A Mother's Love? Postpartum Disorders, the DSM-5 and Criminal Responsibility – A South African Medicolegal Perspective

Abstract

The interface between criminal law and the field of psychiatry has manifested predominantly with reference to the defence of pathological criminal incapacity, more commonly referred to as the insanity defence. The threshold requirement for establishing the defence of pathological criminal incapacity entails that the accused at the time of the commission of the offence should have suffered from a ‘mental illness’ or ‘mental defect’. Once it is established that the accused suffered from a mental illness or mental defect at the time of the commission of the offence, an assessment is conducted to determine whether the illness or defect rendered the accused either incapable of appreciating the wrongfulness of the act or of acting in accordance with such appreciation. The problem that inevitably arises during the assessment of the defence relates to the fact that the terms ‘mental illness’ and ‘mental defect’ are not defined. Mental health practitioners mainly rely on the DSM for answers, yet the DSM cautions that the disorders contained may not be wholly relevant for legal purposes. Postpartum disorders are generally classified as postpartum depression and the more serious manifestation, postpartum psychosis. Postpartum disorders were not provided for in the DSM-IV (1994) or the DSM-IV-TR (2000) as distinct mental disorders. The DSM-5 came into operation in 2013, and yet again these disorders fall outside the scope of the DSM-5. Research indicates that the mental health professional plays a vital and pivotal role in explaining these disorders and the various complexities associated with them. The focus of this article is to illustrate the phenomena of postpartum depression and postpartum psychosis against the backdrop of the defence of pathological criminal incapacity within the context of South African criminal law. The vital and essential role of the mental health expert within this context is explored.