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Andrea was remorseful after trying to kill herself. "I have my family to live for," she told nurse Bridget Fenton, who recorded the conversation in her notes. She worried to another nurse that the trazodone would make it unsafe to continue breast-feeding. But she couldn't discuss her hopelessness. "She was only able to ask if she had done any permanent damage to her body," Flack reported.

June 18
Social worker Norma Tauriac described Andrea as "unwilling" or "not able to identify any recent life stressors." Rusty was "aware and accepting" of his wife's problems and was more comfortable calling her condition postpartum depression than major depression. Tauriac noted Rusty's concern that his wife was "struggling with the concept of salvation." Tauriac also found the Yates's living arrangements objectionable. "As a rule the patient and her husband and the four children live in a converted bus," she wrote in her notes. Tauriac called Texas's Child Protective Services abuse hotline on June 23 to report the family's "living arrangements and the fact that patient's husband allows the 31/2-year-old son to use a power drill."

Seven days after Tauriac's complaint, Dan Willbur, CPS Supervisor II, wrote to thank her for her concern. However, "because the situation does not appear to involve the occurrence and/or substantial risk of abuse or neglect�we plan no further inquiries," he said. The letter stated that her concerns had been forwarded to the Houston Police Department, because "they do appear to have jurisdiction in such matters." Tauriac jotted a note on the bottom of the CPS letter: "Important. Please place in the chart of Andrea Yates." The letter lay dormant in her file until the murders.

June 24
"Interviewed patient again this a.m.," Flack noted on. "I also spoke to the patient's husband at length. They are requesting that she be discharged to the family's care. They have agreed to watch her around the clock and are aware that she is at risk of harming herself again." But Flack later indicated that Yates was being "discharged because of insurance restrictions" after only seven days in the hospital. He also noted that she might be suffering from delusional guilt. Flack raised Andrea's dose of the antidepressant Zoloft to 150 milligrams a day (a fairly routine dosage), referred her to outpatient therapy with Eileen Starbranch, MD, and discharged her.

Three weeks later...
Andrea tried to slit her throat. Rusty found her in the bathroom and stopped her. This time she was admitted to Memorial Spring Shadows Glen hospital. She had been taking Zoloft inconsistently and had flushed the Zyprexa prescribed by Starbranch down the toilet when she realized the drug was an antipsychotic.

Asked what had happened, Yates was quoted by hospital psychologist James P. Thompson as saying "I had a fear I would hurt somebody. � I thought it better to end my own life and prevent it [from happening]." She described hallucinations: "There was a voice, then an image of the knife. I had a vision in my mind—get a knife, get a knife." She acknowledged obsessive thoughts "over our children and how they'll turn out." She grew nervous about "the kids, trying to train them up right, being so young. [It's a] big responsibility. � I don't want to fail." Asked to write a sentence spontaneously, she scribbled, "I love my husband and kids."

Yates was transferred to the psychiatric unit of Methodist Hospital, where James Flack, M.D., diagnosed her with "major depressive disorder, single episode, severe." This marked the beginning of a spiral into full-blown psychosis that was never adequately treated.

A Cry in the Dark continues...

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