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What was going through the mind of Lindsay Clancy when she sent her husband out for children’s medicine and to pick up takeout food then killed their three young children using exercise resistance bands?
Clancy – a 35-year-old former labor and delivery nurse at the Massachusetts general hospital (MGH) – then stabbed herself in the neck, slashed her wrists and jumped out a 20ft high window, paralyzing herself from the waist down.
Clancy’s mental wellbeing will be the central question when a jury sits next week in the Plymouth county superior court in Plymouth, Massachusetts, as she is prosecuted for the killings of Cora, five; Dawson, three; and Callan, eight months.
Clancy has pleaded not guilty but that she committed the crimes is not in question. Prosecutors say the murders were premeditated, and evidence of Clancy’s actions, including Googling how far the restaurant and pharmacy was from the home, on the night of 24 January 2023 will prove it.
Clancy’s defense team, supported by her ex-husband and father of the children, Patrick Clancy, will argue that she was suffering a mental health crisis, exacerbated by overmedication for severe postpartum mental illness, and should not be found criminally responsible for her actions. Clancy has said she heard a voice in her head telling her to kill the children and herself.
It is an almost unimaginable crime. Yet the extraordinary circumstances of the case will also put a spotlight on the medical care Clancy had been receiving and the broader issue of how woman are treated after giving birth. Clancy had been released from McLean, a Massachusetts mental health hospital, earlier in the month, and both her husband and her parents had avoided leaving her alone with the children.
Ahead of opening statements on Monday, Clancy has been sitting in a wheelchair stone-faced, attended by two nurses sitting behind the defense table. Efforts by defense attorney Kevin Reddington to limit the graphic evidence or the number of first responders who will testify led to an emotional pretrial hearing on Thursday.
“Even though we are in court, let’s talk a little about humanity, let’s talk about how we should try this case,” Reddington said.
The court heard that intense media attention had led to the family of Patrick Clancy’s new wife being hounded. He is “trying to move on with his life” and accused prosecutors of wanting to “put that guy on the stand and show little onesies”, referring to the pyjamas the children were wearing when they were killed.
Soon after the murders at the couple’s house in Duxbury, about 30 miles (48km) south of Boston, Patrick Clancy released a statement saying: “Our marriage was wonderful and diametrically grew stronger as her condition rapidly worsened. I took as much pride in being her husband as I did in being a father and felt persistently lucky to have her in my life.”
Prosecutors have said that Lindsay Clancy spoke by phone with her husband from a hospital room in the presence of a psychiatric professional, telling him that “she killed the kids because she heard a voice and had ‘a moment of psychosis’ and that she heard a man’s voice telling her to kill the kids and kill herself because it was her last chance”.
The trial gets under way as states across the US look to limit what is widely known as the insanity defense after a 2020 supreme court decision that the constitution does not mandate states to offer it. Four states – Montana, Utah, Kansas and Idaho – have since abolished it. Ten others offer alternative verdicts, including guilty but mentally ill, or GBMI.
Massachusetts uses a different standard referred to as “lack of criminal responsibility”. If the defense succeeds, a verdict of not guilty by reason of insanity is found and Clancy will sent to a state psychiatric hospital. If it fails, Clancy faces a life sentence.
The trial will spotlight the rare condition of postpartum psychosis, found at the extreme end of the more common postpartum depression.
Previous prosecutions of a mother claiming a postpartum depression defense (PPDD) after the murder of her children have had mixed resolutions.
In 2001, Houston mother Andrea Yates drowned her five children in a bathtub. In her psychotic mind, ending the lives of her children was necessary to protect them from eternal damnation, and her own execution by the state would rid the world of Satan’s evil.
In her first trial, she was convicted of murder and sentenced to life in prison after prosecutors argued that she understood she was not insane because she knew what she was doing was legally wrong. But in a second trial, Yates was acquitted by reason of insanity.
In 2014, California mom Carol Coronado stabbed her three daughters, aged two and a half years, 16 months and two months, to death. Police found her lying naked in bed next to the children, attempting to pry the stab wounds open with her fingers. Coronado had no recollection of the events.
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A forensic psychiatrist for the prosecution found her to be insane, but a second said that she had been sane and only mildly depressed. Coronado was sentenced to three consecutive life sentences, without the possibility of parole.
A 2021 study of infanticide published in Psychiatry Online found that “myriad factors influence the outcome of these trials” and that “determining criminal responsibility and the guilt or innocence of a woman includes a wide range of inconsistencies”.
The study found that women in the reproductive and postpartum period are in the most vulnerable stage of life for developing a mental illness and requiring psychiatric hospitalization.
The Clancy trial gets under way nine months after the Massachusetts state legislature began considering a bill to prioritize treatment over punishment for new mothers with postpartum psychiatric illness.
“Patients suffering postpartum psychosis often suffer a delay in diagnosis, incomplete treatment, and are at risk from outcomes that are almost unthinkable, namely maternal suicide and infanticide,” Dr Lee Cohen, director of the MGH Center for Women’s Mental Health in Boston, told lawmakers.
“Postpartum psychosis is brain circuitry disconnected resulting in psychotic symptoms including paranoia, delusional thinking and hallucinations,” he added. “New moms lose touch with reality, placing themselves and their children at risk.” He warned that it could appear quickly and without prior psychiatric diagnoses.
Cohen testified that postpartum psychosis was “exquisitely” treatable with medications and therapy.
Whether Clancy was correctly treated before the murders and attempted suicide took place will likely come up during the trial, along with why she had been discharged from psychiatric care shortly before they took place.
That is part of a civil case brought by Patrick Clancy against his former wife’s mental health care providers, including psychiatrist Dr Jennifer Tufts, nurse practitioner Rebecca Jollotta, Aster Mental Health and South Shore Health System.
Reddington claims that regardless of whether Clancy suffered postpartum depression or postpartum psychosis, she was overmedicated with 13 different drugs over four months, in combinations he called a “horrific overmedication of drugs that caused homicidal ideation, suicidal ideation”.
The drugs Clancy was prescribed included three benzodiazepines – Klonopin, Valium, and Ativan – mood stabilizers or antidepressants including Zoloft, Remeron, Prozac, trazodone, Lamictal and Seroquel; as well as the anti-anxiety drug hydroxyzine and the sedative-hypnotic Ambien.
“Our society fails miserably in treating women with postpartum depression or even postpartum psychosis,” Reddington said in court. “It’s medicate, medicate, medicate. Throw the pills at you and then see how it works.”
“She obviously had no reason to kill those three beautiful children, so you have to ask yourself why. Why?” Reddington asked.
