I have been trying to put into words why the Lindsay Clancy trial has affected me so deeply.
Three children died. Cora, Dawson and Callan deserved to grow up. Nothing about discussing Lindsay’s mental health, the treatment she received or the failures of our healthcare system changes that. Understanding how someone became so sick is not the same thing as excusing what happened.
But I also don’t think we can listen to everything that has come out during this trial and walk away talking only about guilt or innocence.
Because this trial has exposed something much bigger.
For more than ten years, I have been a strong advocate for maternal mental health. And for much of that time, it has felt like yelling into the darkness.
We tell mothers to ask for help.
We tell them postpartum depression and anxiety are common and treatable. We tell them not to be ashamed. We tell them to speak up when something doesn’t feel right.
But this trial has made me think much more seriously about the question that comes next:
What happens after a mother actually asks for help?
Because Lindsay did.
She sought treatment. She saw multiple providers. She took medications. She was hospitalized. Her family was involved. She continued going to appointments.
And somehow, while interacting with multiple parts of our mental health system, she continued to deteriorate.
That is what I cannot stop thinking about.
We place an incredible amount of responsibility on a person experiencing mental illness to recognize that they are getting worse, accurately describe what is happening inside their own mind, advocate for themselves, navigate insurance, coordinate providers and recognize when they have crossed some invisible line between needing outpatient treatment and needing emergency intervention.
Think about how backwards that is.
We are asking the person whose mind may no longer be functioning the way it normally does to be the person responsible for recognizing that their mind is no longer functioning the way it normally does.
And then we call that a safety net.
A six-week postpartum appointment cannot carry the responsibility of protecting a mother’s mental health.
A questionnaire is not treatment.
A pamphlet handed to a mother when she leaves the hospital is not a mental health system.
A prescription is not a mental health infrastructure.
And a family desperately trying to keep someone safe cannot substitute for coordinated psychiatric care.
One of the things that has struck me most during this trial is how many different people held pieces of Lindsay’s story.
Different providers. Different appointments. Different medications. Hospitalizations. Family members.
And I keep coming back to one question:
Who was responsible for seeing the whole person?
That is one of the biggest problems with the way we deliver mental health care. We have OBs, primary care providers, therapists, psychiatrists, emergency departments, inpatient units, insurance companies and families all holding different pieces of someone’s story.
Everyone can technically be doing their job while a patient is still falling through the spaces between them.
And I don’t think the answer is to find one doctor and destroy her.
Providers are working inside this system too.
They are dealing with short appointments, limited access to specialists, fragmented records, insurance restrictions, staffing shortages, administrative requirements and very few meaningful ways to coordinate care across different systems.
There may be individual decisions from this case that deserve scrutiny. That is different from deciding that one clinician represents everything wrong with maternal mental health care.
Patients and healthcare workers should not be standing on opposite sides of this conversation.
A broken system can fail both of them.
And that leads me to something even more uncomfortable.
What if much of what happened was considered standard care?
What if the appointments happened?
What if symptoms were discussed?
What if medications were adjusted?
What if hospitalization occurred when the criteria were met?
What if the family tried?
What if the patient sought treatment?
And somehow this was still the safety net?
Because if everyone followed the procedures and this could still happen, then maybe we need to stop defending the standard simply because it is the standard.
Maybe the standard itself isn’t good enough.
We also desperately need more education about postpartum psychosis, not less.
It is frightening to talk about. I understand that.
But making postpartum psychosis synonymous with mothers harming their children would be dangerous in its own way.
Most mothers experiencing postpartum mental illness will never hurt their children. Intrusive thoughts are not the same as intent. Experiencing frightening thoughts does not make someone a dangerous mother.
If women become terrified that admitting what is happening inside their minds will cause people to see them as monsters or take their children away, we risk making mothers less likely to tell us the very things we need them to feel safe telling us.
The answer to fear is not silence.
It is education.
Families should know what postpartum psychosis is before they encounter it in a tragedy. Partners should understand warning signs. Providers across disciplines should understand perinatal mental illness. Mothers should know that they can say the frightening things out loud and be met with knowledgeable care rather than immediate judgment.
And screening has to lead somewhere.
We don’t need to congratulate ourselves because we handed a mother a questionnaire.
We need to ask what happens when she checks the box.
Who calls her?
How quickly can she see someone?
Does that person understand perinatal mental health?
Can she afford the treatment?
Will insurance cover it?
Who follows up?
Who notices if she stops showing up?
Who checks whether a medication change actually helped?
Who talks to the other providers?
Who helps her partner understand what to watch for?
Where does she go if outpatient treatment isn’t enough but she doesn’t meet the threshold for an acute psychiatric admission?
And why are there so few options between those two extremes?
Other places have developed specialized approaches, including psychiatric programs designed specifically around mothers and babies. We should at least be willing to ask why our own system offers so few options specifically designed around the realities of severe perinatal mental illness.
And mental health care doesn’t exist separately from the rest of a mother’s life.
Childcare matters.
Paid family leave matters.
Sleep matters.
Financial security matters.
Having another parent who can be home matters.
Being able to attend an appointment without figuring out who will watch three children matters.
Being able to take time away from work without wondering how your family will pay the bills matters.
We cannot talk seriously about maternal mental health while ignoring the conditions in which we’re asking mothers to recover.
There is an irony in having these conversations right now that isn’t lost on me.
At a time when we are talking about how desperately this country needs stronger mental health systems, I am also seeing firsthand how easily mental health resources can be reduced within healthcare.
We keep saying we need more access. More continuity. More people helping patients navigate an already fragmented system.
And then decisions continue to be made that move us in the opposite direction.
That contradiction has been particularly difficult for me to sit with while watching this trial.
Maybe that’s also why I understand why so many mothers cannot look away.
The experience of telling someone they’re struggling and wondering whether they’re actually being heard.
They recognize how intensely a woman is medically monitored throughout pregnancy and how quickly, after the baby arrives, the focus shifts almost entirely away from her.
They recognize filling out the questionnaire.
They recognize being told to call if things get worse.
They recognize trying to figure out exactly how bad “worse” is supposed to be.
That doesn’t mean those mothers identify with what Lindsay ultimately did.
It means they recognize pieces of the road.
We’re watching the worst imaginable outcome while recognizing parts of a system many of us have encountered ourselves.
I don’t want another mother’s psychiatric history dissected in a courtroom before we decide maternal mental health deserves our attention.
I don’t want “get help” to be the end of our mental health messaging.
Getting help has to actually lead to help.
Real help.
Accessible help.
Specialized help.
Coordinated help.
Help that follows up.
Help that involves families appropriately.
Help that recognizes deterioration before someone reaches the point of no return.
Help that doesn’t require the sickest person in the room to coordinate the entire thing.
Three children are dead.
Acknowledging failures or limitations within our mental health system does not erase their lives. It doesn’t excuse what happened. And it doesn’t automatically answer questions about legal responsibility.
It means we care enough about the next mother, the next child and the next family to ask what could be different.
When this courtroom eventually empties, I hope the conversation about maternal mental health doesn’t empty with it.
Sometimes advocating for maternal mental health still feels like yelling into the darkness.
That doesn’t mean I stop yelling.
Maternal Mental Health Resources
If you or someone you love is struggling during pregnancy or postpartum, support is available. You do not have to wait until things feel unbearable to reach out.
- National Maternal Mental Health Hotline: Call or text 1-833-TLC-MAMA (1-833-852-6262). Free, confidential support is available 24/7 for pregnant and postpartum people and their families. Trained counselors can provide support and connect callers with local or telehealth resources. This is a maternal mental-health support line, not an emergency crisis line.
- 988 Suicide & Crisis Lifeline: Call or text 988 for immediate emotional or mental-health crisis support, 24 hours a day. You do not have to be suicidal to contact 988.
- Postpartum Support International (PSI) HelpLine: Call 1-800-944-4773 (#1 Spanish, #2 English), text HELP to 800-944-4773 in English, or text 971-203-7773 in Spanish. PSI provides information, support and connections to perinatal mental-health resources. The PSI HelpLine is not a crisis or emergency service.
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