MA - Lindsay Clancy, Strangled 3 Children in Murder/Suicide Attempt, Duxbury, Jan 2023

[fred&edna]

PPD: Postpartum depression
PPS/PPP: Postpartum psychosis. Both abbreviations are used.

The first FDA approved treatment for postpartum depression just came out in 2019. 1990-2000 is “relatively new” i.e. recent, as compared to other known medical conditions. Mental health has not gotten the attention it’s deserved until recent years; “recent” being subjective, but within the last 30’ish years is what I’m referring to. Many people still don’t recognize mental health issues as legit medical issues.

PPD and PPS are not one and the same. Not all PPD is also PPS.

Yes, the first FDA-approved medication "specifically" for PPD was approved in 2019 but other medications (i.e. anti-anxiety) were used to treat symptoms long before then. Hmmm... interesting to know about that PPS abbreviation... I guess it means "postpartum psychiatric syndrome" or something. Thanks for the info.

 

[Tower]

Does Massachusetts have anything like a CA 5150 or FL Baker Act where someone can be involuntarily placed on a psych hold if they are believed to be a danger to others or themselves?

RSBM
Massachusetts receives a “F” for their involuntary commitment laws. This mother would not have been able to receive outpatient emergent treatment.

“Three states still have no law allowing civil commitment to occur on an outpatient basis (AOT) (Connecticut, Maryland and Massachusetts).”

https://www.treatmentadvocacycenter.org/grading-the-states

 

[mendicant]

RSBM
Massachusetts receives a “F” for their involuntary commitment laws. This mother would not have been able to receive outpatient emergent treatment.

“Three states still have no law allowing civil commitment to occur on an outpatient basis (AOT) (Connecticut, Maryland and Massachusetts).”

https://www.treatmentadvocacycenter.org/grading-the-states

Mass, however, does have civil commitment laws on an inpatient basis, which is what was needed here as she was already undergoing outpatient counseling.

 

[Seattle1]

Husband of midwife accused of killing their kids says he forgives her

Patrick Clancy, 34, said he forgives his wife Lindsay, 32, after she allegedly murdered their three young children and then attempted suicide at their Massachusetts home last week.

www.dailymail.co.uk

 

[Howl]

I believe there are some risk factors (personal relationship, support) associated with postpartum depression. I don't know if these would be the same for postpartum psychosis, but I think it's worth consideration for further info.

I keep going back in my mind to the information on the NHS site for post-partum psychosis -- the onset can be SUDDEN.

If a woman has a close support group (husband/family/social group), much greater likelihood that someone will recognize that something is horribly amiss and get help fast.

 

[BrownRice]

Question for @BeginnerSleuther and @LaborDayRN (or others with clinical knowledge) regarding PPP, when a mom has been diagnosed with this, are they showing signs of this all day long or does it come and go? Is mom able to interact with and take care of the kids most of the time and then has sudden onset of the PPP behavior (which I really don’t even know what that means)?

 

[Bostongirl]

Husband of midwife accused of killing their kids says he forgives her

Patrick Clancy, 34, said he forgives his wife Lindsay, 32, after she allegedly murdered their three young children and then attempted suicide at their Massachusetts home last week.

www.dailymail.co.uk

View attachment 398518

View attachment 398519

Post-partum anything is horrible. I don’t understand how the brain gets so confused when looking at these beautiful faces. It just tells me how awful the messages one must get, voices, etc to get to harming them. Love to these sweet souls.

 

[WingsOverTX]

I don't know if perfectionism is involved in this particular mother's troubles but I suspect it could be. Just something to consider when reality & one's expectations clash.

Perfectionism and Postpartum Anxiety: How to Understand the Link

The quest for perfection as a new mom is an impossible task. Most don't realize how it can also lead to depression and anxiety.Many new mothers struggle with postpartum depression (PPD). A number of new mothers also deal with symptoms of postpartum anxiety (PPA) after giving birth...

www.intervalhealth.com

 

[Knox]

I'm not a medical professional, but I've paid attention to those who are & posting here. I think we need to be careful not to compare PPA & PPD to what Lindsay was said to be experiencing. Postpartum Psychosis is said to be a psychiatric emergency.

Hopefully, as this case moves forward. We'll learn more details as to how Lindsay got to the state she was in when she killed her children. Not in a voyeuristic way, but to help us understand how this happened to a woman described as a fantastic Mom, wife & educated L&D nurse.

Patrick Clancy said, "I want to ask all of you that you find it deep within yourselves to forgive Lindsay, as I have,” he said. “The real Lindsay was generously loving and caring towards everyone – me, our kids, family, friends, and her patients. The very fibers of her soul are loving. All I wish for her now is that she can somehow find peace".

Man Says He Forgives Wife Accused of Strangling Their 3 Children

"I want to ask all of you that you find it deep within yourselves to forgive Lindsay, as I have," he said.

lawandcrime.com

 

[annemc2]

Question for @BeginnerSleuther and @LaborDayRN (or others with clinical knowledge) regarding PPP, when a mom has been diagnosed with this, are they showing signs of this all day long or does it come and go? Is mom able to interact with and take care of the kids most of the time and then has sudden onset of the PPP behavior (which I really don’t even know what that means)?

Some patients are able to do some masking of symptoms. If it's true that LC had recently been discharged from a lengthy inpatient stay to a partial (day) program, she might have improved to the point that her symptoms were not as overt. IMO, there's a chance that she was able to minimize her symptoms while around others. This would be more likely to happen with patients who are historically people-pleasers (like a lot of nurses can be) and who are trying extremely hard to "be good" and tell clinicians what they want/need to hear so that they believe things are going well. It's possible that she outwardly appeared to be getting better but was still completely tortured in her own mind.

 

[Knox]

Some patients are able to do some masking of symptoms. If it's true that LC had recently been discharged from a lengthy inpatient stay to a partial (day) program, she might have improved to the point that her symptoms were not as overt. IMO, there's a chance that she was able to minimize her symptoms while around others. This would be more likely to happen with patients who are historically people-pleasers (like a lot of nurses can be) and who are trying extremely hard to "be good" and tell clinicians what they want/need to hear so that they believe things are going well. It's possible that she outwardly appeared to be getting better but was still completely tortured in her own mind.

I wonder if she was able to avoid taking her prescribed medication once she left inpatient care? Meaning she pretended to take it but didn't in the days leading up to the killings?

 

[annemc2]

I wonder if she was able to avoid taking her prescribed medication once she left inpatient care? Meaning she pretended to take it but didn't in the days leading up to the killings?

When I worked IOP/PHP we'd do the meds unless the family was willing/able to help. If there was any question about compliance we'd do it ourselves at the clinic or do long-lasting injectables (court-ordered if necessary).

eta: this was a county facility so we had patients with severe and often chronic mental illness. There were some who were taking leave from work or school after an acute episode, as well as patients who lived in group homes and needed everyday assistance.

 

[Knox]

When I worked IOP/PHP we'd do the meds unless the family was willing/able to help. If there was any question about compliance we'd do it ourselves at the clinic or do long-lasting injectables (court-ordered if necessary).

eta: this was a county facility so we had patients with severe and often chronic mental illness. There were some who were taking leave from work or school after an acute episode, as well as patients who lived in group homes and needed everyday assistance.

Thank you. Long lasting injectables make sense.

 

[pukasonqo2]

I keep going back in my mind to the information on the NHS site for post-partum psychosis -- the onset can be SUDDEN.

If a woman has a close support group (husband/family/social group), much greater likelihood that someone will recognize that something is horribly amiss and get help fast.

I had severe PPD but hid it as I thought it made me a bad mother, was on a new country and scared of asking for help
I am thankful that, somehow, both my son and I survived

 

[Marysmith]

I had severe PPD but hid it as I thought it made me a bad mother, was on a new country and scared of asking for help
I am thankful that, somehow, both my son and I survived

I’m so sorry that you went through that. Thank you for sharing.

 

[LaineyJ]

Tragic for all involved. Have been following this outside of WS.

We went to the same HS and the town is shaken up. I did hear that she’s a perfectionist—that’s the actual word that was used. Everyone I’ve talked to says they can’t believe this happened, just very surprised/shocked.

I have no idea how either L or husband will move forward. I don’t know if that’s possible. those poor kids..

 

[airportwoman]

I've likely missed the info somewhere on the thread... where was the husband/father when this occurred? Was he working and Lindsay called him to come home, or do we know?

He had ordered takeout and left to pick it up. He was gone for less than 1/2 hour.

One thing I haven't seen here, although I haven't read the entire thread, is that there seems to be a lot of commonality between severe PPD, and difficult breastfeeding. What do other people think? It sure makes sense to me.

 

[airportwoman]

Law to the side, I’m an American mother of three, and a reasonably educated non-mental health professional, and I look at this case and I see a tragic outcome of severe postpartum depression into psychosis. And I see a family that had means and access to care, and was getting care, and it wasn’t enough in retrospect, but no one had a crystal ball.
Lindsay Clancy and her husband and family strike me very much as people I would’ve met in my normal course of professional business, and would have respected and felt commonality with as a similarly-aged family with similar lives - and would’ve liked.
I feel no impetus to thrash her or spend the money of the taxpayers of Massachusetts prosecuting her or even convicting her, honestly. When and if she is conscious and effectively treated, she will be her own punisher, far more than any sentence society could render. I believe MOO that she will have permanent physical disabilities, but that isn’t even close to what I’m fundamentally saying, which is: once the meds and counseling work - she will convict herself 100x over. Whatever life she has left will metaphorically be spent in Dante’s Purgatorio, and her husband will convict himself too, forever, in a different way.
Genuinely believe, as an amateur student of this story - and not a professional or an actively involved person - MOO - that this is a woman who loved her kids and her family for a long time and went into mental health crisis.

The circumstances are not similar, but as I think about Patrick Clancy and what’s ahead for him, my mind went to William Petit less than a hundred miles south in Connecticut. And I hope what happens for PC is what WP was able to get to, in finding a new way to be and survive, respecting that nothing will ever be normal for either again. William Petit - Wikipedia

This story is totally different, however, because Dr. Petit's family were murdered by home invaders, and he almost died himself.

He remarried a few years later and has a son with his new wife; he has never been able to resume his medical practice, due to brain damage he suffered in the attack, but has continued to advocate on behalf of crime victims. If nothing else, he would understand the loss of a child in a murder.

 

[BeginnerSleuther]

Agreed. An inpatient program would likely be for patients who are a safety concern for themselves and/or others. She may have been on anti-psychotic meds and those need to be taken properly and sometimes the meds need to be changed as they aren't working the way they should.
I am hoping there is an inquest into this if that is such a thing in that state. What could have been done better and look at all facets of this tragedy so that maybe the next one can be prevented.

Not necessarily. Inpatient programs are made for anyone with illness that's not easily managed outpatient. Sometimes, that's just unipolar depression with no safety concern. Other times, it's psychosis or mania with fear of harm to themselves or others. This isn't a matter of investigating to see what could have been done better. By all accounts I've read, this woman received exemplary care - inpatient admission with partial hospital (intensive outpatient) step-down. This is exactly how the system is supposed to work.

Sometimes, these illnesses are unpredictable. I hope people keep this in mind whenever a doctor is blamed for "missing" something prior to a mass shooting. None of us can predict human behavior. All we can do is stratify the risk. Was she at high risk of harming her kids on hospital discharge? Likely not, or else she wouldn't have been discharged (per standard of care). So either she was getting better or the imminent thread had resolved. Keep in mind you can still be psychotic and be discharged, so long as you're not thought to be at risk of hurting yourself or others. It happens all the time actually, usually it's if a patient requests discharge. The treatment team felt she was suitable for partial hospitalization/intensive outpatient, and she may have been at that time. Who knows what happened in the next days/week?

 

[Allabouttrial]

I'm not a medical professional, but I've paid attention to those who are & posting here. I think we need to be careful not to compare PPA & PPD to what Lindsay was said to be experiencing. Postpartum Psychosis is said to be a psychiatric emergency.

Hopefully, as this case moves forward. We'll learn more details as to how Lindsay got to the state she was in when she killed her children. Not in a voyeuristic way, but to help us understand how this happened to a woman described as a fantastic Mom, wife & educated L&D nurse.

Patrick Clancy said, "I want to ask all of you that you find it deep within yourselves to forgive Lindsay, as I have,” he said. “The real Lindsay was generously loving and caring towards everyone – me, our kids, family, friends, and her patients. The very fibers of her soul are loving. All I wish for her now is that she can somehow find peace".

Man Says He Forgives Wife Accused of Strangling Their 3 Children

"I want to ask all of you that you find it deep within yourselves to forgive Lindsay, as I have," he said.

lawandcrime.com

Lindsay's going to torture herself for the rest of her life when she comes through this.