‘America’s saddest murder trial’: mental health in focus in Lindsay Clancy case

It’s been called “America’s saddest murder trial” and last week jurors in the Lindsay Clancy case listened to mental health professionals, counsellors, psychiatrists, and medication experts explain the circumstances in which the young mother killed her three children.

It has been a spectacle that has gripped America, not least because Clancy’s legal defense has been supported by her now divorced husband.

The evidence last week bolstered the contention that Clancy was over-medicated and underserved as she tried to get help before she suffered a psychotic mental break – exacerbated by undiagnosed postpartum depression – that led to her kill her young family. It has also backed up the defense argument that Clancy’s medical team failed in its duty of care towards her.

The court in Plymouth, Massachusetts, heard Clancy described as a “very loving mother who cared about her children” but also that she was in a “difficult mental place”, feeling “tired and anxious”.

On Friday, three psychiatrists who saw Clancy in the months leading up to the January 2023 murders explained why they did not diagnose Clancy with postpartum psychosis.

Dr Alia Goodheart said she considered Clancy a “low-risk” patient. Clancy told her she was experiencing insomnia and numbness and having suicidal thoughts but did not have a plan to act on them.

Another, Dr Jennifer Tufts, said Clancy reported feeling worried about possibly “one day having suicidal thoughts” if she continued “to feel poorly”, but exhibited no signs of mania. She advised Clancy to stop taking Zoloft (sertraline), a medication used to treat panic and obsessive-compulsive disorders, try natural remedies such as fish oil, and take lorazepam in instances of “severe anxiety”.

The court has heard that Clancy was prescribed 13 different psychiatric medications in the months leading up to the killings.

Tufts and Goodheart are named in a medical malpractice lawsuit Clancy and her former husband have filed. Clancy does not deny killing her children, but her defense argues postpartum psychosis warped her sense of reality and that she is not criminally liable for their deaths.

After she killed her three children – eight-month old Callan, five-year-old Cora and three-year-old Dawson – Clancy, then 32, slashed her wrists and neck and jumped from a second-story window in a suicide attempt. The fall paralyzed her from the waist down.

The trial has often made for difficult listening – presiding judge William Sullivan has reminded jurors they cannot decide the case on emotion – and prosecutors have come perilously close to arguing that Clancy’s because suicide attempt failed, it lends credence to the contention that she aimed to kill her children.

Friday’s proceeding broke dramatically when defense attorney Kevin Reddington said in open court that a prosecutor had said “shut her up” while Clancy sobbed after the court was shown autopsy photos of her baby while a medical examiner testified on the stand.

The court also heard from a state police investigator that authorities found no evidence that Clancy had ever been abusive toward her children. Her former father-in-law, Christopher Clancy, said Clancy was a “very good” mother. The picture the couple created, he said, was of “the all-American family”.

Childhood friend Amy Bevins said Clancy was “a good person, a good friend, a good mom” and had been open about her struggles with her mental health and told her that a medication she was taking was causing her to have “dark thoughts”.

Bethany DeCollibus, a family therapist, said Clancy’s demeanor appeared normal but that she had said she could not sleep and felt “like a zombie”. A teacher from the elder children’s school said Clancy was a “very loving mother who cared about her children”.

Even on the day of the murders, the court heard, Clancy took Cora for a regular pediatric check-up. The pediatrician, Dr Lindsay Rosshirt, testified that “as far as I can recall, it was a very normal visit”.

Dr Nicole Kumi, an expert in postpartum mental health, said the Clancy trial raises a host of issues about the diagnosis of postpartum mental health disorders and how the healthcare system recognizes and responds to them.

The trial, she said, highlights “a significant gap in care for moms in the postpartum period”. Professionals who work in the field see that postpartum psychosis, while appearing to be rare to the outside world, is in fact readily apparent.

“We see it frequently and we see it escalate to unfortunate outcomes, because of a lack of education and awareness for moms, their partners and for members of the community that could potentially intervene before it gets to the state it got to with Lindsay Clancy,” she said.

Clancy, Kumi said, was actively seeking help. “She knew something was wrong, but she didn’t know what was wrong,” she said. The fact that she had had three children did not protect her from the condition, and may have made people around her assume she was able to cope.

“They start to normalize the stressors of motherhood,” Kumi said.

If the medical community overlooked Clancy, or failed to take her symptoms seriously, it may be because there is a focus on first-time mothers, Kumi said.

‘She was crying out for help within her home and within the healthcare system, and all she was met with was medication and redirection,” Kumi said. “That’s not how we solve problems in maternal healthcare.”

Clancy had told medical professionals and those around her that she was unable to sleep, a condition that can worsen mental health. “Every journey is different and a lack of sleep is an indicator for postpartum moms,” Kumi said.

The Clancy trial exposes what Kumi said was “a maternal healthcare crisis in this country”.

That Clancy appeared to be functioning as a mother, Kumi added, was not itself a measure of her mental health.

“In my opinion, she was influenced by delusions and hallucinations which are part of psychosis. She had moments when she it looked like she was functioning well from the outside. But we don’t know what was going on internally for her,” she said.

• In the US, call or text Mental Health America at 988 or chat 988lifeline.org. You can also reach Crisis Text Line by texting MHA to 741741. In the UK, the charity Mind is available on 0300 123 3393 and Childline on 0800 1111. In Australia, support is available at Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978