Hi, I’m Dr. Kristy Money. I’m a licensed psychologist in Texas, and I’ve been practicing for 20 years. I’m also a mom of five, and I struggled with postpartum anxiety and depression after my twins and again after my fifth child.
So this Lindsay Clancy case has hit me hard.
And I have a message for the therapists and moms who are struggling under the weight of this case: anyone who may be anxious about what it might mean for our profession, or for women’s rights, if there’s a patriarchal backlash around the idea that women are hysterical, dangerous creatures who can snap at any moment, and therefore need to be protected from ourselves through things like constant surveillance or involuntary commitment.
Take a deep breath.
Take the social media apps off your phone for 24 hours. Take a break from this case.
The verdict is coming soon, but whatever happens, there will still be coverage. There may even be an appeal. This can become a marathon, and it can lead to burnout.
You are not alone. And it is okay to step away from the news.
Get the highlights from a colleague.
And if you feel yourself spiraling, ask yourself: What’s one thing I can do right now to make my life better, or to make me a better therapist?
And then go do that.
Do I follow this advice myself?
Not often. Especially when I get sucked into cases where mothers hurt their children, given my own family of origin issues.
But I’m trying.
The Lindsay Clancy Case, Postpartum Psychosis, and What We’re Afraid to Talk About
What the Lindsay Clancy trial can teach us about postpartum mental health, medication/therapy best practices, intrusive thoughts, and the unintended consequences of fear.
By Dr. Kristy Money, PhD. LP
One of my clients is a nurse practitioner. She asked me what my thoughts are on the Lindsay Clancey case. I hadn’t heard anything because I’ve been trying to stay off social media for my mental health, but I told her I’d look into it. Two weeks later I feel like I’ve been on an insane roller-coaster ride of emotions. But the wildest part was probably noticing a viral video on reddit made by my own reproductive medicine psychiatrist who I had seen in Austin 8 years ago–I didn’t think I’d ever see her again. And in the video she tried explaining how, in her professional opinion, she didn’t see anything amiss in any of the prescription practices of the psychiatrist and NP who Lindsay was seeking help from. She noted there was nothing in the trials they offered her that would have concerned her, as these are low doses and they were responding to what she was asking for. She’s one of only 500 specialists in the country. Just 500! Lindsay’s psychiatrist Dr. Tufts was one of them. But more on that later.
I think this case is a little bit of a Rorschach test. Would you agree, at this point?
There has been weeks of testimony, expert witnesses, medical records, prescription records, messages, competing interpretations of Lindsay Clancy’s behavior, and now a jury is deliberating over what happened and what, if anything, her mental state means for her criminal responsibility.
But watching the public conversation around this case, I’ve become increasingly aware of how much we bring ourselves into it.
We bring our own experiences with motherhood. Our own experiences with psychiatric medication. Our own fears about postpartum depression. Our own experiences with intrusive thoughts. Our own opinions about the medical system. Our own feelings about what a “good mother” looks like.
And, perhaps most importantly, we bring our own fears.
That is one reason I think this case deserves a more careful conversation than the one social media is currently giving us.
The Lindsay Clancy case is about more than one woman
There is a temptation, particularly in a case this horrifying, to make everything about the individual person.
Was Lindsay Clancy psychotic?
Was her psychiatrist too new in the field to do right by her?
Did her providers miss something?
Should someone have hospitalized her involuntarily?
Could someone have prevented what happened?
Were her doctors and nurse practitioner negligent?
Was she responsible for her actions?
These are enormously important questions. Some of them are questions the jury must answer based on the evidence presented at trial. And some of them are questions that clinicians, researchers, lawyers, and families will probably be debating for years.
But there are other questions that matter too:
What happens when a woman is terrified to take psychiatric medication because she has read that medication can somehow make her lose control?
What happens when psychiatrists become afraid to treat women with severe postpartum mental illness because they fear being blamed for something their patient might eventually do?
Those questions don’t have easy answers. You might be asking them for your own professional development or trajectory and feeling a bit anxious about the future. You’re not alone there.
As Mormon mental health professionals, we see a lot of postpartum women
There is another reason this case has particularly caught my attention as someone who works with a Mormon population.
Many therapists who work primarily with Mormon and Mormon-adjacent clients are going to encounter a lot of women who have been pregnant. Often, many times.
Large families are a staple in Mormon communities. Neither are complicated relationships with motherhood, expectations around motherhood, perfectionism, religious beliefs about women’s roles, and the enormous pressure that can accompany being perceived as a “good Mormon mother.”
Thus, Mormon mental health professionals encounter postpartum depression, postpartum anxiety, intrusive thoughts, birth trauma, obsessive-compulsive symptoms, and other perinatal mental health concerns with more frequency than other providers.
And we need to know what we’re talking about.
Intrusive thoughts are not the same thing as psychosis
One of the things I worry about most in the public discussion of the Clancy case is that mothers who already experience intrusive thoughts may hear the conversation and become terrified of their own minds.
Intrusive thoughts are common.
They are often disturbing precisely because they involve something a person doesn’t want to happen.
A mother might have a sudden image of dropping her baby down the stairs.
She might imagine accidentally stabbing her child while holding a kitchen knife.
She might have a terrifying thought about driving off a bridge.
The thought can be horrifying.
But a thought is not an intention.
And an intrusive thought is not, by itself, evidence that someone is psychotic or dangerous.
This is what we need to be communicating as best we can to the world right now, in my opinion.
This is one of the cruelest things about anxiety and obsessive-compulsive symptoms: the brain can produce the exact thought that a person is most horrified by, and then anxiety tells them, What if the fact that I thought it means something about me?
It doesn’t.
Psychosis is a different phenomenon. In psychosis, a person’s relationship with reality can become profoundly altered. Hallucinations, delusions, and other symptoms can affect how someone interprets what is happening around them.
The experts who testified in the Clancy trial have disagreed sharply about whether she was experiencing psychosis and about what her mental state meant for her criminal responsibility. That disagreement itself highlights to us something important: these are complicated clinical questions, not simple checklists that can be diagnosed from a TikTok video or a Reddit post.
Are providers responsible for what their patients do?
This is a question many are treading lightly on right now.
If a psychiatric nurse practitioner prescribes a medication and the patient later commits an unimaginable act, how much responsibility belongs to the psychiatrist? If they change a medication at the patient’s request, and the patient later becomes severely mentally ill, is the provider responsible?
If a therapist hears about intrusive thoughts but asks the right questions and determines the patient is not imminently dangerous, but they weren’t telling the truth, and something terrible later happens, was that therapist negligent?
These are not hypothetical questions anymore.
The providers who treated Lindsay Clancy have faced intense scrutiny, and Clancy and her husband have also pursued civil claims against providers. The criminal trial has therefore become intertwined with a much broader conversation about medical responsibility and liability.
If we start treating every catastrophic outcome as proof that a clinician should have known what was coming, we create an impossible standard for mental health providers.
Therapists don’t have a crystal ball. There’s not a blood test to tell if someone is suicidal or homicidal to confirm it, when they insist they are not.
We assess risk based on the information available to us at the time. We make clinical judgments. We ask questions. We monitor symptoms. We consult. We refer. We hospitalize when appropriate.
And sometimes, despite everyone’s best efforts, terrible things happen.
That doesn’t mean we stop trying to improve the system. It means we have to be very careful about how we define responsibility.
I wish we had a blood test for postpartum psychosis
Wouldn’t it be wonderful if we did?
Imagine if a woman could walk into her OB-GYN’s office six weeks after giving birth and there were a blood test that could tell us:
You’re at high risk for postpartum psychosis.
Or:
You’re entering a psychotic episode.
We could identify people earlier. We could intervene earlier. We could potentially prevent tragedies.
But that is not the world we live in.
Right now, clinicians have to work with symptoms, history, observation, collateral information, screening tools, clinical judgment, and an imperfect healthcare system.
There will always be uncertainty.
The unintended consequence I am worried about
There is something else happening around this case that I find genuinely concerning.
I worry that providers will become afraid to treat postpartum women.
That might sound like an abstract concern, but it isn’t.
There are only about 500 psychiatrists in the United States trained in reproductive mental health, despite hundreds of thousands of women experiencing maternal mental health complications each year. General psychiatrists, OB-GYNs, primary care providers, and therapists therefore often become the people providing care when a reproductive psychiatrist isn’t available.
And now imagine being one of those providers. Maybe you don’t have to imagine it, dear reader, because you are one of them!
You have a postpartum patient who is depressed.
She tells you she isn’t sleeping.
She is anxious.
She is having intrusive thoughts.
She wants medication.
You know that untreated psychiatric illness carries risks too.
But you’ve watched the Lindsay Clancy trial.
You’ve seen the headlines.
You’ve seen people online saying that her providers should have known.
And you think:
What if something happens to my patient?
What if I miss something?
What if I’m sued?
The answer cannot be that we stop treating postpartum women.
That would be a devastating outcome of an already broken system.
I was one of the lucky ones
This is personal for me.
After my fifth—and last—child, I was referred to a reproductive psychiatrist in Austin by a doula.
This was a particularly complicated time in my life.
This child was happily unexpected after three rounds of IVF and the emotional rollercoaster that came with that. We were also moving from Georgia to Texas while I was pregnant.
I felt a lot of anxiety.
A lot of loss of control.
And I knew I needed help.
I was incredibly lucky to find someone who specialized in postpartum illnesses.
I was also lucky to be in a position where we had good insurance that covered both medication and regular psychotherapy.
She helped me tremendously. I owe her a lot.
And eight years later, completely by coincidence, I saw her again—this time in a viral Reddit video discussing the Lindsay Clancy case.
It was a surreal experience.
But it also reminded me of something I don’t want to lose sight of in all of this:
Good psychiatric care can change someone’s life.
Medication can change someone’s life.
Therapy can change someone’s life.
Being taken seriously can change someone’s life.
Having a clinician who understands reproductive mental health can change someone’s life.
We cannot lose the plot
The Lindsay Clancy case is horrifying.
The questions surrounding it are complicated.
The mental health system is imperfect.
Postpartum psychosis is real and can be devastating.
Providers should be held to appropriate standards of care.
And women deserve better access to specialized reproductive and postpartum mental health treatment.
All of those things can be true at the same time.
What I don’t want is for the focus on one particular woman and one particular tragedy to cause us to lose the plot when it comes to women’s choices.
I worry about the mother who needs medication but is afraid that taking it will somehow turn her into a different person.
I worry about the mother who is already struggling but doesn’t have health insurance.
And I worry about the provider who decides the safest thing they can do is not treat her.
That is not what we want.
We want clinicians to be able to listen without immediately assuming that every frightening thought represents an intention.
We want providers to understand postpartum psychosis.
We want women to have access to medication when medication is appropriate.
We want therapy when therapy is appropriate.
We want hospitalization when hospitalization is necessary.
And we want better research so that someday, perhaps, we really can identify who is at risk before a crisis occurs.
One mother at a time
I imagine many of you reading this are having these conversations right now: with pregnant women, postpartum women, new parents, couples, ward members, friends, family members, and clients.
Keep having them.
Keep correcting misinformation.
Keep talking about intrusive thoughts.
Keep talking about postpartum depression, postpartum anxiety, postpartum OCD, and postpartum psychosis.
Keep reminding women that asking for help is not a failure. That medication plus psychotherapy are proven time and time again in the research to be the best course of treatment, rather than one or the other.
And keep fighting for a mental healthcare system that makes it easier for mothers to get that help.
That can be difficult in a social media culture driven by algorithms that make money by keeping us angry, frightened, and emotionally activated.
Please don’t worry about winning the entire internet on this.
Please focus on one conversation at a time.
One woman.
One family.
One colleague feeling overwhelmed by what this trial’s verdict could mean for women’s mental health.
One mother who feels safe enough with you to say, “Something is wrong, and I need help.”
One by one.
“He/she that saves one life, saves the world entire.”