Shirley Winters slipped in and out of the mental health system for 30 years.

She landed in psychiatric wards 28 times with more than a dozen illnesses.

While she was being diagnosed and released over and over since 1978, Winters became a rarity: both a serial killer and serial arsonist. She admitted this year that she killed two children -- one her own -- over the past 27 years, and she's suspected of setting fire to as many as 18 homes.

She was a suspect in the deaths of two of her other children in a 1979 fire.

Her mental health record -- more than 300 pages long -- tells the story of a problem the system could not solve. The records were filed under seal in Onondaga County Court four months ago when she was sentenced to prison for killing her 5-month-old son Ronald in 1980.

The records, obtained by The Post-Standard, describe Winters' problems since she was first placed in a mental health facility in California in 1978. They lay out the development of her mental health from an early age. Among the revelations:

• In 1990, she tried to jump off a bridge in St. Lawrence County after visiting the graves of her first two children.

• In 1997, she told a psychiatrist that whenever she went job-searching, she made sure the workplace had a quiet room where she could be alone so she could respond to her hallucinations.

• She claimed in 1999 to have nine alter personalities, but later admitted she was just saying that to appease a psychotherapist in prison.

• She claimed in 2006 that she was hearing "babies' voices," and when she turned around, there was no one there.

• She feared she would die every year on the anniversary of the accidental deaths of her three siblings in 1966.

• In 2006, her therapist noted that Winters felt compelled to bang her head against the wall and stab sharp objects into her legs at Strong Memorial Hospital in Rochester.

• She told counselors she didn't stay on her medications because she couldn't afford them, they made her feel overweight, or she forgot.

The records list a catalog of psychological ills. Among them: dissociative disorder, bipolar disorder, borderline personality disorder, schizophrenia, psychogenic amnesia and pyromania.

At least seven times, she was readmitted within two days after she was released. She was self-medicating with alcohol and drugs, and would often be readmitted when she got drunk or high, the records show.

Winters' records detail a life of frequent contact with therapists, psychologists and psychiatrists.

The records are built mainly around Winters' own recollections and claims. There's no way to know whether she was telling the truth.

Winters, 50, declined repeated requests for interviews at Bedford Hills state prison, where she's serving up to 25 years for smothering her son in 1980 and drowning 2-year-old Ryan Rivers in 2006. She was never charged with the deaths of her first two children, Colleen, 3, and John, 1 1/2, who died in a fire in 1979.

Their grandmother, Mary Lou Winters, said she doesn't buy the claim that the crimes were the result of a mental illness.

"At first I thought it was a psychiatric problem," said Mary Lou, whose son Ronald Winters Jr., divorced Shirley in 1988. "But I think she's too calculating."

Social worker Richard Luciani suggested in court papers that the mental health system failed Winters. Luciani, who was hired by Winters' lawyer, told Judge Joseph Fahey in a sentencing memorandum that he hoped the records would help the state prison system treat Winters.

Luciani refused to comment.

He wrote in court papers that he hoped a psychotherapist in prison would see her long history and engage her in long-term psychotherapy to address her "deep-rooted issues." He believed it would be the first time she'd have a chance for meaningful psychological intervention, because over the years she moved from doctor to doctor, Luciani wrote.

But a psychiatrist who reviewed the file for The Post-Standard thinks otherwise. The system was there for Winters and she rejected it, said Dr. James Knoll. Knoll, a forensic psychiatrist at Upstate Medical University, has written medical journal articles critical of the mental health system.

In Winters' case, it didn't help that she appears to be suffering from borderline personality disorder, he said. Little is known about how to treat it, Knoll said. Someone with the disorder is considered on the border between simply being neurotic -- as many people are -- and being psychotic, he said.

"At this point in time, our treatment is not that great," Knoll said. "What we can do is kind of therapeutically hold their hands through the rough times, and hope."

It's not like a hard-core illness like schizophrenia, which is obviously based in biology, he said.

Winters appears to fall into a class of mentally ill people who are difficult to treat, Knoll said. She was functional enough that she couldn't be involuntarily treated unless she became a danger to herself or others. And she sabotaged any offers for help, he said.

Knoll said he saw something extraordinary in Winters' records. They appeared to describe someone spending her life repeating her own childhood tragedy with a severity and magnitude that he'd rarely seen.

Winters' three siblings died in 1966 when a gas furnace leaked and asphyxiated them in their beds. She was 7 and wasn't home that night. Winters had tricked her sister Joyce into letting her go that night, while Joyce stayed home, the mental health records said.

The records indicate she was obsessed with the deaths.

In an interview on the 33rd anniversary of the deaths, in 1999, Winters made this revelation to a prison psychologist:

"I have always felt each year on this day that I would die," the psychologist's report said. "It is scary. It would be fate."

Even though it was a gas leak, it was similar enough to a house fire that it appears to be a repetition, Knoll said. In psychiatry, it's a concept called the repetition compulsion, he said.

"The thinking is that it's an attempt to try to master the anxiety from that trauma and go back and undo it somehow," Knoll said.

For Winters, the deaths of her brother and sisters presented not only survivor's guilt, but the guilt of placing her sister in harm's way, Knoll said. On top of that, she told counselors that she was molested as a child, beginning shortly after the deaths of her siblings.

A year earlier, Winters had her first traumatic brush with fire, the records show. Her sister's dress had been set on fire when Shirley was 6, according to the records. Years later, she talked with therapists about the impact of that event had, the records show.

Winters' first contact with a therapist was when she was in grade school, the records show. It was a few years after her three siblings died, and her classmates were calling her "Squirrelly Shirley," the records said.

A cousin, June Gross, said Shirley had become a difficult child.

"She would bite, throw things, dig her nails into you," said Gross, of Florida.

The violence escalated. Knoll said it appears to have been an unusual response to her own trauma. Most people who suffer such tragedies direct their abuse inward, he said. It's rare to see someone respond by acting so violently against others over and over, he said.

The mental health records say Winters may have an anti-social personality disorder. That goes more toward "criminalistic-type thinking," Knoll said. It's just someone who's willing to violate social norms, he said.

Winters demonstrated plenty of evidence for that.

One of the fires Winters is suspected of setting was to her home on Willis Avenue in 1989. Winters got out with two of her children, but 5-year-old Joy was left behind. The girl later told people her mother had ordered her to stay inside, according to Joy's grandmother.

In 1997, Gross' son was staying at Winters' house in Syracuse when Winters set it on fire. He escaped. She later pleaded guilty and admitted she knew he was in the home.

Winters has had at least 18 fires in her homes or related places. Nine have been attributed to arson, and Winters was charged with arson in five of them. She was convicted once and went to prison for eight years.

A week after Winters drowned Ryan Rivers in 2006, a police officer pulled her over in her pickup truck because she was swerving. Her shirt was torn and she had deep scratches on her wrist, neck, upper chest and face.

"The evil has to stop," Winters mumbled. "The evil is trying to get out!" Winters told him she hadn't taken her medication for schizophrenia, and that she was trying to get to a psychiatric hospital in Ogdensburg but had gotten lost.

When she pleaded guilty to killing her son, Onondaga County District Attorney William Fitzpatrick said Winters was "the face of evil."

Her ex-husband initially supported her through years of setting fires. But over the past two decades, he's seen the light and has been wary of her, his mother said.

"He's always slept with one eye open," Mary Lou Winters said of her son shortly after Shirley went to prison.

Timeline: The life of Shirley WintersThe Post Standard