Joanne Hill had a history of mental health problems
The jury in the trial of Joanne Hill, who has been convicted of murdering her disabled daughter, had a crucial decision to make about the 32-year-old's state of mind.
Hill, of Connah's Quay, Flintshire had killed four-year-old Naomi but the jury had to decide whether she was ill on the day she killed her daughter.
The defence case rested on proving that Hill, who had a history of mental health problems, was suffering "an abnormality of mind" when she drowned Naomi in the bath.
But Michael Chambers QC, for the prosecution, said Mrs Hill's behaviour in the months and days leading up to the killing had been considered normal and rational.
He said Hill should be found guilty of murder, rather than manslaughter by reason of diminished responsibility, because she had made a "deliberate and conscious" decision to kill her daughter.
Naomi was disabled, having mild cerebral palsy, and Hill could not cope with it, claimed the prosecution.
But deciding whether somebody is mentally ill at a particular time is a complex task.
Wales Today talk to Gordon Huntley, community director of MIND in the Wrexham area.
During the trial at Chester Crown Court, Dr Aideen O'Halloran, a consultant forensic psychiatrist, said Hill's behaviour in the weeks leading up to Naomi's death indicated she was having a relapse of her mental health condition.
The court was told Hill had a history of mental health problems which first became apparent in the early 1990s when she was 17 years old and saw a child psychiatrist for anxiety and repetitive thoughts.
In 2000, Hill twice attempted suicide and throughout the year she was prescribed medication for anxiety, depression and sleeplessness.
In January 2003, shortly before the birth of Naomi, Hill was diagnosed with chronic anxiety and the following April, she had a "hypermanic" episode.
After Naomi was born ten weeks prematurely in a "difficult" birth, Hill suffered a severe form of postnatal depression, although she did respond to treatment.
On Boxing Day 2006 she suffered a severe relapse and left the family home to be cared for by her parents.
Once again Hill recovered, returning to work part-time in the March and full-time a month later.
In June, doctors decided there was no need for further involvement by her local Mental Health Team and in August her case was closed, although she remained under the care of her GP and on several types of medication.
In November, it was recorded that she was drinking heavily, increasing the risk of depression and the likelihood that she would stop taking her medicine.
Later that month she killed Naomi.
Naomi was disabled, having mild cerebral palsy
Dr O'Halloran concluded that Hill was suffering from depression and was able to "disassociate" her feelings, a combination that was "an abnormality of the mind" in her view.
But Dr Paul Chesterman, a consultant forensic psychiatrist, told the jury Hill's actions had not suggested a mental disorder at the time of the killing last year.
Hill had enjoyed a night out and had sex with a workmate on the Thursday before Naomi was killed, behaviour that Dr Chesterman said was "incompatible" with clinical depression.
Away from the trial, Gordon Huntley from the charity Wrexham Mind office sympathised with the jury's difficult task.
"When it comes to mental health it's far more difficult. When it's a physical illness, it's quite visible," he said.
"With mental health it's not quite so easy because the person doesn't necessarily understand what's going on themselves.
"It can be really difficult for jurors to come to any sort of understanding, let alone decision, about why somebody might want to do something like that."
And the complexity of the issue can lead to very different conclusions, even from experts, about a person's state of mind.
"I don't always agree with some of my colleagues in health on occasions," said Mr Huntley.
"I work closely with them and I'm quite friendly with a number but they do face quite difficult decisions in terms of what is happening to an individual.
Simon Hill paid tribute to his 'princess' daughter
"'What diagnosis do I give them and therefore what treatment can I give them or is available, is it the right one?'
"It's quite difficult and can be quite a lonely position for them to carry that burden."
Mr Huntley said it was also incredibly difficult to predict whether somebody with a history of serious mental health problems was likely to commit an extreme act.
"The stigma that people face with mental health issues is significant but it's not warranted, but unfortunately there are incidents that lead to tragic circumstances," he said.
"While for the vast majority, that's not the case, there are some of those events and sometimes people fall through the gaps."
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