Why Did Andrea Yates Drown Her Five Children? Inside the Shocking Case 23 Years Later

Yates, who signed a friend’s high school yearbook as “the struggling butterfly,” suffered from postpartum psychosis when she killed her children in 2001

On June 20, 2001, police responded to a 911 call from the home of Andrea Yates in the Houston suburb of Clear Lake, Texas, and found the mother of five standing in front of the house in a soaking wet blue and white shirt.

“I just killed my children,” she told the officers.

Shortly after Yates’ husband Rusty Yates left for work at the Johnson Space Center, the unthinkable happened.

Yates told police she filled the bathtub in her family’s three-bedroom, brick home and drowned her children, one by one, taking the lives of sons Luke, 2, Paul, 3, John, 5 and daughter Mary, who was just 6 months old.

Her son Noah, 7, saw his baby sister dead in the tub — and ran. But his mother wrestled him into the tub and ended his life, too.

She carefully placed the bodies of the four youngest children on her bed, covered them with a sheet and called 911 over and over again.

Found guilty of capital murder in 2002, she was sentenced to life in prison with the possibility of parole after 40 years.

Yates' attorneys appealed and the verdict was overturned. The case was retried in 2006, when Yates was found not guilty by reason of insanity.

In 2007, Yates was remanded to Kerrville State Hospital, a mental facility in Kerrville, Texas, opting to stay there and continue treatment, PEOPLE previously confirmed.

Related: Andrea Yates, Who Drowned Her 5 Kids in a Tub in 2001, Annually Declines Release from Mental Hospital

But the question remains about what drove Yates to kill her five children.

Earlier Signs of Distress

Immediately after the shocking murders, people wondered what went so awry. "Something had to have snapped,"  Cheryl Johnson, the Yates’ neighbor at the time, told PEOPLE in the aftermath. "She was no monster."

Yates, it was later learned, had struggled for years with mental health issues, suffering from severe depression after the birth of her fourth child, Rusty Yates said.

After the birth of her first child, she was “very happy, very strong,” her longtime friend, Marlene Wark, told PEOPLE previously.

But in 1999, just months after Luke was born, Yates attempted suicide by taking an overdose of medication prescribed for her father, who was ill.

She was hospitalized following the incident. After her release, "there was no concern on the hospital's part that she was a risk to her children, so it was never assigned to a caseworker," a spokeswoman for Harris County Children's Protective Services told PEOPLE previously.

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Yates was prescribed antidepressants and the antipsychotic medication Haldol, which helped her keep the depression at bay, for a time.

Two weeks after she came off the powerful drug, which in itself can have adverse effects, her mental illness worsened, her attorney George Parnham told jurors during her trial.

He told them she believed drowning her children “was the right thing to do."

A Stay-at-Home Mom of 5 Young Children

When the couple wed in 1993, Rusty told Andrea he wanted her to stay home and that he wanted a big family. "He was adamant that they were going to have six kids," neighbor Sylvia Cole told PEOPLE previously. "She was really meek and easygoing, so I'm not sure if it was a joint decision."

When she killed the children, she was also under a lot of pressure, neighbor Mike Clay said at the time. "They had five kids. That's a lot of people in a small space, and she was there 24-7, and home schooling. That's a lot to handle."

The Aftermath

Rusty Yates has since divorced Yates and remarried. Asked by Oprah Winfrey in 2015 if he forgave his ex-wife, he replied “Yes,” adding: “Forgiveness kind of implies that I have ever really blamed her. In some sense I’ve never really blamed her because I’ve always blamed her illness.”

Yates waived her right to annual review for consideration for release, PEOPLE previously confirmed. She "grieves for her children" every day, often watching home videos of them, Parnham, who supports The Yates Children Memorial Fund, previously told PEOPLE.

Related: Andrea Yates' Life in Prison After Drowning Her 5 Children: She 'Misses Them Every Day'

Yates' attorney, husband and a former doctor did not immediately respond to PEOPLE’s requests for interviews.

If you suspect child abuse, call the Childhelp National Child Abuse Hotline at 1-800-4-A-Child or 1-800-422-4453, or go to www.childhelp.org. All calls are toll-free and confidential. The hotline is available 24/7 in more than 170 languages.

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