As Lindsay Clancy's trial nears its end, Dr. Lieberman offers a psychiatric perspective on postpartum psychosis, the medical failures that preceded the tragedy, and why a verdict won't bring closure. Watch the video to learn more, or read the transcript below.
The Lindsay Clancy trial is going to wrap up in the next few days, but unfortunately, that won’t be the end of the journey for Lindsay Clancy.
Psychosis is something that is hard for people to understand who haven’t experienced it (which is most of us). And Lindsay Clancy was in the throes of a postpartum psychosis, which means that her mind had aberrations—like delusions, false beliefs, and hallucinations, hearing voices that weren’t real. But in the throes of a full-blown psychosis, your internal reality becomes your external reality. And the things that she heard and thought, she felt compelled to follow. She was receiving “communications” that were command hallucinations and delusions about how her children were going to be possessed by the devil and she needed to kill them to protect them.
Psychosis is like a rheostat, not like an on/off switch, meaning that when its symptoms are mild, they’re in the background—but when it’s full blown, they take you over; you become fully in their possession and under their control.
Now, the next thing was that her clinical care in the system failed her. First, her OBGYN may have noticed that she was having some symptoms or listened to her complaints. But the question was, how does the OBGYN ensure that she gets good reproductive psychiatry care? And that’s where things broke down. She had a lot of doctors involved—too many cooks in the kitchen—but nobody was taking charge. Nobody was the overall quarterback for this. And as a result, she received multiple medications—and actually not the right medications, because she was having a psychosis, and she only had one brief trial of an antipsychotic drug. The rest of the medications she received were anti-anxiety medications or antidepressant medications or sleep medications. And those were given at sub-therapeutic doses and for not long enough periods of time. So she really didn’t have a chance because she was receiving the wrong medications to counteract her symptoms.
And finally, what will happen is that even if she does get an NGRI (not guilty by reason of insanity) verdict—which she deserves because she’s more the victim of her illness and the system’s failures than she is a perpetrator of something—that’s not going to be the end of it because she will then be remanded to a state forensic psychiatric hospital, which is akin to being in a correctional facility. The criteria for her to be discharged would be when she’s no longer a danger to herself or the community. But that criteria may not be applied until months or years after she’s been there.
It’s a shame, because this is something that happens with recurrence and is totally identifiable and totally predictable. It’s the system that is inadequate to meet the demands of pregnant women, both during and after pregnancy, who suffer from it.
