The Lindsay Clancy postpartum psychosis case has forced an uncomfortable question into public view: what happens when a mother repeatedly asks for help and the system still fails to catch what is happening to her?

Court testimony and trial documents lay out a four-month record of appointments, emergency room visits, a crisis hotline call, and more than a dozen prescriptions — a paper trail showing a woman who was not silent about her suffering.

A Case That Shook Massachusetts

Clancy, 36, stands accused of killing her three children — Cora, 5; Dawson, 3; and eight-month-old Callan — on January 24, 2023, before attempting to end her own life.

Prosecutors built their case over nearly six weeks, calling roughly 70 witnesses. Their argument centered on planning: that Clancy deliberately sent her husband out of the house to create the window in which the deaths occurred.

Her defense told a fundamentally different story. Attorneys argued she was experiencing postpartum psychosis, a rare and genuine psychiatric emergency that can rupture a new mother’s connection to reality. According to that account, she was responding to voices instructing her to harm her children and herself — and had spent months trying to get someone to help her.

Both sides delivered closing arguments Thursday, and jurors began deliberating that afternoon.

Where the Care Broke Down

What emerged during the trial was less a story of neglect than one of fragmentation.

Clancy’s providers testified that they modified her treatment as her symptoms shifted and as she reacted to various medications. But they also acknowledged something significant: they did not always have access to her complete medical record, and they were not consistently communicating with one another. Even the basic timeline of which drugs she was taking, and when she stopped one and started another, became murky.

Dr. Veerle Bergink, who directs the Women’s Mental Health Center at Mount Sinai, reviewed the testimony and reached a blunt conclusion. On several separate occasions, she said, the correct diagnosis was missed and Clancy did not receive appropriate treatment.

Bergink, a specialist in mental health during pregnancy and the postpartum period, pointed to a specific warning sign. Clancy’s poor reactions to antidepressants should have raised the possibility that her illness extended well beyond postpartum depression — and that she required an entirely different treatment approach.

Dr. Tracy Moran Vozar, a psychologist specializing in perinatal mental health, framed the case as a symptom of a wider structural problem. When patients with serious mental illness move between multiple providers across separate healthcare systems, critical information falls through the cracks.

Neither physician treated Clancy directly.

“It’s very tragic, of course, for her, her family, and everything that happened,” Bergink said. “But it’s a tragedy for doctors, as well.”

Autumn 2022: The First Alarms

Clancy’s psychiatric care began in mid-September 2022, roughly three months after Callan’s birth, when she first met with psychiatrist Dr. Jennifer Tufts.

She described anxiety attacks, low mood, an inability to feel pleasure, guilt, poor appetite, and racing thoughts. When asked directly, she denied hearing voices or having thoughts of harming herself or anyone else. Tufts diagnosed generalized anxiety disorder alongside an adjustment disorder with depressed mood, and started her on a common antidepressant.

By October, the picture had darkened. Clancy reported feeling worse after her dose was raised — crying throughout the day, struggling to eat or sleep, plagued by racing thoughts overnight and fear that something terrible was coming. Tufts testified she was very concerned and discontinued the medication, adding anti-anxiety drugs and an antihistamine instead.

November brought a divergence in accounts. Defense attorney Kevin Reddington argued Clancy had deteriorated badly, with worsening insomnia and thoughts of suicide. Tufts testified she had recorded improvement and reduced one medication accordingly.

Mid-month, Clancy went to a hospital emergency room. Days later, a psychiatric nurse practitioner saw her after her former mother-in-law reached out to providers. New antidepressants followed. Clancy reported feeling disconnected and spacey on one, so it was swapped. She then reported dissociation and confusion on the replacement. An antipsychotic was added.

December: Turned Away

By December, the search for help had become urgent.

Clancy told Tufts she was not suicidal but felt close to it. She described worsening depression, intrusive thoughts, and a sensation that she was going to die. Reddington pressed Tufts in court about how she responded to a patient describing hopelessness and indifference to her own survival. Tufts said she reassured Clancy that treatment existed and there was reason for hope.

A perinatal clinician who provided short-term therapy met with Clancy four times and observed no mania or psychosis, but referred her to a Rhode Island hospital over ongoing passive suicidal thoughts. Clancy went. She was discharged.

On December 4, she called a suicide crisis line. She was evaluated and told she did not meet the threshold for inpatient admission.

Her husband contacted providers mid-month reporting she was getting worse. More medications were adjusted. She visited two different emergency rooms before the year ended and participated briefly in a partial hospitalization program for postpartum depression.

January 2023: The Final Weeks

She arrived at McLean Hospital on New Year’s Day. Her chief complaints were sleeplessness and feeling numb, along with medication side effects. A psychiatrist there noted the possibility of bipolar disorder but observed no psychosis, and testified she had no safety concerns when Clancy was discharged on January 5.

Prescriptions continued to shift through mid-January. Clancy repeatedly described numbness, and said bonding with her infant felt forced.

At her final appointment on January 23, she reported depressed mood, numbness, and having to force herself out of bed. No suicidal or homicidal thoughts were noted. No psychosis was observed.

The following day, prosecutors say, three children died.

If you or someone you know is struggling or in emotional distress, call or text 988, or chat at 988lifeline.org, to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day.