The After Show: The Lindsay Clancy Trial

Of course, the car is back. We're on the way to the park.

For a young man. What? It's the plan. It's all about his father, a young man with a connection with a doctor. He's a radio in the U-Labor. Who's the one?

Who's the one? What's the matter? We're not going to find a way to get a new man. And he lives the summer of his life. It's a small trip, though.

You're a great guy. The story is a bit different. The many good communities of the year. At the end of September, no one is in China. And it's sparking lots of social media debate.

And you know this case. It is the one of Lindsay Clancy. You have no doubt heard about this excruciatingly tragic case. Thirty-six-year-old Clancy is accused of the unthinkable. Killing for three young children.

Five-year-old Corea, three-year-old Dawson, and her eight-month-old infant son, Calon. She also tried to take her own life on that day. And in this past August, she pleaded not guilty. We've watched emotional moments in the courtroom, including Clancy sobbing as medical examiners and doctors testified about her children's death.

We've also seen hundreds of women rallying outside the courtroom, standing in solidarity with this mom, arguing that it is a failure of the medical system that she was struggling with her mental health. This trial has captured the public's attention, as I said, raising questions about the prosecution of mothers with mental illness and putting a spotlight on a lesser-known mental

health condition known as postpartum psychosis. Now, Lindsay's defense does not refute that she killed her children.

“That's so important here, but they do argue that she should not be held criminally responsible.”

The prosecution, in this case, is arguing that she was fully aware of her actions, methodically planning, and carrying out these murders, so the big question is, how to process these conflicting assessments of this case. Joining us now to help answer big questions about this case, and also to understand more about mental illness, particularly amongst new mothers, is a friend of our show, emergency rooms

psychiatrist, Dr. Ajoa Smallz-Monti, Dr. Monti, good to have you, as always.

Thank you. You often bring such clarity to us when we talk about these cases, and whether you've actually worked on them or not, when it comes to stories, and in this case, we should make it very clear. You had no dealings with this case, you had no connection to Lindsay Clancy, you have not treated her observed her, but clearly you know a lot about moms dealing with mental health crisis after they've had children. So let's talk about what is like for you to

“even just watch this case. I mean, is it sort of unfolded over the last couple of years?”

It is gut-wrenching what happened. Not only are three children gone, a father has lost his children, a mother has lost her children, and a woman is also harmed in paralyzed. That is so hard for me to see, especially when there are so many discussions on mental health in this case, but it truly is a tragedy, and I think we just all want to understand what is happening and what we all do better to prevent things like this from happening again. And we want to talk to you

about that. I remember, I mean, so many of us who are old enough, remember the case of Andrea Yates in 2001, that's immediately what came to mind when I heard about this case, tragically a woman who drowned her five children in the bathtub and said that she was suffering from a mental health crisis and voices were in her head. Her conviction, she was actually convicted of capital murder in the very beginning, and then her conviction was overturned,

she was found not guilty by reason of insanity, and she remains in a mental health facility.

“Let's talk a big, that's what could possibly happen in this case. Lindsay could actually”

wind up going to prison for the rest of her life, or she could also be committed to a mental health facility. When we talk about postpartum psychosis, we know about postpartum depression, we know about anxiety, we know about all kinds of issues that new moms deal with. What is postpartum psychosis all about? So we're looking at two things. We're looking at psychosis in the postpartum time.

So let's first talk about psychosis. With psychosis, you have a loss of touch with reality.

having things that are not true, but you believe it's true, even when that anyone who tells you

“that this is happening, that you're thinking is happening cannot happen. But what psychosis,”

you can also have hallucinations, whether you're hearing things, or seeing things that aren't there. In her case, she said she was hearing voices, very, very common in psychosis, and people can also have disorganized thought, like they're not clear, and that disorganized thought can also make their behaviors just not seem put together. They can do odd things. So when you have all three of those, or even two of them, that is what we're calling psychosis. And then to have

postpartum psychosis, we're usually talking about 12 weeks after a pregnancy. And when I say

pregnancy, that can include whether you had a live birth, or even if you had a still birth,

or a miscarriage, you can have postpartum psychosis happen in those instances as well. Postpartum psychosis is relatively rare. It's about one to two women experience it out of

“1,000 live birth. So it is rare. It is pretty rare, so we don't see it often. I've seen it a”

few times in my practice in my career, but it is still something now now we have more heightened awareness of because of this. Is this typically, does this typically happen amongst women who have already had some kind of mental health struggles? Or does this, is it just triggered by a childbirth? So for many women, they do have a history of having a bipolar disorder or a psychotic disorder before,

but for 50% of people that have postpartum psychosis, that can be their first manifestation of

a bipolar disorder that they might have for the rest of their life or any psychotic disorder, or even a depression with psychosis. So while definitely having a mental health disorder can raise your susceptibility to this happening because pregnancy is a very stressful time for your body. You're having a lot of hormonal spikes, changes happen. Yes, definitely this can be the first occurrence for somebody at end their mental health. When talking about someone like Lindsay Clancy,

three children, and by all accounts people said that she's a nurse, she seemed to love her children, help us understand how someone could love their children, but yet do something that is just so unthinkable. So unthinkable and when I see patients that mentioned that they want to hurt themselves or that they're even having the urge to hurt somebody else, what I often hear is that they have to do that in order to protect themselves or to protect whoever that they think that they

have to hurt. People might say they're imposters, they're aliens, they're spies that are

“after them, and that's the only way that they can protect themselves. And so while it is”

unimaginable that someone could hurt someone that they love, sometimes it's because they don't recognize a person as being someone that they really know and love, or they think they are killing somebody out of benevolence. They're not even thinking in that rational way you would think. Well one of the most devastating moments in this trial was one that I think a lot of people glued in on was when the hospital chaplain testified that Lindsay Clancy said she allegedly

hurt a voice that told her to kill her children, and then she said now they were safe. She felt she was making her children safe by taking their lives. Well as a psychiatrist, how do you react to that? Is that something you've heard before? It is and that's the very scary thing for anyone to hear, but unfortunately in my line of work in the emergency room I have encountered people that have heard other people but they thought they were doing it to protect that other

person or to protect themselves because the other person was at the red. And so that is a psychosis you're not in touch with reality. You don't really recognize what's going on. Your mind is playing tricks on you. The one thing that so many people feel that this is this case is highlighting is not only the mental health crisis but the medicines that people are taking the medications. Clancy by all accounts had been having problems for a while, her husband had even talked about that

and testified. She has sought help from a number of therapists and many of them had been telehealth visits that she had had. She had been taking a number of medications even sought help at a psychiatric hospital. What we like to hear with regards to anyone that's experiencing a mental health disorder is that they are willing to go and get help. And so that's the good thing but there are so many other things that we're learning about going to see a number of different

cuts in the kitchen sometimes things can get a little bit jumbled one person doesn't know what

“another doctor has prescribed. You might be prescribed one medication from a doctor and then”

get another medication that can actually exacerbate a condition that you have and are you disclosing everything that you're experiencing to your doctor. The one thing about psychiatry that makes it a little bit more difficult than other fields of medicine and making a diagnosis is a lot of it is relying on the report of the patient or somebody close to them. There's not too many blood tests or that are going to give us obvious answers. And so we really rely on that disclosure on everything

that's happening but seeing you over a course of time so that we can really see our behaviors and

understand what's happening and if someone is going and seeing a lot of doctors it makes it harder

for one person to get the whole picture. So whenever people are seeking psychiatric care we really implore them to stick with one provider unless you have a very clear plan of transitioning to somebody else or at least two providers are talking about what is happening so things don't get confused. Many see this as a symptom of a broken system. I mean people are pointing to the fact that she was crying for help and it's seen multiple experts and sought help many times. Do you see it

as a system that is broken? Well, I do want to acknowledge that there are many parts of the healthcare system that is broken. I don't want to say whether this in this case the system was broken because we do understand that there were many opportunities to get help but the confusing the hard part is if that care is fragmented and whether it's fragmented from the patient going around to a lot of people or even as doctors sometimes we're saying see that specialist that specialist

but you need one person looking at the picture completely. Another complicating factor here is that if you're taking a lot of medications are you taking them for the full course that you're supposed to take. If you're not taking it all the time consistently then you're not possibly getting the benefit and one thing that a lot of patients actually do is they might supplement the medications that we're getting them with over-the-counter supplements even with recreational drugs and all those things

can come into play and interact with how with someone's mental health and so I don't want to say that the in this case the system was broken but I do think it points out that fragmented care

“is not optimal which is why I think it has captivated so many people there's a lot of”

talk about this case out there online particularly on social media which is one of the reasons

this case I think is just captivated so many people and there's a lot more first to talk about so

don't go anywhere we're going to take a quick break when we come back we're going to talk to Dr. Small's Monty weigh-in on what is being said out there so don't go anywhere. Mysteries unravel and stunning truths are revealed when 2020 investigate follow the clues the evidence the breaking new details ABC's 2020 news true murder mystery shocking if you follow true crime in 2020 then you've got to listen to this subscribe now to 2020

true crime plus add free exclusive true crime content search 2020 true crime plus on Apple podcasts and start your free trial terms apply Hi I'm John Favre we are launching the all new Star Wars the Mandalorian Growgo official podcast I'm sorry I can't focus at the moment we're going behind the scenes but the casting crew sharing

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little snack watch and listen to Star Wars the Mandalorian and Growgo official podcast premiering September 2nd on Disney Plus or wherever you get your podcasts and catch Star Wars the Mandalorian and Growgo on September 2nd on Disney Plus turns apply Welcome back to 2020 the after show I am sitting with Dr. Small's Monta discussing the case of Lindsey Clancy so Dr. Monti let's talk about postpartum psychosis um books on TikTok are talking

about it and women are relating to Clancy because they feel like they really understand what women suffer with um armchair uh shrinks diagnosing her coming up with their own theories how can all of this conversation and speculation impact not just what people are thinking about this trial but also going forward just the conversation around mental health it certainly is bringing

past 20 years but definitely in the past 10 years people have been talking about mental health

but in the past few years we've heard more women talking about their postpartum struggles and I think

“that's very important it's so hard to um say that another person should have seen the signs you should”

have been able to recognize because psychosis can happen just like that so I really think that we have to be aware you cannot blame other people for what has happened. In some ways this case has been a case of dueling experts we've heard from medical experts throughout this trial talking about um Clancy situation about the medicines that she was taking um according to court records she was prescribed medications for anxiety and some near mood stabilization I mean there were times

we're supposedly she had not slept in 24 hours or 48 hours because of what she was dealing with um prosecutors argue the Clancy jumped between medical providers and medications they argue that she had the means the access the mental health support that most people don't and that she

“chose to deal with her mental health issues in the worst way in other words they say that she's”

culpable her defense lawyers argue that she was prescribed more than a dozen psychiatric medications in four months that medical professionals did not communicate with each other which you say is so very important um and her lawyer also argued that the SSRI is that she was prescribed we're making her symptoms worse now you are in practice and you get a chance to know a lot about these medications talked to us a little bit about how someone should be reassessed if they're taking these

kinds of medications if somebody has mania or a history of bipolar disorder and SSRI could make that worse it can bring on the mania or make your mania worse and mania can have psychosis associated with it now one doctor may not know that you were prescribed an SSRI and it can be argued how do you not know very easily when i'm sitting in the hospital i can see see on my electronic medical records the medications that have been prescribed by doctors in that health care system i can't see

the medications that were prescribed by another medical system by another doctor unless the patient has given us access and many times the patient may not remember all the medications that they are taking they may not remember the doses i spend time trying to follow up on that but sometimes it's hard even today i was trying to reach out to many different people trying to clarify some of these medications couldn't reach anyone so even if you're doing your best it's hard to do for you to keep

track of for you for me as a doctor to do that and um would it be great if everyone had their medications written down and came to you and these disclose everything that they're taking yes but that

doesn't always happen and it is to a certain extent the responsibility of the patient to disclose

what they're taking so that a doctor can know everything but sometimes that just isn't possible for many different reasons yeah it's a lot to take on as a as a doctor when you're talking about a big big um situation this case i've heard so many people online even talking not only just about the importance of this case but comparing it to another big case in the news the case of the actress Hayden penitair who died in in in a very tragic way recently she had spoken out about her

postpartum issues um candidly she talked about postpartum depression uh opioid addiction um talked to us a little bit about the importance of monitoring um the mental health of of moms and particularly the fact that she talked so openly about it and said that people almost didn't want to hear about these kinds of things tell us a little bit about how important it is to try to monitor women who are suffering it is very important and what is happening now is that gynecologist

obstetricians even in your primary care office a lot of times with every visit they are screening for depression um at those visits but maybe not necessarily psychosis and how do you screen for that you might start asking the questions i ask as a psychiatrist are you hearing voices are you seeing things are you having any odd thoughts a lot of times people that have delusions are not going to say yes I'm having an odd thought that will be brought to the attention of a doctor usually

“by somebody else or somebody saying you need to go get help for that because that isn't normal”

and sometimes you're embarrassed they don't want to say that they don't want to sound like

terrible parents mothers yes and that is the key thing that i think with this case and as

they're normalizing that this is an experience that many people have and also that you can see

treatment for it that you can get help just last year Jennifer Lawrence disclosed that she had taken a medication to help with her postpartum anxiety and i'm so happy that we have new advancements and medications to treat this particular condition definitely this case and all of the women that are talking about their experience has brought it just more to the forefront of all physicians you know to think about it to screen for it more to keep it on your differential of

things that could be happening to a mom so while it is very tragic the situations that we're

“dealing with now the increase awareness i think will definitely be the benefit to society if”

nothing else we will be talking about a subject that is no longer taboo you often offer advice and we want to get some advice from you so don't go anywhere because we want to come back and hopefully you can offer some help to women out there who may be suffering or someone in your life who may be suffering so stay with this will be right back there's a headline every 30 minutes for our show i'm pretty sure welcome to get real i'm your host Amanda Hirsch this is the show for the

reality to be obsessed you thought the show was crazy living it was crazy but i was dripping sweat for i even stopped for the stars and stands of the hula reality birth do we think she's stirring the pot to secure a place on the show find and listen to get real wherever you get your podcast and stream new episodes Thursdays on hulu and hulu and hulu and Disney Plads term the pie welcome back to 2020 the after show i'm sitting here with Dr. Ajua small mantei discussing

the devastating case of Lindsey Clancy that mom in Massachusetts who admitted to killing her three young children but also saying that she was suffering from a mental health crisis let's talk about warning signs there's a big difference between having the blues and having postpartum depression and having a real psychosis which can be dangerous so help us know what the warning signs are

so first we'll talk about that a lot of times we have fleeting bad thoughts in our head and I

think that is the scariest thing for people to admit but the if the thought is fleeting you're recognized was it's happening you can still bring that up to somebody and say but i'm a little control my actions but it's very very very dark they're troubling to you and if you even

“hear somebody else mentioning something that is very alarming to you that is when you should seek help”

that is when you should seek emergency help emergency room emergency room it's not just a call to the OBGYN if the person is and be good control they're able to do what they have to do whether it's taking care of themselves and taking care of their baby they're not having thoughts of I want to hurt this baby I feel like I'm not in control of my actions as a huge thing if they feel like I can't control myself that it raises alarm bells and that is when they should go to the emergency

room if someone has a fleeting thought I hate to say it but many times I do see people it's a fleeting

thought they're like I would never do anything to hurt somebody I'm just like so mad I'm so stress

I'm overwhelmed and I want moms to know that it's common um it really is when my dad and were born sure it definitely but you recognize like I would never do that I have so much love

“I'm in control I just needed to take a break a minute I'm all right I'm fine but when you are”

feeling compelled a lot of times people that do things well almost describe retroactively they feel like a puppet almost like their actions are being controlled like they can't even know whatever they're thinking they don't want to do they cannot control it but also if a voice is compelling you to do things if you're not sleeping if you're feeling like you're dissociating like you're out of your body you're kind of on the outside looking at and those are all really

serious warning signs and that is when I would seek the emergency room as opposed to I'm having some thoughts I'm not sleeping well a little bit I'm still able to do things it's a little bit slower than I would like to then maybe you can still talk to your obstetrician your pediatrician for the child but really the obstetrician for the mother and then you can also try to find a psychiatrist but let's be honest so wait to get a psychiatrist is pretty long nowadays

and so sometimes going to the emergency room can get you a little faster access you mentioned earlier that one if there's any little glimmer of hope that comes out of this horrible case is that we're talking now about mental health and mental health among amongst moms and and hopefully helping

that is not talked about all the time is your hope that in the middle of this tragic horrible case

“that that might be the lasting impact that we continue to support and talk about”

moms who are dealing with mental health issues it certainly is and as you said this is a complete tragedy but I do hope that people feel more comfortable with talking about their

symptoms if they're experiencing any type of psychotic symptoms if you were even experiencing

depression or anxiety associated with the postpartum period or even if you're not postpartum

“if you're just a person going through life and you're experiencing this feeling more empowered”

to go and seek help because there is help available and it can be wonderful it can work well

for many many people let's hope so let's hope that people will definitely think about

seeking help before the worst happens and we should also add that if you or someone you know is struggling with thoughts of suicide free confidential help is available 24 hours a day 7 days

“a week you can call or text the National Lifeline at 988 Dr. Smalls Monte you are always”

such a help thanks so much for being here with us and we thank you our listeners for choosing to spend some time with us today and of course you can find 2020 on Friday night on ABC and you can stream episodes anytime on Disney plus and Hulu thanks so much for being with us and we wish you all the good day in 2023 a source sent me a tip it tied baseball's biggest star to a vast illegal sports betting

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