With the ongoing trial of Lindsay Clancy for the murder of her 3 children, I can’t help but reflect on this tragedy from a mental health perspective. While I am not an expert in criminology or forensics, and quite frankly I don’t even have opinions on how her family should have responded differently since I don’t have their lived experience. But I am an expert in perinatal mental health, given my PMH-C certification, and my professional opinion here is that the system failed this family beyond a shadow of a doubt.
Why We Don’t Talk Enough About Perinatal Mental Health
It starts with awareness. Before Lindsay, or any woman for that matter, is even struggling with her mental health, we see that people are generally uninformed about what to look out for. We don’t talk about the realities of Perinatal Mood and Anxiety Disorders (PMADs) enough for people to truly understand them. Without this understanding, how can anyone act accordingly?
When people think of postpartum mental health they often only think of depression, in fact I’ve heard people who had postpartum diagnoses say ,“ I had postpartum” … postpartum what?! This tells me providers aren’t even educating patients on their own experiences as they are enduring them.
And if you look it up and try to get informed, most sources will tell you PMADs, in particular postpartum psychoses, happen in the first few weeks after birth. But we know that PMADs peak 6-8 months postpartum, so if you’re only looking for signs for a few weeks, you’re likely to miss it.
In her husband’s testimony, he even says “I didn’t know what psychosis was until after this happened.” How on Earth are we supposed to support women in our families when we don’t even know this exists?
And unfortunately, it seems her providers didn’t even know enough about them to act appropriately. This is a failing of our system - of not giving enough voice to women’s experiences postpartum. So people hear things like postpartum depression and assume it’s sadness. They hear postpartum anxiety and assume it’s worry. They rarely hear about postpartum rage because it’s dripping with shame, and therefore secrecy. After all, what kind of mother feels this toward her children?
Postpartum Psychosis Isn’t as Rare as You Think
Postpartum psychosis is often described as “rare.” But it’s not rare. In fact, a few weeks back I wrote a post about the dangers of calling it rare. It has the same prevalence rates as Down Syndrome, roughly 1-2 in 1,000. That’s not truly rare. Now, if you add in the 4% of cases that end in tragedy (infanticide), such as in the Lindsay Clancy case, it can seem rare. But it’s not. And calling it rare makes this even more dangerous, because that insinuates it’s “unlikely” to happen to you or someone you know.
How Shame Silences Women Seeking Help
All of these ways of looking at perinatal mental health can minimize a woman’s experience. It’s not simply sadness or worry, even if it starts that way. And the shame of this can prevent women from seeking help when it does escalate. On top of that, even when women do seek help, there’s no guarantee they’ll get what they need without significantly advocating for themselves - which can be hard to do when you’re not even sure yourself what is happening to you.
Postpartum Psychosis Can Happen to Anyone
The thing about this is that it can literally happen to anyone. And I’m seeing all these opinions flying about who should have done what differently, and I also know that’s just people trying to make sense of it and gain comfort that it won’t happen to us or people that we know. But can we just stop doing that for a moment and recognize that it can?
We need to know the risks - if we think it can’t happen to us, we will put our heads in the sand, and that’s when it becomes most dangerous. We need to understand this can happen to any postpartum woman. Yes, there are risk factors such as traumatic birth and previous history of anxiety, depression, bipolar disorder, etc. But even without those factors, if you’ve had a child, it can happen to you.
Lindsay Clancy Worked in Healthcare — And Still Wasn’t Caught
What makes this more complex is that Lindsay worked in the medical field. She worked in labor and delivery, seeing postpartum women every day. She spoke to doctors who put her on medication. In fact, she was prescribed 13 medications in total, and while I’m not a prescriber and cannot speak to the logic behind these medication decisions, I cannot believe that somehow no one looked at her situation and said “something seems wrong here.”
She herself could not see the full extent of it because that’s nearly impossible when you’re the one undergoing a mental health crisis. She needed the people around her to notice and to help. This is why awareness matters. This is why talking about women’s health, women’s mental health, and the mental health of parents matters so much. Because how can we catch the earliest signs of something if we aren’t even aware it exists?
The System Failed This Family
Patrick Clancy not knowing that postpartum psychosis existed is not his fault. He should have been educated on it. The system failed him. It failed Lindsay. It failed the children. It failed this family, and it will continue to do so unless we bring perinatal mental health out of the shadows of shame and into the light of awareness.