A Systemic Problem

On the tape of the 911 call, Otty Sanchez screams in the background that the devil made her do it. It was an early morning in July, and Sanchez’s sister was calling for help. When San Antonio police arrived, they found a gruesome scene: Sanchez had decapitated her 3-week-old son, mutilated his body and eaten some of the flesh.

The case made national news and became one of the summer’s most lurid crime stories. In recent weeks, more details about the case have emerged, and it appears Texas’ public mental health system—long neglected by state lawmakers—was partly to blame for the tragedy. The 33-year-old Sanchez has a history of severe mental illness. She had been released from a state-run mental health facility and was offered few services in the weeks leading up to the murder, despite reporting that she was hearing voices.

A jury will soon determine whether she’s competent to stand trial. A court-appointed psychologist has already concluded that she is of sufficiently sound mind. If Sanchez does stand trial, the state, which offered few mental health services, will try to give her a death sentence.

Texas ranks 49th nationally in per-capita spending on mental health services. For adults with severe mental illness, there are few affordable options. Texas’ dozen state hospitals—the state’s only public inpatient facilities—are frequently full. Patients usually don’t stay longer than a few months. When people like Sanchez descend into crisis, there is a dearth of services. Clinics and hospitals that offer temporary beds for mental patients are often overwhelmed. In many areas, patients in crisis are offered medication and outpatient treatment. Sometimes that’s not enough. That appears to be what happened with Sanchez.

Sanchez suffered from schizophrenia. She was institutionalized for six weeks last year after she was found wandering in an Austin drugstore searching for a trip to China, her lawyer recently told the San Antonio Express-News. Like so many others, she was released from the public facility to make room for new patients. Private inpatient facilities are expensive, and few insurance plans cover lengthy stays.

After giving birth to her son this summer, Sanchez was prescribed an anti-depressant, her lawyer, Ed Camera, told the Express-News, but she rarely took it. Sanchez was suffering postpartum psychosis, a rare but extreme version of postpartum depression in which new mothers hallucinate and feel urges to harm their newborns. It’s especially common in women with a history of severe mental illness. Andrea Yates, the Houston mother who killed her five children in 2001, is perhaps the most famous case.

A week before the murder, Sanchez went to a counseling center to complain of hearing voices, Camera told the Express-News. The clinic called an ambulance, and Sanchez was taken to the emergency room, but later released. She returned home, and a few days later, attacked her young son.

At press time, a jury in San Antonio hadn’t decided whether she is fit to stand trial. If Sanchez is found competent, prosecutors have said repeatedly that they plan to seek the death penalty.