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WARNING: This story contains graphic and sensitive content.

A psychiatric expert says there is no evidence that Lauren Dickason was experiencing psychosis or delusions at the time she allegedly murdered her three little girls.

While she was depressed - he said - she was not at the severe end of the scale and does not meet the threshold for insanity.

Further he says there is no basis for a defence of infanticide because any depression Dickason experienced started as a teenager and not as a result of any pregnancy.

 “I agree she was depressed at the time, I agree it was a significant depression... but it is not connected to childbirth - how could it be? It started before that,” he said.

Dickason is charged with murdering Liane, 6, and 2-year-old twins Maya and Karla at their Timaru home in September 2021 shortly after the family emigrated from Pretoria, South Africa.

The 42-year-old admits to killing the girls but pleaded not guilty to the murder charges by reason of insanity or infanticide.

For 12 days the jury at her High Court trial has been hearing evidence about Dickason’s life - her upbringing, marriage, the gruelling fertility treatment she underwent to have children and her long battle with anxiety and depression.

The trial is now in the expert witness phase, with five psychiatrists - two for the Crown and three for the defence - being called to give opinions on whether Dickason was insane at the time of the alleged murders and if this is a case of infanticide.

Twins Maya and Karla with their older sister Liane Dickason.

The first Crown expert is Dr Erik Monasterio, who began giving evidence yesterday.

The jury heard earlier from prosecutor Andrew McRae that the Crown experts determined that “there is no medical defence here, and that the evidence will firmly point towards murder”.

Monasterio is a consultant forensic psychiatrist with almost 30 years of experience as a specialist assessor and former clinical director and director of area mental health services for the Canterbury Regional Forensic Service.

He has experience in hundreds of homicides, including specific insanity and infanticide cases.

He began giving evidence yesterday, telling the court that he spent about nine hours interviewing Dickason as soon as she was well enough after the alleged murders.

Monasterio said his duty - in all cases - was “to the court” and he did not “favour” any party.

“You will get my opinion - irrespective of whether I am instructed by the court, the defence or the prosecution,” he said.

Today before he gave his formal findings on insanity and infanticide Monasterio revealed what Dickason told him she was feeling in the hours leading up to the alleged murders.

“I felt like a failed mother,” she said.

“My children always prefer Graham … they didn’t want to be with me.”

She said she felt “like a spring getting tighter” and that “I am going to do something”.

She felt her husband was “not coping” and she felt “overworked and alone”.

“I didn’t feel like myself … I couldn’t see myself going through another day,” she told Monasterio.

“All I wanted was some quiet… I want this to stop … I didn’t want to feel like a bad parent anymore.”

Crown Prosecutor Andrew McRae. Photo / George Heard

Monasterio said Dickason then “remembered” the children had played with cable ties in South Africa which led her to think about strangling them.

She went and got cable ties from the garage and proceeded to try and asphyxiate the girls.

Dickason eventually smothered the children with a towel.

After they were dead Monasterio said she was “shaking really badly” and she took several pills to calm herself down.

She said she “had not planned a suicide method” until after she killed her daughters.

She tried various ways to end her own life. The Herald will not publish these details.

“Her next memory is of waking up in the intensive care unit in ‘shock and horror’ and ‘surprised to be alive’,” Monasterio said

Dickason told Monasterio she felt “deeply depressed”, despondent, hopeless and pessimistic.

“The worst I have felt in my life,” she claimed.

She did not engage in any suicide attempts or self-harm before the night she killed the girls and even then Monasterio said she “had no clear plan of suicide” at the time.

“She denied any sign of psychosis at any time,” he said.

“She denied any delusional beliefs.”

Monasterio said he carefully looked at “every single piece of information” provided to him about Dickason and “critically looked” at whether there was any sign of a “psychotic symptom”.

“I have not found any evidence for that in my review of all of the information that’s been disclosed,” he said.

Monasterio said Dickason reported her actions were “unplanned and impulsive” and stemmed from feelings “of desperation” and “inability to cope with the pressure” of living in New Zealand.

“She acknowledged considerable anger towards the twins … she said when Graham left the house she was overwhelmed with a sense that she could not cope and could not see a way forward,” he said.

“The reported that she then thought ‘this has to stop, I can’t do another day’.”

The Dickason girls. Photo / Supplied

Monasterio said Dickason described “awareness of her actions” during the alleged murders which he believed would have taken up to 20 minutes.

“She reported that once she set about harming the children, they had to die … she reported she had no clear plan on how she would commit suicide after killing the children although her intention was to die,” he said.

He told the court in his fourth interview with Dickason she told him a different story.

“She reported that she realised she committed the offences ‘to protect my children’,” he said.

“She reported ‘I couldn’t leave them behind they would suffer too much … I was very, very sick - I have never been that depressed.

“She was convinced her children would not be able to cope and would suffer too much if she committed suicide and left them behind.

“She reported that her inability to talk to Graham and his lack of understanding and support was a strong factor in her sense of despair.”

In the final interview, Dickason continued to deny any psychosis and said she was “in a muddle” during earlier sessions with Monasterio and had only recently been able to understand why she killed the girls.

Accused ‘drove’ emigration to New Zealand - what Graham Dickason told Dr Monasterio

Dickason gave consent for Monasterio to interview her husband.

Graham Dickason told the expert his wife was “on board with emigrating to New Zealand” and in fact “she drove it”.

“It was clear we could have backed out at any time,” Graham Dickason said.

While he knew his wife was “stressed” about their cramped temporary home in Timaru and what she saw as an inadequate rental market, her depression “did not appear to be that severe”.

“It was all under control with medications,” Graham Dickason told Monasterio.

He said his wife was “actively involved with settling in” including taking care of the grocery shopping and making preparations for the girls to start school.

“He did not notice the defendant was objectively disabled,” Monasterio told the jury.

“There was nothing outwardly unusual on the day of the alleged offences … there seemed to be nothing out of the ordinary with Lauren.

“She was not observedly distressed or with any unusual behaviour.”

Dr Monasterio’s formal finding - no to insanity, infanticide

Monasterio told the court he had conducted at least 2000 “mental state examinations” and carried one out with Dickason.

He said she “engaged well” and had “appropriate rapport”.

Her emotions were “blunted” and she “consistently cried” but despite her distress remained cooperative and concentrated at all times.

“She did not appear to be suspicious, there was no indication of unusual or bizarre behaviours,” said Monasterio.

“Her thought processes were linear and goal-directed without evidence of poverty of thought or thought disorder.

“She did not exhibit any cognitive impairment.”

Monasterio gave the jury his clinical and legal opinions just after midday today.

He acknowledged Dickason’s lifelong struggle with perfectionism, anxiety and “recurrent” depression and noted she had “vulnerable personality traits”.

He also noted she had thoughts of suicide but reiterated she never made any plans to carry out any form of self-harm.

In the lead-up to the alleged murders, there was an “insidious” increase in her depression and anxiety.

Monasterio said that was directly “precipitated and perpetuated” by “an unfortunate number of severe stressors and adverse incidents”.

Those included:

• Recurrent long periods of Covid lockdown
• Serious civil unrest and risk to the safety of the defendant’s family in South Africa.
• Multiple challenges and delays before immigration to New Zealand
• Covid infection of two of the defendant’s daughters
• A minor surgical procedure on her foot
• An alleged marked deterioration in the children’s behaviours
• Marital stress

“The defendant describes marked sleep impairment, poor appetite for faint loss, loss of enjoyment for most activities, diminished energy levels fluctuating in feelings of hopelessness and morbid preoccupations,” he told the jury.

Dickason also described “persistent and pronounced anxiety symptoms” and “intermittent marked exacerbation of anxiety consistent with panic episodes”.

However, Monasterio did not believe this was a case of infanticide or insanity.

“In my opinion, the defendant’s psychiatric diagnosis in the lead up to and at the time of the alleged offences is major depressive per recurrent with moderate to severe severity,” he told the jury.

“There is no evidence that this current episode of depression has a pregnancy, postpartum or lactation cause.

“There was no clear evidence that the defendant experienced any symptoms of psychosis associated with this condition.”

Police at the scene of the alleged murders. Photo / George Heard

Monasterio said he was “impressed” with Dickason’s “cognitive flexibility” in the days and hours before she killed the girls.

“There is no evidence that she was significantly cognitively impaired in the lead-up to the alleged offences … she was not at the severe end of the spectrum,” he opined.

“There is no evidence that this current episode of depression has a pregnancy, postpartum cause ... There is no clear evidence that the defendant experienced any symptoms of psychosis associated with this condition.

“In terms of severity - the defendant describes marked severity of subjective distress and impairment, melancholia with limited objective functional impairment.

“In my opinion, there is no evidence that the defendant has suffered from catatonic symptoms ... or abnormal behaviours at times associated with severe depression or psychosis in the lead up to or at the material time.

“In my opinion, the anxiety symptoms and worrying ruminations are mostly consistent with the severe stresses the defendant faced in the 6 to 12-month period before the alleged offences, the underlying temperament and the depressive disorder and are not accounted for by a separate diagnosis.”

In legal terms, Monasterio said Dickason suffered from a relapsing depressive illness and generalised anxiety.

However, the evidence did not show Dickason met the legal threshold for insanity.

“In my opinion, the severe impact of the mood and anxiety symptoms on the defendant’s mental state suggests - but is not conclusive - that she fulfilled criteria for a disease of the mind at the time

“The objective evidence of the impact of the mood and anxiety symptoms on the defendant’s capacity to function in the lead up to the alleged offences is moderate.”

Monasterio said it was more likely that “anger and frustration” at her children “contributed to the alleged offences”.

He also said there was no clear evidence of an altruistic motive, as claimed by the defence earlier in the trial.

Monasterio said Dickason “maintained awareness of her behaviours” and “does not have an insanity defence”.

“She systematically strangled the children and seemingly methodically checked for vital signs before resorting to smothering them until they were dead.

“The alleged offences are unlikely to have been impulsive.

“In my opinion, as the defendant maintained awareness and behaved systematically, there is no evidence that she was in an automat state or that she did not understand the nature and quality of her actions at the material time.”

No basis for infanticide defence says expert

Monasterio accepted Dickason had a disease of the mind “as a starting point” but it was not severe enough to provide a defence of insanity or infanticide.

He told the jury he had looked “assiduously” for evidence of the “severe depression” Dickason claimed.

He could not find any evidence of that and said “objectively” - her depression was moderate.

“There is no evidence that the defendant suffered from any symptoms of psychosis and particular delusional preoccupations.

“The defendant’s mood and anxiety disorder does not appear to have caused such significant cognitive impairment that she was rendered incapable of understanding the moral wrongfulness of the alleged offences.

“There is also no evidence that the defendant suffers from ‘natural’ and ‘intellectual impairment’ as defined in… the Crimes Act.

“Therefore, on the balance of probability, in my opinion, the defendant does not have an insanity defence.”

“The balance falls quite heavily against the defence of insanity.”

The trial for Lauren Dickason is underway at the High Court in Christchurch. Photo / George Heard

In terms of infanticide, Monasterio said any depression Dickason suffered at the times of the alleged murders could not be linked to the birth of her children.

“The defendant had fully recovered from the episodes of depression associated with the effects of giving birth.

“(She) achieved full remission of symptoms… even when she weaned herself off the antidepressant medication.

“She had a history of these symptoms before pregnancy… the depressive disorder… occurred well before the defendant’s pregnancy… the depression was already there before she gave birth so it cannot be called postpartum.

“It is likely that the effects of pregnancy and adaptation to the demands of motherhood and the care of three young children contributed too - but did not fully account for the defendant’s major depressive disorder at the time of the children’s birth.”

“There is no evidence the defendant has an infanticide defence available,” he said.

His evidence continues and he will be cross-examined by the defence later today.

Defence expert - Dickason killed ‘out of love’

Monasterio’s evidence followed the first defence expert Dr Susan Hatters-Friedman - a forensic and reproductive psychiatrist.

Her formal  - where a parent kills “out of love” rather than out of anger or hate.

She believed Dickason was “severely depressed and had developed psychotic thinking”.

“It is my opinion that at the time of her alleged offending Lauren Dickason was labouring under a disease of the mind to such an extent that it rendered her incapable of knowing that the act was morally wrong,” she opined.

“She conceptualised that [killing the children] was the right thing to do.”

The case so far:

Lauren Anne Dickason is on trial in the High Court at Christchurch before Justice Cameron Mander and a jury of eight women and four men.

The Crown alleges Dickason murdered the children in a “calculated” way because she was frustrated, angry and resentful of them.

Graham and Lauren Dickason with their children before the triple homicide. Photo / Supplied

It acknowledges Dickason suffered from sometimes-serious depression, it maintains she knew what she was doing when she killed the girls.

Last week, and killed them “methodically and purposefully, perhaps even clinically”.

The defence says Dickason was a severely mentally disturbed woman in the depths of postpartum depression and did not know the act of killing the children was morally wrong at the time of their deaths.

Further, it says she was “in such a dark place” she had decided to kill herself and felt “it was the right thing to do” to “take the girls with her”.

The trial is expected to run for at least another week.

SUICIDE AND DEPRESSION

Where to get help:
• : Call 0800 543 354 or text 4357 (HELP) (available 24/7)
• : Call 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• : Call 0800 376 633 or text 234
• : Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)
• : Call 0800 111 757 or text 4202 (available 24/7)
• Helpline: Need to talk? Call or text 1737
If it is an emergency and you feel like you or someone else is at risk, call 111