"Are You There Alone?"
is a remarkable account of the mental illness of Andrea Yates and her
subsequent trial for the murder of her five young children.  As Suzanne
O’Malley relates the facts of the case, there is no doubt that Yates had a
major mental illness.  She had been hospitalized many times, had attempted
suicide, and had been on a long list of psychiatric drugs.  While O’Malley
herself remains neutral about the values inherent in the Texas legal system
that would allow the death penalty for Yates’ crime, the facts she provides
leave almost no room for any decent person to believe it could be reasonable to
execute her, even for such a terrible action.  O’Malley’s book provides strong
grounds for the utter condemnation of the policy allowing the capital
punishment of people with severe mental illness.  It is a powerful book and
essential reading for those interested in the intersection of psychiatry and
the law. 

Andrea Yates had firm religious
convictions not untypical of those in the Bible Belt, with belief in the
literal truth of the Old Testament and maybe even more troubling, the prophetic
parts of the New Testament, including the reality of Heaven, Hell, and Satan. 
These clearly played a role in her motivation for killing her children, since
she seemed to believe that they needed to die in order to be saved from Satan. 
From the transcribed interviews with psychiatrists, it appears that she
believed if she killed them, then they would go to Heaven, but otherwise they
would be at risk from Satan.  More mundanely, she seemed to worry that her
children were not normal and that they were not developing properly.  It is
also possible that Yates was relying on getting the death penalty for killing
her children, since she believed that she was not a good mother and deserved
punishment.  She was often suicidal and had been unsuccessful at committing
suicide, so killing her children may have been an attempt for her to bring
about her own death.  It was clear that her murders were premeditated and
deliberate and that she knew that she would be punished for them, and according
to Texas law, that was sufficient for her to be fully legally responsible for
her crime. 

Some speculate that Yates’ motive
in killing her children was nothing to do with their spiritual well-being, but
rather revenge against her husband Rusty Yates.  For example, that was the view
of religious zealot Michael Woroniecki who Andrea and her husband become
involved with; in fact, she was strongly influenced by his extreme doctrines. 
Judging from O’Malley’s account, Woroniecki’s theories lack all credibility,
and could have been motivated by a wish to escape blame for his role in leading
to her crime. 

One of the other elements of the
book that will be shocking to many, but unfortunately only too familiar to
others, is the inadequate mental health care Andrea Yates received in the years
before her crime.  She had symptoms of psychosis and depression, and had
received a variety of diagnoses.  She had received a variety of treatments,
some of them demonstrably inappropriate.  For example, in hospital, she was
made to watch videos about substance abuse, when she did not even drink.  There
was a failure of communication among mental health professionals, and her
in-patient care was frequently limited by her HMO plan so she had to leave
hospital when she was not ready to do so.  Some of her psychiatrists seem to be
simply incompetent.  Given the seriousness of her mental illness, it is not
clear whether her descent into such severe psychosis could have been prevented,
but it is clear that professionals could have done to spot the danger she
presented to her children. 

"Are You There Alone?"
is an alarming book because the failures of the legal and psychiatric system
that it demonstrates do not seem special cases, but rather are just particular
horrific examples of the failures that happen every day. 

Becky Ann Baker reads an abridged
version for the audiobook with energy and variety of intonation, making it all
the more absorbing.

Links:

• Links
  concerning Andrea Yates at About.com
• Website
  by former follower of Michael Woroniecki
• Wikipedia
  Encyclopedia entry for Michael Woroniecki
•  

© 2004 Christian Perring. All
rights reserved.