What I Can’t Tell You About the Lindsay Clancy Case
Written August 19, 2026, while the trial is ongoing and before any verdict. I’m not involved in the case. I practice in Massachusetts and work with postpartum patients.
I haven’t been able to stop thinking about this case for a week. And I’ve wanted to write about it, but here’s what that’s looked like thus far:
5 Instagram posts I haven’t hit send on, and 3 blog drafts, centered on the following topics, respectively:
Proper documentation
The importance and challenge of coordination of care
The diagnosis of postpartum bipolar and psychotic symptoms.
But nothing felt true enough to publish.
Providers occupying similar spaces online have taken the opportunity to educate their audiences about the importance of thorough documentation. Some paired that with a sales pitch to their toolkits. Others posted about the diagnostic challenges with postpartum psychiatry, or explained all the medications Clancy was prescribed by different providers. Still others (and I’m still talking about healthcare providers here) offered theories about who really murdered the children. If that’s not a cautionary tale about scope creep and staying in our lanes, I’m not sure what is.
Meanwhile, the comments section in every clinician Facebook group I’m in overflows with righteous anger and blame—towards the clinicians on the stand, the hospitals, or the system overall.
These sentiments bring up a lot of ambivalence for me. Some seem self-soothing in an “if I were the clinician I would’ve done X better” kind of way. A step above, but not altogether different from “but what was she wearing?”
But some also feel justified and grounded in truth. And with such tragedy at the center of the case, they’re tempting to join with, even if just to assuage the pain and dread I sit with thinking about this case. Some of that ambivalence is personal. I went to school with one of the clinicians who read her charting out loud and defended her choices in a courtroom, and I’m not going to pretend that doesn’t sit somewhere in how I’m reading all of this. At minimum, it made the stakes palpable knowing I could’ve easily been in her shoes. But today I realized what had bothered me about all of these posts and discussions, and why I couldn’t say anything that resembled them.
It was the certainty people spoke from. Over and over, seeing the pipeline from hot take to how-to-guide that’s far too easy to create with generative AI, first of all, and somehow glided past all the discomfort to offer people a way out of their dread. While that script isn’t new in the world of marketing, it felt odd in this case. How had they come to such confidence? Such clarity that afforded them such an immediate perspective, and an ability to offer us something tangible?
I’ve always struggled to do this, seeing way too many shades of gray in almost everything. I’d be a disaster on a debate team, form all my ideas after the 24-hour news cycle is bored of the topic, and have multiple op-ed rejections because I don’t do the op part very well.
So, certainty is an output my system struggles to produce about most things, but especially about circumstances this confounding.
So now that I’m settled on what I can’t do, I feel a lot freer to offer something that does feel real. Because I do think there are a few things worth thinking about differently now that this case is in our consciousness. Especially if you’re a mental health provider.
If you’re a new parent, or you love one, I hope it’s useful to overhear. So, here goes.
First: Postpartum psychosis is easier to miss than we’d like to believe it is.
It doesn’t look like schizophrenia or a typical bipolar presentation with euphoric mood and grandiosity. Prominent features include anxiety, irritability, sadness, and disorganization or confusion, in a waxing and waning course. And if you’re a parent reading this thinking “isn’t that just called ‘having a baby’?” - girl, yes. I’m with you, and that’s what makes this so challenging to spot if you aren’t looking for it every time you see your patient.
Postpartum psychosis requires thoughtful history-taking, ideally a longitudinal assessment period, and accurate information from the patient and their support people. You’re ruling it OUT, not in, so as not to mistake a life-threatening condition for normal parenting struggles turned up a few notches.
Second: Clinicians could benefit from a brush-up on social psych 101.
In this case, I’m thinking about the dual phenomena of diffusion of responsibility and social conformity. The first being that the more people involved in a crisis, the more likely we are to assume someone else will take action, and therefore not take action ourselves. And the second describes the intense power of social conformity, causing research participants to say laughably wrong things, like insisting that two obviously different lines are the same length, so as to conform with their peers.
So why might they apply here? Clancy saw three separate outpatient psychiatric prescribers, an outpatient therapist, and had multiple ED visits and a hospitalization in the 5 months leading up to the eventual tragedy. With the responsibility of her care falling upon this many different people, it’s hard to identify a single person responsible for making the right assessment, prescribing the right medication, or offering the right level of care. When you’re working among others, it’s simply a lot easier to feel like it’s not all on you, and someone else will be able to escalate the case if circumstances allow. So that’s how the responsibility got diffused across the system of care, lending credence to arguments about how Clancy was failed by “the system” and not one provider alone.
But I think conformity is an even more insidious player in dynamics like these. For a condition that’s rare like postpartum psychosis, you’re going out on a limb if everyone else in the case thought it was depression/anxiety. And taking a risk like that is just something that social psychology teaches us is harder to do than we’d like to think it is.
Third: We won’t be able to prevent all tragedies like this, even when we do everything right.
This is the thing we don’t want to look at. This is the knowing, gnawing dread we avoid when we blame, simmer in righteous anger, or perform certainty. Some mental illnesses are fatal to the sufferer - others fatal at the hands of the one suffering. And that is tragic. Yes. But there’s something strange about how we perceive the nature of mental vs. physiologic illness. Some sense that we can ultimately control the outcomes better. But it’s not that simple. And by accepting that tragedies will happen, we can actually engage with reality much more skillfully because we aren’t operating in denial. We have a much more precise sense of the things inside our control and outside it, and from that place, it’s a lot clearer what important preventive action is.
What we should do differently, if we weren’t already, is subtle, but important. We look at anxiety, confusion, perplexity, and mood dysregulation in postpartum patients and rule OUT psychosis vs. ruling it in. We should have releases of information for collateral providers and time blocked out in our schedules to coordinate care. We should have case consultation around challenging or confounding cases–not to diffuse responsibility, but to offer time to think about it differently. Time to be more discerning about biases, and to consider the case outside the pressure of knowing you have 3 more patients to see after this one, and a family to get home to that wishes you got out at 5pm for once. Those are simple to state but perhaps challenging to implement, so I’m not suggesting a person or system-level responsibility to enact them. I’m just suggesting that they’re common-sense safeguards that guarantee nothing, but help us all practice more thoughtfully and safely.
And most of all, we have to stop pretending we know what would’ve gone differently in this case “if someone just”.
We don’t.
All we can do is learn from it, do a little better ourselves, and keep practicing.
Before you go: I'm a psychiatric nurse practitioner, but I'm not your psychiatric nurse practitioner. Nothing here is medical advice, nothing here creates a clinical relationship, and nothing here should replace a conversation with someone who can actually assess you.
Everything I've written about the case comes from public reporting. I have no access to any record, I'm not offering an opinion on anyone's guilt or on how the trial should come out, and I'm not evaluating any individual clinician's care. No patient information appears anywhere in this piece. If you're a new parent and something in here scared you, please read the next part.
If you're struggling right now
Scary, unwanted thoughts about something happening to your baby are extremely common. Something like half of all new parents have them. Having them is not the same thing as being dangerous, and telling a clinician about them is the fastest way to get the right kind of help.
In an emergency, call 911 or go to your nearest emergency room.
988 Suicide & Crisis Lifeline. Call or text 988, or chat at 988lifeline.org. Free, confidential, 24/7.
National Maternal Mental Health Hotline. Call or text 1-833-TLC-MAMA (1-833-852-6262). Free, confidential, 24/7, English and Spanish. For pregnant and postpartum people, and for partners and family too.
Postpartum Support International HelpLine. Call 1-800-944-4773, or text "Help" to 800-944-4773 (English) or 971-203-7773 (Spanish). Open 8am to 11pm ET. Not a crisis line; a trained volunteer returns your message, so use 988 if you need someone now.
To find a clinician, PSI keeps a directory at psidirectory.com.
If you're a clinician who wants a tool
Free psychiatric consultation for any US prescriber, through PSI's Perinatal Psychiatric Consultation Program. Book at postpartumsupportinternational.simplybook.me or email consultation@postpartum.net, confirmed within one business day. Thirty-eight states, DC, and a VA program also run their own access lines, listed at postpartum.net. In Massachusetts that's MCPAP for Moms.
ACOG Clinical Practice Guidelines No. 4 and No. 5 (2023) cover screening and management. No. 4 carries a strong recommendation to screen for bipolar disorder before starting pharmacotherapy.
On instruments: the Edinburgh has no mania, hypomania, or psychosis items, so a normal Edinburgh doesn't rule out what this piece is about. ACOG names the CIDI branching questions for bipolar screening; the MDQ scored the standard way runs about 39% sensitivity perinatally.
