Los Angeles County Faces Urgent Demands for Perinatal Mental Health Reform Following the Liliana Carrillo Tragedy
The tragic case of Liliana Carrillo, a Los Angeles mother charged with the deaths of her three young children in 2021, has become the catalyst for a sweeping advocacy campaign aimed at overhauling the county’s approach to maternal mental health. Maternal Mental Health NOW, a leading advocacy organization, has issued an urgent call to the Los Angeles County Board of Supervisors to mandate comprehensive training on perinatal mood and anxiety disorders (PMADs) for all county employees and to fund a robust, coordinated system of care. The organization asserts that the deaths of Joanna, Terry, and Sierra Carrillo represent a systemic failure that could have been prevented had there been a more informed and integrated response from county agencies.
The advocacy group’s executive director, Kelly O’Connor, recently emphasized that the Carrillo case illustrates a desperate need for Los Angeles County to invest in specialized training and a seamless network of mental health support. The proposed motion would require employees across all county departments—ranging from social services and law enforcement to public health and the courts—to receive education on the nuances of perinatal mental health. Advocates argue that without a mandate for high-quality, culturally appropriate, and easily accessible care, the risk of similar tragedies remains unacceptably high for the county’s growing families.
The Reseda Tragedy: A Chronology of Systemic Gaps
The events leading up to the April 10, 2021, discovery of the three children in a Reseda apartment provide a harrowing timeline of missed opportunities and jurisdictional confusion. Liliana Carrillo was 30 years old at the time her children, aged 3 years, 2 years, and 6 months, were found deceased. The case immediately drew national attention, not only for its brutality but for the revelations that the children’s father, Erik Denton, had spent months attempting to alert authorities to Carrillo’s deteriorating mental state.
According to court records and public statements from the family, the timeline of the tragedy began months prior to the murders. In early 2021, Denton sought emergency custody of the children, citing Carrillo’s severe postpartum depression and escalating delusions. He reported that Carrillo believed she was responsible for the COVID-19 pandemic and that she had become increasingly paranoid. Despite these red flags, the legal and social service response was fragmented. In March 2021, a custody battle was underway in both Los Angeles and Tulare counties, with different agencies receiving conflicting information about the immediate danger posed to the children.
On several occasions, law enforcement and social workers from the Department of Children and Family Services (DCFS) were reportedly contacted. However, because Carrillo did not always meet the narrow, immediate criteria for involuntary psychiatric hospitalization at the moments of contact, she remained the primary caregiver. This lack of a "coordinated system of care"—the very thing Maternal Mental Health NOW is now demanding—meant that the mental health crisis was treated as a legal dispute rather than a medical emergency requiring specialized perinatal intervention.
Understanding Perinatal Mood and Anxiety Disorders (PMADs)
A central pillar of the current advocacy effort is the education of county officials on the clinical realities of PMADs. Maternal mental health encompasses a spectrum of conditions that occur during pregnancy or in the first year postpartum. While many are familiar with "postpartum depression," the spectrum also includes perinatal anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and, most severely, postpartum psychosis.
Supporting data indicates that PMADs are the most common complication of childbirth, affecting approximately one in five birthing people. In Los Angeles County, which sees over 100,000 births annually, this translates to tens of thousands of families affected each year. Despite the prevalence, research shows that nearly 75% of those experiencing symptoms do not receive a diagnosis or adequate treatment. For women of color and those in low-income communities, the barriers to care are even higher, involving lack of insurance, cultural stigma, and a historical mistrust of the foster care and legal systems.
Postpartum psychosis, which is suspected to have played a role in the Carrillo case, is a rare but extreme medical emergency occurring in approximately 1 to 2 out of every 1,000 births. It is characterized by a break from reality, delusions, and hallucinations. Unlike standard depression, psychosis requires immediate inpatient treatment. Advocates argue that if county employees—particularly those in the "First District" and "Fifth District" who often serve as first responders—were trained to recognize the symptoms of psychosis versus standard depression, the intervention in Reseda might have been medical rather than purely administrative.
The Role of the Los Angeles County Board of Supervisors
The Los Angeles County Board of Supervisors holds unique power in this struggle. As the governing body for one of the most populous counties in the United States, the five-member board functions in executive, legislative, and quasi-judicial roles. For the first time in the county’s history, all five supervisors identify as female: Hilda Solis (First District), Holly Mitchell (Second District), Lindsey Horvath (Third District), Janice Hahn (Fourth District), and Kathryn Barger (Fifth District).
This historic all-female composition has led advocates to hold the board to a higher standard regarding women’s health issues. Maternal Mental Health NOW is mobilizing constituents across all five districts to contact their respective supervisors. The goal is to move beyond "awareness months" and into the realm of mandated policy.
The proposed mandate seeks to ensure that:
- Universal Training: Every county agency, from the Sheriff’s Department to the Department of Public Social Services, implements a curriculum on maternal mental health.
- Integrated Referral Pathways: A standardized protocol is established so that a social worker in the Second District can immediately connect a mother in crisis with a specialized perinatal psychiatrist in the Fourth District without bureaucratic delays.
- Cultural Competency: Funding is directed toward providers who reflect the diverse demographics of Los Angeles, ensuring that language barriers and cultural nuances do not prevent mothers from seeking help.
Supporting Data: The Cost of Inaction
The economic and social costs of untreated maternal mental health conditions are staggering. A 2019 study by the Mathematica Policy Research firm estimated that the national cost of untreated PMADs is $14.2 billion annually. These costs stem from lost workplace productivity, increased use of emergency public services, and long-term developmental challenges for children raised by parents with untreated mental illness.
In California, maternal suicide and overdose are leading causes of pregnancy-related deaths. Data from the California Maternal Quality Care Collaborative (CMQCC) suggests that a significant portion of these deaths are preventable through early screening and intervention. In Los Angeles County, the disparity in outcomes is particularly stark for Black and Latina mothers, who experience higher rates of maternal morbidity and are less likely to be screened for mental health issues during prenatal and postpartum visits.
Advocates point out that the funding required to train county employees is a fraction of the cost associated with the aftermath of tragedies like the Carrillo case. The legal proceedings, foster care costs, and the lifelong psychological impact on surviving family members and the community create a financial and moral debt that the county continues to pay.
Official Responses and the Path Forward
While the Board of Supervisors has expressed sympathy for the Carrillo family in the past, the current push for a formal mandate is testing the board’s commitment to structural change. Supervisor Kathryn Barger, representing the Fifth District, has previously championed mental health initiatives, while Supervisor Holly Mitchell of the Second District has been a vocal advocate for maternal health equity. However, the specific demand for mandated training across all departments is a significant policy shift that involves labor negotiations and budgetary reallocations.
The legal case against Liliana Carrillo remains ongoing, with her defense team focusing heavily on her mental state at the time of the incident. This legal battle continues to serve as a public reminder of the consequences of a failed safety net. Maternal Mental Health NOW’s "Action Alert" is designed to ensure that the memory of the three children results in more than just a court verdict; they seek a legacy of legislative protection.
Broader Impact and Implications for Public Policy
The outcome of this advocacy in Los Angeles County could set a precedent for the rest of California and the United States. As the nation grapples with a burgeoning mental health crisis, the "Reseda Tragedy" serves as a case study in why specialized care is necessary. General mental health training is often insufficient for addressing the rapid hormonal and psychological shifts associated with the perinatal period.
The implications of a successful motion by the Board of Supervisors would be far-reaching. It would validate the necessity of "culturally appropriate" care, acknowledging that a one-size-fits-all approach fails the diverse population of Los Angeles. Furthermore, it would shift the burden of recognition from the suffering parent to the system designed to support them.
As Kelly O’Connor stated in her letter to the editor at the LA Times, the mission is to ensure that all growing families have access to timely and informed care. The "Action Alert" issued this week is more than a request for funding; it is a demand for a fundamental shift in how the government values the lives and mental well-being of mothers. With the support of the public and the political will of the Board of Supervisors, advocates hope to ensure that the names of Joanna, Terry, and Sierra Carrillo become synonymous with a turning point in maternal healthcare, rather than just a tragedy of the past.
