When police responded to a 911 call from Andrea Yates‘ Texas home in June 2001, she delivered a chilling confession: “I just killed my children.”

That horrific sentence launched a years-long saga of legal battles, allegations of cult influence and national conversation about postpartum mental health. Though Andrea — initially convicted of capital murder — was ultimately found not guilty by reason of insanity and committed to a mental health facility, debate over what drove her actions continues to this day.

“On June 20, 2001, there were six victims at the home of Andrea and Rusty Yates,” her lawyer, George Parnham, wrote in a June 2013 essay for the Houston Chronicle. “Her five children, certainly, but also Andrea herself – all victims of the real culprit, in this case a severe mental illness known as postpartum psychosis.”

A severe form of postpartum depression, postpartum psychosis (PPP) is a rare condition that causes hallucinations and delusions, per the Cleveland Clinic. Though today it’s considered a mental health emergency, awareness of the disorder was far more limited at the time of Andrea’s case, with her attorney even admitting to the Houston Chronicle in June 2016 that he “had no earthly idea” what postpartum meant.

At both of her trials, her defense argued that the Texas mother’s untreated delusions became intertwined with deeply held religious beliefs, which led her to believe that killing her young children was the only way to save them.

Even after two decades, the question remains: why did Andrea Yates kill her children? Here’s everything to know about her mental health history and the religious influence that allegedly distorted her beliefs.

What did Andrea Yates do? 

On June 20, 2001, police responded to a 911 call from a home in the Houston suburb of Clear Lake, Texas, and found Andrea standing in front of the house in a soaking wet blue and white shirt. She told the officers that she had killed her five children.

Shortly after Andrea’s husband, Rusty, left for work at the Johnson Space Center, Andrea said 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.

What led up to Andrea Yates killing her children?

Immediately after the shocking murders, people wondered what had gone wrong. “Something had to have snapped,” Cheryl Johnson, the Yates’ neighbor at the time, told PEOPLE in the aftermath. “She was no monster.”

It was later revealed that Andrea had struggled for years with mental health issues, suffering from severe depression after the birth of her fourth child, Rusty said. When the couple wed in 1993, Rusty told his wife 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.”

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, Andrea 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.

Andrea 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, Parnham argued during her trial.

He told jurors that she believed drowning her children “was the right thing to do.”

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.”

Why did Andrea Yates kill her children?

Jail psychiatrist Melissa Ferguson testified during Andrea’s first trial in 2002 that the mother had believed she was evil and that drowning her five children was fulfilling a prophecy, the Midland Reporter-Telegram reported.

“It was the seventh deadly sin,” Andrea reportedly said. “My children weren’t righteous. They stumbled because I was evil. The way I was raising them, they could never be saved. They were doomed to perish in the fires of hell.”

Both the defense and the prosecution argued that the Texas mom was under the influence of a controversial traveling preacher named Michael Woroniecki. The religious leader — of what was characterized by some as a “cult” in the 2026 Investigation Discovery docuseries The Cult Behind the Killer: The Andrea Yates Story — allegedly preached that “unrighteous mothers” gave birth to “unrighteous children.” No legal responsibility was ever assigned to Woroniecki in connection with the Yates children’s deaths.

His controversial teachings also allegedly asserted that if children died before the age of 12, they wouldn’t go to hell, per the Houston Chronicle. All of Andrea’s kids were under the age of 8 when they died.

Woroniecki has denied having any influence over Andrea and told Good Morning America in March 2002 that the claims were “ridiculous.”

What happened to Andrea Yates after killing her children?

In 2002, Andrea was found guilty of capital murder and sentenced to life in prison with the possibility of parole after 40 years. However, her conviction was reversed after a key prosecution witness admitted he wrongly testified that a Law & Order episode resembling her case could have influenced her actions.

The episode never existed at all. Andrea’s conviction was reversed, and the case was retried in 2006. She was found not guilty by reason of insanity.

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

Rusty has since divorced Andrea, and had another child with Laura Arnold, whom he divorced in 2015. When asked by Oprah Winfrey in 2016 if he forgave Andrea, 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.”

Andrea has waived her right to an annual review for consideration for release as recently as 2022. She “grieves for her children” every day, often watching home videos of them, Parnham, who supports The Yates Children Memorial Fund, which funds maternal mental health education, told PEOPLE in September 2016.

“She’s where she wants to be. Where she needs to be,” Parnham told ABC News in June 2021. “And I mean, hypothetically, where would she go? What would she do?”

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.