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Welcome Back to the Dr. Leslie Show. Today we are going to talk about postpartum psychosis, the Clancy case, and not guilty by reason of insanity. I am a clinical and forensic psychologist and I am a mother and I had postpartum depression. That is not what this is. This is one of the most severe cases of postpartum psychosis I've ever seen in my career. And I've also worked plenty not guilty by reason of insanity cases, testing the people on the inside, also testing people in prison, seeing if people in state hospitals needed to stay. So doing risk assessments and sanity evaluations. I have seen it all. And I will be glued to this trial because this is wild. Let's dive in. So Patrick Clancy goes on a 25 minute errand. That's it. 25 minutes. And he returns to see his three babies were no longer alive. His wife had strangled all three of them with exercise bands. She then went to a second story window, slit her neck and her wrists, and tried to jump out and end her life. She was not successful. And now she's paralyzed and in a wheelchair in trial. This happened more than three years ago. She's been in a state hospital. She was incompetent to stand trial for a while. She was. I can't believe we're finally here. But it goes to show that this is very serious with explaining the severity of mental health and medications to a jury. Her name is Lindsay Clancy, and you've probably seen on the Internet people have already taken sides. I have to say, I think I'm on her side. I'm not really waiting to hold judgment because I'm not working this case. And there is so much we've seen where there was such a cry for help and then active psychosis and really, really poor treatment from providers and institutions and all of the support from people she worked with in labor and delivery guys. This case is gnarly. So, yeah, say I'm judging before the finale. Whatever. I have worked with women who have gone through this, who have ended the lives of their babies. I have seen it. I'm open to having my mind changed, but this is fucking scary. I want to walk you through what not guilty by reason of insanity actually means, because I'm seeing things all over the Internet that are not true at all. So let's back up a little bit. Lindsay Clancy was a labor and delivery nurse. She and her husband Patrick lived in Massachusetts. They had three kids under the age of five. Everyone says that Lindsay was warm, competent, a natural, loving mother. She had just had another baby A few months before this happened. So we're in the window of postpartum criteria. I don't think people saw her unraveling right at the beginning, and then they didn't see the severity of how much she had unraveled when the incident happened. She had been diagnosed with postpartum depression, not psychosis. She was being treated with a plethora of psychiatric medication. I'm all for psychiatric medication, but I'm for consistency, stability, and a whole treatment team working together to understand what we're doing. Psychology is looking at behavior. We have nurses and social workers and psychiatrists. The fact that this woman was thrown around and given all of these medications that could have still been in her system when others entered and was in the throes of full psychosis, I don't know what came first, the chicken or the egg. The medications are the psychosis. But her babies are dead. So her defense is arguing that she was over medicated and it significantly destabilized her and did not help her. She was in a total fog depression and then went into full blown psychosis with command hallucinations. Now, that matters because they're not just hallucinations. You're not just hearing things that aren't real. You're hearing someone tell you to do something or the world is gonn if you don't end your children, somebody else is, and then they won't go to heaven. And you genuinely believe this because it is now your reality. Psychosis means you're no longer in our shared reality. You are in your own. And then a command voice is usually very dangerous because it feels obligatory and it feels utterly convincing. But we'll come back to that because it's definitely a key point when it comes to how this is going to be treated in the courtroom. So on January 24, 2018, 23, Patrick leaves the house on an errand that his wife asked him to run. Picking up food that his wife had asked and she had googled and looked up. She, or maybe the hallucination had looked up the time it would take him to do this drive. Now, I'm sure the prosecution is going to play on the fact that she had superficial wounds to herself and that she didn't actually end her life by jumping out the second story. So she didn't really want to end her life. But let's just step back. Why the hell would anyone want any of this in their life at all? So since the incident, well, she confessed she's been in the psychiatric facility, well, since 2023. And if she wins this plea of not guilty by reason of insanity, she'll just go back there, and she'll stay there for probably decades. Okay. The legal Strategy, beginning in December 2024, her defense attorney, Kevin Rattington Reddington, filed the formal notice that they intended to pur a defense of lack of criminal responsibility. Not guilty by reason of insanity. If you're insane, you can't be held criminally responsible. The formal legal term in Massachusetts. It's. It's what we would call insanity defense across any state, really. The trial has been delayed so many times, but it officially just began this week. I'm sure it was delayed because of court stuff and holidays, but also, I would imagine this woman has been given so much psychological testing and assessments, so many people, so many cooks in the kitchen, because both sides are going to want to have every inch of information, every ounce of information that they can, because this is such a high profile and horrifying case. They're even including notes from reporters who had talked to Lindsay's husband. And the lawyers fought all about that. But that tells you how much this case is going to hinge on what was her mindset, what was going on inside this woman's mind at the time of the killings, but especially right before them, hours and days before. Was this premeditated? Does that mean that she's criminally guilty? Because you can also be premeditated and psychotic if the voices are telling you to do so. So this is just so utterly complicated. And we normally have quite a theater when it comes to trials. It's really like a lawyer's day to shine. But this is so nuanced and careful and serious that I feel like this is actually going to be a respectable trial to witness. I'm going to say that this is one of the most significant not guilty by reason of insanity trials of our lifetime. And that's because it so cleanly sits in the very middle of the biggest question. Was this a mom making a choice, or was this a mom who had lost complete ability to control her brain? What does NGRI mean? What does not guilty by reason of insanity mean? It's not a courtroom trick. It's not some rich defendant's way out. And believe me, it's not cushy to be in a state psychiatric facility. My office was literally a converted cell next to everybody else's beds, the patients and the inmates. And it was terrifying every minute of every day of every year that I worked there. Important to note that the legal criteria varies state by state. So we are Going to be talking about Massachusetts. Don't ask me to spell that because I can't. To be found not criminally responsible, the defense has to prove that at the time of the crime the person was from a severe mental disease or defect. These are age old terms. They need to be updated. FYI. Anyways, that caused one of two things. Either they didn't understand the nature and quality of what they were doing or they couldn't understand that what they were doing was. That's it. That's the bar. And it is an extraordinarily high bar to meet. It's not depression. Being overwhelmed, they snapped. It requires a. A complete break from reality. The kind worry person might genuinely believe that by ending the lives of children they are saving the lives. And this is way different than Laurie Daybell and her freaking delusional mind. No, I don't think that woman should be alive at all. Postpartum psychosis, totally different. Lori had an mo. Lori was premeditated. Lori tried to hide it and get away with it. I don't know what is wrong with the state of Utah, but I have no sympathy for Lori. I have sympathy for this. Now here's what happens if a jury actually returns with a verdict that she is not going to be held criminally responsible because of her state of mind. And this is the part that's going to get buried on social media because it's not really click worthy bait, clickbait worthy. I don't know. A not guilty by reason of insanity finding is not an acquittal in any meaningful sense. She's not going to get out of that courtroom and go home. It will result in immediate indefinite commitment to a secure psychiatric facility. And indefinite is the scariest part because every time you get evaluated for your likeliness to recidivate for your mental health condition, possibly declining. My goodness. With the stakes of what she did, the bar of getting out and meeting what a psychologist deems appropriate to meet based on a lot of science and testing to me is nearly impossible. She'll be in there for decades, if not her entire life, because she won't get out until a court is completely convinced. And yeah, she'll be evaluated a lot over the decades, but those evaluations are spanned out long periods. Like maybe every three years you get one, so you get evaluated every three years. And how do we know that she doesn't pose a danger at all, at all in any way? She just murdered three individuals. She lost control of her mind. How do we promise the world that she's safe and Many people found not guilty by reason of insanity spend more time in a state psychiatric facility than they would have if they were sentenced to prison. And that's because prison sentences have an end date. Psychiatric commitments just don't. So what I assume is that state psychiatric facility that she's in right now is going to become her permanent address, and she is going to live with the weight of what she did for the rest of her life until she finds a way to end her life, which is what I would assume she is going to do. Because when you get your wits back, when you get back to normal after psychosis and you realize what you did, I've been there. I've seen them. They're both broken. They don't want to live anymore. So if you see someone saying, oh, my God, she's just trying to get away with it, that's not what's happening. That's not true. What is she trying to do? Lock her entire life away in a state psychiatric facility? It's just uneducated, an opinion like that. They don't give you a release date when you're ngr. This isn't a loophole. It's actually one of the most restrictive commitments we have in our legal system. Now let's talk about postpartum psychosis, particularly as it differentiates from postpartum depression or anxiety. And I say this as a mother because sloppy language around these diagnoses is so important to women, to mothers, to the reality of crimes. Depression, anxiety, psychosis, you add in postpartum, they're very different things. Postpartum depression is actually very common. It affects a lot of new mothers. I had it, and I had postpartum anxiety as well. You feel sad, you feel anxious, exhausted, you feel inadequate, like they shouldn't have let you take your baby home. It's serious. It's very serious. But not as serious as postpartum psychosis, because when you have postpartum depression, you're still in touch with reality. Postpartum psychosis is. Is so rare, we're thinking one to two out of every 1,000 birthed babies. It typically comes on fast, within two weeks of delivery, sometimes quicker. And it can escalate rapidly. It can include delusions, which are fixed, false beliefs that feel completely real to the person experiencing them. Can include hallucinations. That's when you're seeing something, hearing something, smelling something that is not real. It feels real to you. It can also include disorganized thinking. That's where a person can no longer differentiate what's happening in reality from what's happening in their brain, which is not reality, it's psychosis. And that's the piece that matters the most for this case. In the most severe cases, postpartum depression has been linked to delusions and hallucinations, especially command hallucinations. That's where the voice is telling you to do something. I said that politely. They're commanding you. This is clinically, categorically different from someone who is simply overwhelmed or exhausted because they just had a baby. There's a difference between a mother who is genuinely struggling and a mother who no longer has a functioning brain and doesn't know if she's in reality or not. I want you to think about Andrea Yates. Yeah, that name that will forever be in my mind. She is the Texas mother who drowned her five children. This was in 2001. And she was initially convicted, then had that conviction overturned on appeal and was found not guilty by reason of insanity. They were more able to describe postpartum psychosis in the second trial. And that's why her defense won. And to this day, she remains in a state psychiatric facility. So the Clancy defense is going to weigh heavily into the Yates defense. So if you're curious, I would just refresh yourself on the Yates trial and how all of that went down. But the thing with the Clancy trial that's a bit different is that they are leaning heavily into the psychiatric medications that she was prescribed and that she was taking and then that she was taken off and then put back on and it's a fucking mess. I don't prescribe, but even me just looking at this, I'm like, oh my God, I've never seen a patient go like, with such a messy prescription history like this when they have such acute symptoms and babies at home, like, she should have been locked up and they should have organized her medications. She, she should have been placed on hold. The world, the neighbor, neighborhood, the system, everyone, this was preventable and they didn't stop it. Those babies are not alive anymore because we failed her, not the other way around. So let's say there was an underlying vulnerability. There was an underlying psychotic disorder, something. It was significantly amplified by the poor administration of psychiatric medications. Now that's going to be for some heavy hitting psychiatrists to explain because there are so many involved, so many medications and, you know, half lives and what they were doing to her neurotransmitters and her overall brain while she's thrust into active psychosis and command hallucinations and wanting to end her life and end the Children. That is going to be central to this trial and how they explain it and how those experts testify. Okay, here's the part I really want you to sit with. And it's very, very uncomfortable. Sorry. It's reality. And if you know me, you know I don't bullshit around reality. Yeah, we're just gonna say it how it is. Our entire criminal legal system is based on one foundational idea. We punish intent, not just outcome. Two people can cause the exact same harm and the law treats them differently based on what was going on in their mind at the time of the crime. That's why we distinguish murder from manslaughter. That's why self defense exists. That's why we have an entire category of did they know what they were doing? The insanity defense is the most extreme expression of this principle. It says if a person's brain was so profoundly affected by mental illness that they could not understand what they were doing or could not understand that it was wrong, then the normal legal weight that we assign and the moral weight that we assign doesn't get to attach to them in the same way. And I get it. That's uncomfortable, because where's the justice? What do you do? How do you find closure? Who do you blame when everyone's at fault and everyone's not? It's duality. It's very uncomfortable to sit with that the harm is not less real. The children are not less gone. It's just that criminal responsibility requires a brain that's present, a brain capable of choosing. And the defense is arguing that in these moments, it wasn't there. So that's not the system failing. That's the system doing what it was designed to do. It's drawing a line between punishment and treatment based on what a person was actually capable of at the time and in the future. And I want to be clear, because this cuts both ways, and it really should. If the jury looks at the evidence and they believe that Clancy understood what she was doing, that she planned it, that she knew it was wrong and she did it anyways, then this defense fails and she will be convicted and sentenced like anybody else. Like the defense doesn't get credit just for existing. They have a huge job to do and they have to prove this to the jury. The same rigor of any other criminal case. And juries reject this defense far more than any. If you watch a lot of true crime, you might not really see that. I don't know how much this really is covered, but the reality is bring in 12 jurors, think of 12 people, you know, how are you all going to decide together when it's so complicated? Because we're talking about the inside mind of another human being as though we were there. Nobody was there in her brain with her. So there's a real tension there. You know, we don't punish people because they're sick. We can't let every violent act hide behind some type of mental health claim. That's exactly why the world is watching this case. It sits right in the middle of that line. Okay, so where does that leave us? Because. Well, that was intense. But this is very intense. Lindsay Clancy is on trial for killing her three children. Nobody disputes that she did it. The entire trial is going to come down to one question. Was her brain functioning well enough in that 25 minute window that her husband was gone for the law to hold her criminally responsible? Or had postpartum psychosis worsened by medication taken her full capacity away from her? If the jury says yes, she understood she's convicted like anyone else. Since she's probably facing a life sentence in prison. If the jury says no, she didn't know what was happening at the time of the crime, she does not not walk free. She's probably got another life sentence in the wild throes of a psychiatric facility. I honestly can't tell you what's worse. Neither is a win for this woman. Neither is a win for those children. Neither is a win for her husband. There's no winning here. But now we wait because the only real question that's left is how the jury is going to feel and the decision that they are going to make. That's the case. That's the defense. That's not guilty by reason of insanity, criminal responsibility, the insanity plea, that's psychosis. That's postpartum psychosis, different from depression and anxiety. And that's all of it. So we have started trial this week and we will see how it goes. I will catch you guys next Wednesday for some other Dr. Leslie Random. I don't know what this show is, but relevant ideas, true crime, celebrity cases, and the psychology behind all of this, which we're missing. Right. We're not thinking, we're not using discernment as much. It's difficult to hold duality. We need transparency. We need authenticity. We've got to talk about the world as it actually is. Not for clickbait or propaganda or because somebody's paying us to say things in a certain way. So I guess what I meant is I'll see you next week for the Dr. Leslie show of just my intrusive thoughts and the reality of this world. Okay, bye.