead.

Why Dickason killed - defence psychiatrist’s opinion

Barry-Walsh said in establishing Dickason’s motivation for the killings a “critical piece of evidence” was “what actually happened”.

“This is a woman with no history of previous offending, who had children through IVF, who comes to NZ and kills the three of them in a sustained and deliberate way over 20 minutes to half an hour.

“That is an unusual act in and of itself.

“Then layer on that the history… she had a history of depression and that as far as anyone could determine she cared for and loved her children.

“Research shows that in these rare events, often these women may be depressed and that that depression may be central to their actions at the time.”

His preliminary opinion on Dickason after his initial assessments was that at the time of the alleged offending, “she had a major depressive illness” and he was “satisfied that would represent a disease of the mind”.

Further, he said there was “a continuity of mental health problems following the birth of the twins” and postpartum depression was “still an active problem for her” when she killed the children.

His preliminary view was that Dickason had a defence of insanity or infanticide.

After considering the reports of the other expert, all of the information available to the court and attending the trial in person each day - he has not moved from that opinion.

“She was depressed, that in itself is enough… there was a clear nexus between her depression and her actions at the time,” he said.

“It’s my conclusion that there was (a connection to childbirth)... She was vulnerable to postpartum depression, she’d had a previous postpartum depression.

“Mostly the depression in terms of symptoms looks the same (as general depression)... it’s common to have problems attaching and bonding to children as a result of postnatal depression... it is a common expression of postnatal depression to feel like you’ve failed as a mother.

“Research would say that about 40 per cent of women with postpartum depression would have such thoughts (of harming their children)... it’s another feature of postpartum depression.”

Barry-Walsh said he did not believe Dickason had “fully recovered” from postpartum depression in a legal sense when she killed her daughters.

“It would mean that the person had largely or completely recovered from their postnatal depression, that they no longer had symptoms and that would include that she no longer the kinds of difficulties or feeling like being a failure as a mother - those negative cognitions that you see in postnatal depression.”

He said he would want to see someone “with a sustained improvement for at least two months” before he would deem them “recovered” from postpartum depression.

Barry-Walsh said his view, based on all the information available, was that Dickason had a major depressive disorder and two bouts of postpartum depression - after Liane and then the twins.

He said reports of her being positive and behaving normally in the lead-up to the alleged murders - including embarking on a health programme in South Africa - showed she was “probably getting better” and had she “continued on that pathway and not stopped her antidepressants” she would “not have got to the state” where she killed the children.

He said there was no doubt Dickason’s IVF journey and having children - including a baby that died before Liane’s arrival - “changed her world fundamentally”.

“Her mental illness needs to be understood in the context of those changes - her role as a mother and so forth,” Barry-Walsh explained.

“There was a period when she was (first) married, for about two years, where she didn’t have any problems with her mood.”

Lauren Dickason with twins Maya and Karla. Photo / Supplied

Lauren Dickason with twins Maya and Karla. Photo / Supplied

He said Dickason had major depressive disorder and postpartum depression twice with fluctuating symptoms - and those things could not necessarily be separated.

“There’s only one person there,” he said.

“She more likely than not had not fully recovered (from postpartum depression after the twins).

“Although she felt better… she still had underlying sadness, she still had problems as a parent - with attachment, with a sense of herself, as a failure.”

Barry-Walsh said a “concrete description” Dickason gave of her state in a message to a friend before she emigrated was “I cry every day”.

He said the “positive times in between” described by others and the Crown experts, were indicative of “someone who is recovering - getting better, but still struggling”.

“She did this extraordinarily awful thing at a time when she was getting more and more depressed,” he said.

Dickason’s mental health treatment ‘not as good as it should have been’

Barry-Walsh also said Dickason’s mental health care “wasn’t as good as it should have been” for many years.

She’d been self-medicating - a legal and common practice for doctors in South Africa - which was “never a good idea”.

Dickason also stopped her medication without consulting the doctor she had turned to for help after having thoughts of harming her children the first time.

“Her personality… she was someone who was on the obsessional side of the spectrum,” Barry-Walsh continued.

“The interaction between her depression and her personality… it’s hard to split them off… being depressed exaggerates… your view of the world changes, when bad things happen you see them more catastrophically.

“The two spin around and feed off each other.”

Barry-Walsh said if he had seen Dickason in a medical context in 2021 before she moved to New Zealand he would have said: “look you’re getting better but you still have postnatal depression issues and you still need more treatment”.

He explained to the court that, unlike the Crown experts, he felt Dickason was somewhat psychotic at the time of the alleged murders.

“She probably did have some psychotic symptoms… her primary problem was not psychosis… this woman was depressed and particularly towards the end, perhaps even in the last day or two moved to the point where it may reasonably be described as delusions or psychosis.

“I think you can say there was a psychotic component to a depressive illness.”

Barry-Walsh’s evidence continues and this afternoon Crown Prosecutor Andew McRae has undertaken a cross-examination.

The trial continues.

Insanity, infanticide or murder - what the earlier experts told the court

Dr Susan Hatters-Friedman is a forensic and reproductive psychiatrist and gave expert evidence in support of the defence.

She told the jury Dickason’s actions were that of a parent killing “out of love” rather than out of anger or hate.

“She had been severely depressed and had developed psychotic thinking,” she said.

“She attempted to kill herself … she viewed the world as dangerous for her children to grow up in.

“She saw a joint suicide and filicide as a way out of this for her beloved children and herself … She thought she was getting her children to safety.”

She said when Dickason killed the girls, she was effectively insane.

“She was ... labouring under a disease of the mind to such an extent that it rendered her incapable of knowing that the act was morally wrong,” she said.

“Having regard to the commonly accepted standards of right and wrong, it is my opinion that her disease of the mind at the time of the offending was a major depressive disorder with mood-congruent psychotic features.”

She also said it was a clear case of infanticide.

“It is further my opinion that at the time of her alleged offending, the balance of her mind was disturbed by reason of a disorder of consequence upon childbirth - specifically, she had been suffering from a severe depression which was closely tied to her infertility, pregnancy loss, postpartum and parenting.”

Crown expert Dr Erik Monasterio opined while there was no doubt Dickason had a mental illness, it did not extend far enough for her to have a defence of insanity or infanticide.

Further, he found there was no evidence of an altruistic motive and it was more likely that Dickason killed out of “anger and frustration.

“She systematically strangled the children and seemingly methodically checked for vital signs before resorting to smothering them until they were dead,” he said.

“The alleged offences are unlikely to have been impulsive.

“In my opinion, as the defendant maintained awareness and behaved systematically, there is no evidence that she was in an automatic state or that she did not understand the nature and quality of her actions at the material time.”

Lauren Anne Dickason appears in court on the first day of her two-week trial for the murder of her three children.

Lauren Anne Dickason appears in court on the first day of her two-week trial for the murder of her three children.

Monasterio said as Dickason had battled depression since she was 15, she could not claim her “disease of the mind” was connected to childbirth, thus removing infanticide as a defence.

“She had a history of these symptoms before pregnancy … the depressive disorder … occurred well before the defendant’s pregnancy … the depression was already there before she gave birth, so it cannot be called postpartum,” he said.

“It is likely that the effects of pregnancy and adaptation to the demands of motherhood and the care of three young children contributed to but did not fully account for the defendant’s major depressive disorder at the time of the children’s birth.

“There is no evidence the defendant has an infanticide defence available.”

Monasterio said he “accepts without reservation” Dickason had “continuing fluctuations with mood and anxiety symptoms”.

However, on the balance of probabilities, her mood disorder had “remitted” at the time of the alleged murders.

He could not say “beyond a reasonable doubt” that was the case - but that was the job of the jury, not him.

“On the balance of probabilities, my opinion still stands,” he said.

“The defendant had a relatively high level of functioning in these days [before the girls died]. Her mood disturbance was impinging and weighing on her - but she was engaging in complex tasks that required attention and concentration.

“She had sufficient capacity to appreciate what was occurring at the time of the alleged offence - therefore on the balance of probabilities, the defence of insanity is not available.”

Monasterio reiterated there was no evidence in his opinion of an altruistic motive - where a parent kills a child out of love and fear of what will happen to them if they continue to live. The defence has told the jury Dickason’s case is a clear example of this.

“For an altruistic motive, there has to be a sufficient concern that the children needed to be killed in order to spare them the suffering of living ... I have found, in particular through social media communications ... no evidence of that.

“I accept the defendant has provided motive of altruism to other experts - but to me, she did not give an account that would justify that position.”

He said it was not his role to decide on Dickason’s fate, just to give his professional opinion.

“Ultimately, the position sits with the jury … and not with me,” he said.

Following Monasterio was Dr Simone McLeavey - a consultant forensic psychiatrist at Hillmorton Hospital for Te Whatu Ora Waitaha Canterbury, formerly the Canterbury District Health Board.

She was the first of the experts to interview Dickason - her first session just six days after the alleged murders.

She outlined her interviews with Dickason and the information she considered in forming her professional opinion on the accused.

McLeavey said while the was no question Dickason had a “disease of the mind”, there simply was not any evidence of insanity.

“It remains my opinion that the defendant’s disease of mind did not seriously impair her reality, testing ability and capacities thereof such that she did not know the alleged offending was morally wrong, having regard to the commonly accepted standards of right and wrong,” she said.

“Any altruistic motivation was, in my opinion, fueled more so by a need for control and anger.”

She said that stemmed from a “vulnerable” Dickason finding the thought of her husband remarrying after her suicide - and another woman parenting her children - untenable.

“Accordingly, I am of the opinion that this is a tragic case where a mentally disordered woman with a vulnerable personality killed her children in the context of the situation which she perceived to be beyond her limited capacity to manage stress ... in addition to underlying mental illness.

“Taking these factors into consideration, on the balance of probability, I am of the opinion the defendant would not be eligible for an insanity defence.”

Police at the scene of the alleged triple murder. Photo / George Heard

Police at the scene of the alleged triple murder. Photo / George Heard

McLeavey then turned to the infanticide defence.

She said while Dickason had an “abnormal mental health state”, she “cannot unequivocally subscribe” to the theory that the “balance of her mind was disturbed by reason of her not having fully recovered from the effect of giving birth”.

That was partly because of Dickason’s “propensity for depression” dating back to when she was 15 years old.

She said Dickason suffered “a relapse of depression and anxiety disturbance from mid to late June 2021″ that arose out of her life circumstances.

That exacerbated her “life-long propensity towards anxiety and perfectionism” and “entrenched personality trait ... of demanding very high standards” from herself with “the tendency towards self-criticism for any action or perceived failure to meet these standards”.

McLeavey said there was no correlation between Dickason’s “reproductive issues” and “psychological psychiatric wellbeing presentation.

“It is my opinion on the balance of probability, there is no evidence that the defendant has an infanticide defence available.”

The King v Lauren Anne Dickason - the trial so far:

Lauren Anne Dickason is on trial in the High Court at Christchurch before Justice Cameron Mander and a jury of eight women and four men.

The Crown alleges Dickason murdered the children in a “calculated” way because she was frustrated, angry and resentful of them.

It acknowledges Dickason suffered from sometimes-serious depression, but maintains she knew what she was doing when she killed the girls.

Last week, Crown prosecutor Andrew McRae alleged Dickason was an angry and frustrated woman who was “resentful of how the children stood in the way of her relationship with her husband” and killed them “methodically and purposefully, perhaps even clinically”.

The defence says Dickason was a severely mentally disturbed woman in the depths of postpartum depression and did not know the act of killing the children was morally wrong at the time of their deaths.

Further, it says she was “in such a dark place” she had decided to kill herself and felt “it was the right thing to do” to “take the girls with her”.

The trial is expected to run for at least another week.

SUICIDE AND DEPRESSION


Where to get help:
• Lifeline: Call 0800 543 354 or text 4357 (HELP) (available 24/7)
• Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• Youthline: Call 0800 376 633 or text 234
• What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)
• Depression helpline: Call 0800 111 757 or text 4202 (available 24/7)
• Helpline: Need to talk? Call or text 1737
If it is an emergency and you feel like you or someone else is at risk, call 111

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