Melissa Arbuckle was spared jail over the death of her baby. The headlines don't tell the whole story.

This post discusses postnatal depression, suicide and death of a child and could be triggering for some readers.

Last week, in Victoria's Supreme Court, Melissa Arbuckle was spared a jail sentence over the death of her daughter, Lily.

The 32-year-old veterinarian pleaded guilty to infanticide - a rare charge that applies only to mothers who kill children under the age of two while suffering a "disturbed" mind linked to birth. 

On July 11, 2021, Melissa laid down on train tracks in Melbourne's outer east with her three-month-old daughter. She lived, her baby died. 

Watch: The facts on postnatal depression. 

Melissa's decisions that day were made in the midst of a spiralling depression, Justice Jane Dixon told a court on Thursday.

While Melissa believed she deserved to suffer for her crime, Justice Dixon spared her a prison sentence and instead ordered her to continue treatment and supervision for three years. The court was told Melissa's postpartum depression, suicidal ideations and psychosis had subsided after medication and psychiatric community-based treatment. 

In her verdict, as was reported by The Age, Justice Dixon acknowledged that, "It is beyond the power of this court to repair the suffering and loss flowing from your actions in causing Lily’s death. Your life and the lives of others have been forever changed."

“It’s apparent that no one understood at that time the extent to which your judgment and decision-making were impaired by delusional thinking and frank psychosis," she continued.

What we know now, is Melissa was in the depths of severe postpartum depression and psychosis - a reality experienced by 1-2 in every 1000 pregnancies. A diagnosis she received after her daughter died. 

"Prior to the incident her [Melissa's] anxiety increased, her sleep deteriorated and she became focused on a fixed, delusional belief that she had harmed her child and they were both broken," said Justice Dixon.

Anita Link knows what that feels like. In fact, her circumstances mirror Melissa's so exactly, it could very easily have been her staring back from the pages of newspapers last week.

Anita was 32 when she had her first baby. She too was a veterinarian. She developed postnatal psychosis after giving birth, having no history of mental illness before that. 

As she told Mamamia, "My postnatal psychosis set in by day six of first-time motherhood. By days seven and eight I was completely detached from reality, denying knowledge of my baby and my husband."

As Anita explained, "Had I been home with my baby daughter when my husband briefly left our house, I have no idea what the psychosis might have told me to do. But I do know I would have believed it and followed its instructions to the letter. Not because I am stupid, immoral, or monstrous. But because I had a severe illness that had gobbled up my free will, my beliefs, my logic, my opinions, my normal emotions, and my knowledge of the world. My husband may well have come home from the shops to a scene no one should ever come home to. And I would have been cheap fodder for the headlines."

This is the reality of what postnatal psychosis can look like. 

As Perinatal Anxiety & Depression Australia (PANDA) CEO Julie Borninkhof told Mamamia, "There is no simple way to predict who will experience postnatal psychosis and there is no simple link between perinatal depression and anxiety, and postnatal psychosis. 

"Psychosis refers to a loss of a sense of reality and for people who experience it, the onset will typically be within weeks of giving birth. We don’t know exactly why some women develop postnatal psychosis, but there are specific risk factors including a previous psychotic episode or a personal or family history of bipolar disorder. Women who experience perinatal psychosis are at higher risk for developing it again with subsequent children."

It lies at the far end of a spectrum which affects a much broader range of women:

One in seven mums experience postnatal depression. 

One in five experience postnatal anxiety.

PTSD as a consequence of childbirth is a reality in six percent of all deliveries.  

Suicide is the leading cause of maternal death in Australia during pregnancy and the 12 months following birth.  

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The problem with this spectrum is that while the less serious on the scale tend to go unnoticed and underdiagnosed as either symptoms of pregnancy or just the reality of being a new mum, the more complicated, like psychosis, are often misdiagnosed or simply misunderstood.

As Anita points out, "Journalism around psychosis, even decent journalism, focuses on the sensational."

It's how many of the headlines about Melissa read. But that's because her psychosis led to the unthinkable. Because the death of a baby at the hands of her mother is catastrophic, and the news reports reflect that fact.

But motive and malice is important. And psychosis can manifest in ways that are truly incomprehensible to those looking in from the outside. And because we don't talk about it enough, these depths of mental delusion are hard for most to comprehend. 

READ: The postpartum realities we're not talking about.

What happened to baby Lily was truly awful. That is why a case against Melissa before a Victorian court was necessary to sift through the facts. 

But what needs to be pointed out amongst the coverage of this worst-case scenario, is that postnatal illness is a severe, debilitating condition. It's also curable, and this case highlights that as a society we are simply not doing enough to help women at risk of, or already suffering from, postpartum illness. 

Because this tragedy could have been avoided.

When Anita was accurately diagnosed with postnatal psychosis in the safety of a mother-baby unit in a private psychiatric hospital, her husband asked what he should have done if this had happened at home. 

"Call an ambulance. Postnatal psychosis is a psychiatric emergency, but it is treatable," he was told.

Melissa's diagnosis came too late. The court heard she is in full remission now, and struggling with profound guilt, sadness and remorse. 

As PANDA CEO Julie Borninkhof told Mamamia, "Early intervention and appropriate treatment are the keys to facilitating recovery from postnatal psychosis. Women who experience perinatal psychosis need specialised treatment, as well as practical and emotional support."

She noted that there are real economic and social costs to perinatal illness and we need to do as much as we can to support families.

Some warning signs family and friends should be aware of include; confusion, disorientation and agitation, difficulty concentrating or unusual, racing thoughts. Delusions or thoughts that aren’t true, severe anxiety about wellbeing or the baby’s safety and talking about suicidal thoughts.

"It's important that the community understands that postnatal psychosis is an illness, it is treatable, and there is help available," Ms Borninkhof told Mamamia.

- With AAP.

If you think you or someone you know may be suffering, contact PANDA – Perinatal Anxiety & Depression Australia. You can find their website here or call their helpline – 1300 726 306. PANDA’s National Perinatal Helpline is funded Monday to Friday.

If you're based in Australia, 24-hour support is also available through Lifeline on 13 11 14 or beyondblue on 1300 22 4636.

To find out more about Anita's story, you can find her book Abductions From My Beautiful Life, here.

Feature image: Facebook.