Los Angeles Advocacy Group Demands Systemic Reform of Perinatal Mental Health Services Following Reseda Tragedy
The advocacy organization Maternal Mental Health NOW has issued a formal call to action directed at the Los Angeles County Board of Supervisors, urging the immediate implementation of mandatory training and increased funding for a coordinated system of perinatal mental health care. This mobilization comes in the wake of the devastating Liliana Carrillo case, which advocates cite as a primary example of catastrophic systemic failure within the county’s social safety net. The organization argues that the tragedy, which resulted in the deaths of three young children, could have been prevented had county employees across various departments been equipped with the necessary training to identify and respond to perinatal mood and anxiety disorders (PMADs).
The proposed reforms seek to move beyond traditional clinical settings, mandating that employees in every county agency—ranging from the Department of Children and Family Services (DCFS) to administrative offices and public safety departments—receive comprehensive education on maternal mental health. By establishing a robust, culturally appropriate, and easily accessible system of care, advocates believe the county can close the gaps that currently allow high-risk families to fall through the cracks of the bureaucratic landscape.
The Catalyst: The Liliana Carrillo Case and Systemic Oversight
The urgency behind this legislative push is deeply rooted in the events leading up to April 10, 2021, when three children—aged three years, two years, and six months—were found deceased in a Reseda apartment. Their mother, Liliana Carrillo, was subsequently arrested and charged. However, investigative reports, including extensive coverage by the Los Angeles Times, revealed a long trail of red flags and missed opportunities for intervention by Los Angeles County authorities.
In the months preceding the tragedy, the children’s father, Erik Denton, had repeatedly sought help from the court system and child welfare agencies. Denton expressed grave concerns regarding Carrillo’s deteriorating mental state, describing behaviors consistent with postpartum psychosis and severe delusions. Despite multiple interactions with the Department of Children and Family Services and the local court system, the family’s situation was not treated as a psychiatric emergency.
Advocates point out that each interaction with a county agency represented a potential touchpoint where a trained professional could have recognized the signs of a perinatal mental health crisis. Instead, the lack of a coordinated response meant that information was siloed, and the severity of Carrillo’s condition was underestimated. Maternal Mental Health NOW asserts that the Carrillo family’s experience is not an isolated incident of bad luck, but rather a symptom of a systemic lack of awareness regarding the unique presentation of perinatal mood disorders.
Understanding Perinatal Mood and Anxiety Disorders (PMADs)
To understand the necessity of the proposed training, it is essential to define the scope of perinatal mood and anxiety disorders. PMADs is an umbrella term that includes postpartum depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and, in rare but severe cases, postpartum psychosis.
Statistical data highlights the prevalence of these conditions:
- Approximately one in five to one in seven birthing people will experience a PMAD.
- In Los Angeles County, which sees over 100,000 births annually, this translates to tens of thousands of families affected every year.
- Suicide and overdose are among the leading causes of death for people in the first year following childbirth, often linked to untreated mental health conditions.
- Despite the high prevalence, it is estimated that less than 25% of affected individuals receive appropriate treatment.
PMADs do not discriminate based on socioeconomic status, race, or education level, though systemic barriers often make it more difficult for marginalized communities to access care. When left untreated, these disorders can lead to impaired bonding, developmental delays in children, family instability, and, in extreme cases, infanticide or suicide.
The Scope of the Proposed Training Mandate
A central pillar of the advocacy effort is the insistence that training should not be limited to mental health professionals. Maternal Mental Health NOW argues that because many individuals suffering from PMADs do not initially seek out psychiatric care, the "first responders" to a mental health crisis are often county employees in unrelated roles.
The organization’s proposal calls for a motion by the Board of Supervisors to mandate training for:
- Social Workers and Child Welfare Officers: To better distinguish between intentional neglect and the symptoms of a treatable mental health disorder.
- Law Enforcement and First Responders: To ensure that welfare checks involving new parents are handled with a clinical understanding of postpartum psychosis.
- Administrative Staff at Public Health Clinics: To identify "red flag" behaviors during routine appointments or paperwork filings.
- Court Personnel: To ensure that custody and domestic or family law cases take perinatal mental health into account when evaluating the safety of a household.
The goal is to create a "no wrong door" policy where any interaction with a county agency can serve as a gateway to mental health resources. By training a wide array of employees to detect the subtle and overt signs of PMADs, the county can create a safety net that is proactive rather than reactive.
The Economic and Social Argument for a Coordinated System of Care
Beyond the moral imperative to save lives, there is a significant economic argument for investing in a coordinated system of perinatal mental health care. Research into the "cost of inaction" regarding maternal mental health suggests that untreated conditions carry a heavy financial burden for taxpayers.
According to data from Mathematica Policy Research, the cost of untreated maternal mental health conditions in the United States is estimated at $14.2 billion annually. This figure includes:
- Reduced Economic Productivity: Mothers struggling with untreated depression or anxiety are less likely to participate effectively in the workforce.
- Increased Health Care Costs: Untreated PMADs often lead to more frequent emergency room visits and complications during subsequent pregnancies.
- Social Services and Criminal Justice Costs: When families collapse due to mental health crises, the burden falls on the foster care system, homeless services, and the legal system.
In Los Angeles County, a coordinated system of care would involve a centralized referral network, standardized screening protocols across all public health touchpoints, and a robust pool of culturally competent providers. Culturally appropriate care is particularly emphasized, as language barriers and historical distrust of government agencies can prevent many Los Angeles residents from seeking help.
Reactions and Stakeholder Perspectives
The call for action is directed specifically at the five members of the Los Angeles County Board of Supervisors: Hilda Solis (First District), Holly Mitchell (Second District), Sheila Kuehl (Third District), Janice Hahn (Fourth District), and Kathryn Barger (Fifth District). These supervisors oversee a county budget exceeding $36 billion and have significant influence over the policies of the Department of Public Health and the Department of Mental Health.
While the Board has previously expressed support for mental health initiatives, advocates argue that the specific nuances of the perinatal period have been overlooked. The Liliana Carrillo case has served as a wake-up call for many local leaders. In previous statements regarding child welfare, Supervisor Kathryn Barger has emphasized the need for better inter-agency communication, while Supervisor Holly Mitchell has been a vocal proponent of addressing health disparities among birthing people of color.
Maternal Mental Health NOW is joined by a growing coalition of parents, mental health clinicians, and community activists who believe that the county’s current approach is too fragmented. "We owe this to our county’s mothers, birthing people, and families," the organization stated in its appeal. "The Carrillo family’s numerous interactions provided an opportunity to offer the mother help, treatment, and hope. Catastrophically, each and every opportunity was missed."
The Path Forward: Legislative and Structural Changes
To prevent future tragedies, the advocacy group is pushing for a formal motion that includes specific benchmarks for success. These include the development of a standardized curriculum for county employees, the establishment of a task force to oversee the coordination of care, and the allocation of permanent funding streams for maternal mental health services.
The proposed timeline for these reforms suggests that training could begin within the next fiscal year, provided the Board of Supervisors moves quickly to pass the necessary mandates. The focus remains on ensuring that "high-quality, easily accessible, and culturally appropriate care" is not just a goal, but a realizable standard for all residents of Los Angeles County.
As the county continues to grapple with the aftermath of the Carrillo case, the pressure on local government to act is mounting. The tragedy has moved beyond the realm of a local news story and into a broader debate about the responsibilities of a public health system. For the advocates at Maternal Mental Health NOW and the families they represent, the message is clear: the tools to prevent these tragedies exist, but they must be supported by the political will to implement them across the entirety of Los Angeles County’s government infrastructure.
By mandating training and funding a coordinated system, Los Angeles has the opportunity to lead the nation in maternal mental health policy. The alternative, as seen in the Reseda apartment in 2021, is a continuation of missed opportunities that carry the highest possible price.
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