Paragraph 19 states: "The day before the attack, Feinberg met with her therapist who was sufficiently worried about her patient's mental state to call her psychiatrist, who raised the dosage of her antidepressant".

http://www.centredaily.com/mld/centredaily/news/4659953.htm

Posted on Wed, Dec. 04, 2002
Pediatrician not guilty by reason of insanity in attacks on children
BY KAREN MELLEN AND BONNIE MILLER RUBIN
Chicago Tribune
URBANA, Ill. - (KRT) - A Champaign pediatrician who attacked her 6- and 10-year-old sons with a knife in February, killing the older boy, was found not guilty by reason of insanity Tuesday after three psychiatrists - including one hired by the prosecution - declared she was mentally impaired.
In a one-day bench trial, Ellen Feinberg, 44, was acquitted of first-degree murder in the death of 10-year-old Adam Feinberg and of attempted first-degree murder in the stabbing of 6-year-old Matthew Feinberg. Matthew was hospitalized for about a week after he was stabbed in the chest and abdomen Feb. 28.
"She was overcome by a belief of emptiness," Champaign County Judge Michael Q. Jones said as he issued his ruling Tuesday. "An idea just crept into her head: `I want to kill my kids.'"
Feinberg, who did not testify and is in the custody of the Illinois Department of Mental Health, faces an evaluation hearing in January, when she could be released from the inpatient facility at which she was ordered held on Tuesday. But her attorney, Steve Beckett, said she would more likely continue to receive inpatient care.
Lawyers on both sides hired heavy-hitters to provide expert testimony on Feinberg's mental state.
But it was the testimony of Dr. Park Dietz, a forensic psychiatrist who has testified for the prosecution against high-profile defendants such as Andrea Yates and Jeffrey Dahmer, that crippled the case against Feinberg.
Dietz, who was hired by prosecutors, concluded that Feinberg suffered from major depression and undiagnosed psychosis. It was the first time in 10 years that Dietz found a defendant who met the standard for acquittal by reason of insanity.
In Illinois, a person is not criminally responsible if "as a result of a mental disease or mental defect, he lacks substantial capacity to appreciate the criminality of his conduct."
The case had been scheduled for a jury trial next week, but after Dietz's report was filed, both sides agreed to a stipulated bench trial - meaning that the evidence would be presented, unchallenged by either side, to Jones, who would decide the verdict.
Prosecutors were still seeking a finding of "guilty but mentally ill," arguing that Feinberg was lucid shortly after the attacks, when she called 911 and later when she talked to police. That sentence would have required prison time and mental health treatment.
According to Dietz's report, Feinberg asked a friend two to three weeks before the stabbings, "'Don't your kids drive you nuts, don't you just want to kill them sometimes?' When the friend responded that she would cope with anger by hitting a pillow or walking away, Feinberg said: `No I really mean kill them.' (Adam) is not going to make it to his next birthday.'"
On Tuesday, no witnesses were called, but excerpts of reports from police to mental health professionals were read. The defendant, dressed in a black suit, often broke down and cried when details of the stabbings were described.
The judge agreed with the psychiatric evaluations of Feinberg, who had been on and off antidepressants since Matthew's birth, according to court documents.
Other factors that weighed in the judge's decision included two previous suicide attempts, the fact there were no previous arrests and no apparent motive or triggers for the attack, when police found a knife in the kitchen sink and her sons in the basement and bedroom, he said.
Champaign County State's Atty. John Piland supported a verdict of guilty but mentally ill, but he stopped short of criticizing the court's ruling. He said he had trouble imagining how the mother did not understand that her actions were wrong, especially because she called 911. "There is evidence suggesting that she knew what she was doing and she did appreciate the criminality of her conduct," he said.
By all outward appearances, the family had a comfortable life in Champaign's upscale Cherry Hills neighborhood. Adam was a student at Barkstall Elementary School, while Matthew attended a nearby Montessori school. Sam Feinberg, a surgeon at Christie Clinic, had a thriving practice.
But inside the two-story brick colonial, trouble was brewing, according to Dietz's findings. Ellen Feinberg - who grew up in New York, the only child of a Holocaust survivor and his wife_had suffered up to five major depressive episodes, which started either during medical school or with Matthew's birth. While she was pregnant with Matthew, she went into a diabetic coma, and he was delivered by Caesarean section at 33 weeks. She became obsessed with the notion that her younger son was "not right," a recurring theme since his birth.
At one point, wrote Dietz, she asked her husband to consider giving Matthew up for adoption because she feared being unable to care for him. In addition, her older son, Adam, had attention deficit hyperactivity disorder and her father had been diagnosed with Alzheimer's disease.
She often felt overwhelmed with responsibilities of caring for both children and parents, who had moved to Champaign in early 2000, according to the psychiatric reports.
It is rare for an insanity defense to prevail because the public is skeptical of such claims, according to Brian Silverman, an Urbana attorney who successfully used the defense in a 1983 case of a woman who drowned her two sons, both under 5.
"Most people don't believe such a concept exists … but in this everyone agreed that it did exist, which made it a lot easier."
Silverman noted that the last time Dietz made a similar finding was in 1991. When the report came in, he said, "that clinched the case."
Dr. James Cavanaugh, director of law and psychiatry at Rush-Presbyterian-St. Luke's Medical Center, said that just because Feinberg had not been diagnosed with a full-blown psychosis, such an acute psychotic episode was still possible.
The day before the attack, Feinberg met with her therapist who was sufficiently worried about her patient's mental state to call her psychiatrist, who raised the dosage of her antidepressant. The psychiatrist wanted to meet with her on Friday, but he never had the chance.
Though Feinberg did not testify, her lawyers released a statement from her after the trial.
" … As a result of this mental illness, I have lost a precious son named Adam and am separated indefinitely from my son Matthew.
"I pray that all who cover this and all who hear this will take the time to educate themselves and others about the entire spectrum of depression. ... Perhaps other tragedies like this one can be prevented." The statement concluded with her agreement to have "no contact with Adam whatsoever until such time, if ever, it is in his best interest."
After a motion was made Tuesday to terminate her parental rights, Feinberg sobbed on the shoulder of her attorney, Carol Dison. No ruling was made on the motion.
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