The prosecution of Lindsay Clancy, the Massachusetts mother who strangled her three young children and then attempted to take her own life, is now with a jury that will determine whether or not she is criminally responsible for killing them. Countless pundits, pedestrians, practitioners and parents are argue over the merits of the case, both online and IRL.
As much as the prosecution would like it to be otherwise, the Clancy case has morphed from a Rorschach test of whether she could understand the wrongfulness of her actions and control her conduct into something quite different. It has become a moment of reckoning on America’s mental health crisis, the “pill first” approach to treatment, systemic failures of perinatal care, and an inflexible legal system that’s more punitive than therapeutic. It only adds insult to tragedy to consider that America’s prison system, where Clancy could well find herself, already function as the nation’s largest de facto mental health provider, where more than 40 percent of inmates have a history of psychiatric problems.
Why has Clancy’s case struck such a nerve? It’s not just because of her white privilege, or the horrific horrific nature of this tragic crime. Those are surely factors, but what we are witnessing is a legal show trial, acting out institutionalized vengeance toward a mother who was severely and obviously mentally ill, something on which both sides agree.
Clancy was clinically diagnosed with major depressive disorder by multiple professionals: McLean Hospital psychiatrist Dr. Alia Goodheart, outpatient psychiatrist Dr. Jennifer Tufts and prosecution expert Dr. Avram Mack. Bipolar disorder was suspected by psychiatric nurse practitioner Rebecca Jollotta and diagnosed by Tewksbury State Hospital and later by Dr. Kirk Heilbrun, the prosecution’s forensic psychology expert. Postpartum psychosis, the basis of her defense, was diagnosed by Dr. Phillip Resnick and Dr. Paul Zeizel, who testified on her behalf. Clancy experienced a cluster of symptoms that neither side disputes, whatever the official diagnoses: dark and intrusive thoughts, suicidal ideation, paranoia, severe depression, anxiety, insomnia, sleep deprivation and emotional numbness.
Clancy’s case also resonates with so many people, especially but not exclusively women, because it’s tough to find a mother anywhere — whether it’s you, your spouse, your sister, your daughter, your friend or your co-worker — who has not stressed out over the same issues that worried Clancy: taking medication while breastfeeding, getting a baby to sleep through the night, not spending enough time with the other kids, and returning to work shortly after giving birth.
Clancy’s case resonates with so many people because it’s tough to find a mother anywhere — whether it’s you, your spouse, your sister, your daughter, your friend or your co-worker — who has not stressed out over the same issues that worried her.
Yet her case cut deeper still. For many who watched this trial, witnesses triggered memories of experiencing serious mood disorders that were minimized or dismissed as “baby blues” — cue the bestseller “Good Moms Have Scary Thoughts,” which is useful when shrugging off unsolicited parenting advice, but not so much when it comes to ignoring command hallucinations to kill or injure your children. Testimony reopened scars of unnecessary episiotomies, which prosecution witness Mack equated to a perineal tear. (He was forced to resign amid a torrent of righteous female indignation, on the same day his brutal cross-examination ended.) The entire spectacle has highlighted America’s overmedication of motherhood, from the “little yellow pill” of the 1960s and 1970s to the same small yellow pill (i.e., Valium) prescribed for Clancy as her mind deteriorated from dark ideation into all-out madness.
At this writing, the jury does not appear close to a verdict in the Clancy case, and may well be deadlocked. However this case ends, it will enter the history books as a landmark criminal trial that became a cultural and legal touchstone for maternal mental health. It calls to mind the 2006 retrial of Andrea Yates, who was found not guilty by reason of insanity after she drowned her five children while suffering from severe postpartum psychosis. (There’s a narrative link here: Dr. Resnick was a critical forensic psychiatrist and defense witness for Yates 20 years before he became Clancy’s final defense witness.)
Ten years later came the 2016 trial of Carol Coronado, who fatally stabbed her three daughters — close in age to Clancy’s kids — and then tried to kill herself. Several psychiatrists diagnosed Coronado with postpartum psychosis and, like Clancy, she had the support of her husband and family. Yet her insanity defense failed and she was sentenced to three consecutive terms of life without parole. (Unlike the Clancy case, Coronado’s was decided in a bench trial, meaning that a judge, not a jury, determined both her guilt and the question of her sanity.)
Flash forward another decade and it remains to be seen whether maternal mental healthcare — including the central question of how American society deals with mothers in extremis — has evolved. The fact that this case was prosecuted at all does not bode well. I have no idea whether the prosecution and defense discussed a plea deal before trial, but a negotiated criminal/psychiatric disposition would surely have been preferable to a five-week trial that further traumatized the clearly unwell defendant as well as her parents, her sister, her former husband and his family, as well as many of the 85 other witnesses — not to mention the viewing public and perhaps even the much-vilified assistant district attorneys who prosecuted the case, Jennifer Sprague and Shanan “Hair Bow” Buckingham.
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The larger tragedy of the Clancy nightmare is that a verdict of not guilty by reason of insanity would offer the best possible option for keeping her in a secure psychiatric facility where she will continue to be confined, but still receive treatment. Only in America can regaining mental “competency” while posing no realistic danger to others — Clancy is permanently paralyzed from the sternum down and requires round-the-clock suicide prevention — and having no less-restrictive placement alternatives than prison create worse outcomes than remaining comatose, catatonic or severely cognitively impaired. That’s something worthy of putting on trial.
Other developed nations do better. Canada, Australia, Japan, Brazil, Sweden, the U.K. and more than a dozen other countries have maternal filicide laws that cover cases like Clancy’s. Most are modeled after Britain’s Infanticide Act, which operates on the assumption that a woman who harms her child within a year of giving birth is suffering from a postpartum mental illness. Such women often receive supervision orders, hospital orders or community sentences rather than prison time; more significantly, they also receive treatment.
On the final day of testimony in Clancy’s case, Judge William Sullivan granted a defense request that allows the jury to consider manslaughter. While “best case scenario” is hardly an apt phrase to describe anything in this case, a manslaughter conviction would at least allow her attorney to push for a heavily-mitigated sentence served at a specialized medical-psychiatric prison facility rather than a mandatory sentence of life without parole. After all, Lindsay Clancy is already a prisoner of her own mind, body and memories, which will last the rest of her days.
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