Lindsay Clancy trial underscores shortcomings in postpartum psychosis care

The criminal case against Lindsay Clancy, a Boston-area mother accused of killing her three young children in 2023, has drawn renewed attention to postpartum psychosis, a rare mental-health disorder that can emerge in the weeks after childbirth. While prosecutors argue that Clancy planned the killings, her defense maintains that she suffered from severe postpartum psychosis and did not receive adequate medical care.

Advocates say the trial highlights systemic gaps in recognizing and treating the condition. Meghan Cliffel, a postpartum-psychosis survivor and mental-health advocate, described her own sudden onset of paranoia and delusions in 2015, noting that a formal diagnosis came only after months of hospitalization. "That moment of somebody naming it was so helpful to me," she said.

Postpartum psychosis is estimated to affect 1-2 per 1,000 births, far less common than postpartum depression but more frequent than some other infant health issues. Experts point to a lack of training among physicians and the fact that the disorder is not listed as a distinct diagnosis in the DSM-5, which can lead to missed or delayed identification. Dr. Veerle Bergink, director of the Women’s Mental Health Center at Icahn School of Medicine, said, "We know that we don't train our doctors in it, that it's massively missed."

In Clancy’s case, attorneys say she experienced insomnia, anxiety and depression after delivery and sought psychiatric care, including a brief inpatient stay at McLean Hospital. She was prescribed several medications, and a psychiatrist suggested she might have an underlying bipolar disorder, but did not diagnose postpartum psychosis. Bergink, who has treated many women with the condition, described Clancy’s presentation as a "classical, typical story of a woman with postpartum psychosis not being diagnosed, not being treated."

Medical professionals emphasize that, when correctly identified, postpartum psychosis is treatable with mood stabilizers such as lithium, antipsychotics, or electroconvulsive therapy. Dr. Uruj Kamal Haider, medical director of the Massachusetts Psychiatry Access Program for Moms, called for broader education of obstetricians, pediatricians, doulas and midwives, noting that many new mothers are seen by these providers before the standard six-week postpartum check-up.

The case also revives discussion of past high-profile trials, such as that of Andrea Yates, and underscores the need for research infrastructure that can study mothers and infants together. Advocates argue that improved parental leave policies, accessible child-care and family-centered support systems could reduce stressors that contribute to severe perinatal mental illness.

While the trial proceeds, mental-health experts hope the public focus will translate into lasting reforms rather than temporary attention tied to a tragic event.