The After Show: The Lindsay Clancy Trial

20/20

In this special edition of '20/20: The After Show,' Deborah Roberts discusses the Lindsay Clancy trial with emergency room psychiatrist Dr. Ajua Smalls-Monte. The episode explores postpartum psychosis, a

Key takeaways

Postpartum psychosis is rare but severe, affecting about one to two women per thousand live births.
It can occur even without prior mental health history, often being the first manifestation of a psychiatric disorder.

Main topics

Postpartum psychosis
Lindsay Clancy trial

Notable quotes

"She said now they were safe. She felt she was making her children safe by taking their lives."

Conclusion

While the Lindsay Clancy case remains deeply tragic, it has sparked vital conversations about

Transcript preview

Speaker 5 (0:04) The Speaker 7 (0:05) city moves fast, but your vibe, that's different. Sharper, smoother, more alive. Speaker 4 (0:15) The new Speaker 7 (0:20) Honda City isn't just made to drive, it's made to feel. The new Honda City, all new vibe. Speaker 2 (0:32) Hi, everybody, and welcome to 2020 The After Show. I'm Debra Roberts, and as always, I'm so glad you're with us today. Those Speaker 1 (0:39) of you who follow us know that normally we take you Speaker 2 (0:42) behind the scenes and inside our latest 2020 episode that aired the Friday before. Today, we're going to take a little turn and take a look at a story that has just captivated this country, grabbing headlines everywhere, one that is sparking lots of social media debate. And you know this case. It is the one of Lindsay Clancy. You have no doubt heard about this excruciatingly tragic case. 36-year-old Clancy is accused of the unthinkable, killing her three young children, five-year-old Cora, three-year-old Dawson, and her eight-month-old infant son, Callan. She also tried to take her own life on that day. And this past August, she pleaded not guilty. We've watched emotional moments in the courtroom, including Clancy sobbing as medical examiners and doctors testified about her children's death. We've also seen hundreds of women rallying outside the courtroom, standing in solidarity with this mom, arguing that it is a failure of the medical system that she was struggling with her mental health. This trial has captured the public's attention, as I said, raising questions about the prosecution of mothers with mental illness and putting a spotlight on a lesser known mental health condition known as postpartum psychosis. Now, Lindsay's defense does not refute that she killed her children. That's so important here. But they do argue that she should not be held criminally responsible. The prosecution in this case is arguing that she was. fully aware of her actions, methodically planning and carrying out these murders. So the big question is, how to process these conflicting assessments of this case. Joining us now to help answer big questions about this case and also to understand more about mental illness, particularly amongst new mothers, is a friend of our show, emergency room psychiatrist, Dr. Ajua Smalls-Monte. Dr. Monte, good to have you, as always. Thank Speaker 1 (2:43) you. Speaker 2 (2:43) You often bring such clarity to us when we talk about these cases and whether you've actually worked on them or not when it comes to stories. And in this case, we should make it very clear. You had no dealings with this case. You had no connection to Lindsay Clancy. You have not treated her, observed her. But clearly, you know a lot about moms dealing with mental health crisis after they've had children. So let's talk about what it's like for you to even just watch this case. I mean, as it sort of unfolded over the last couple of years. It Speaker 1 (3:17) is gut-wrenching what happened. Not only are three children gone, a father has lost his children, a mother has lost her children, and a woman is also harmed and paralyzed. That is so hard for me to see, especially when there are so many discussions on mental health in this case. But it truly is a tragedy. And I think we just all want to understand what is happening and what can we all do better Speaker 2 (3:47) to prevent things like this from happening again. And we want to talk to you about that. I remember, I mean, so many of us who are old enough remember the case of Andrea Yates in 2001. That's immediately what came to mind when I heard about this case. Tragically, a woman who drowned her five children in the bathtub and said that she was suffering from a mental health crisis and voices were in her head. Her conviction, she was actually convicted of capital murder in the very beginning, and then her conviction was overturned. She was found not guilty by reason of insanity, and she remains in a mental health facility. Let's talk a bit, that's what could possibly happen in this case. Lindsay could actually wind up going to prison for the rest of her life, or she could also be committed to a mental health facility. When we talk about postpartum psychosis, we know about postpartum depression. We know about anxiety. We know about all kinds of issues that new moms deal with. What is postpartum psychosis all about? Speaker 1 (4:46) So we're looking at two things. We're looking at psychosis in the postpartum time. So let's first talk about psychosis. With psychosis, you have a loss of touch with reality. So that loss of touch with reality can be due to delusions. Those are odd thoughts that you're having, things that are not true, but you believe it's true, even when anyone tells you that this is happening. that you're thinking is happening cannot happen. But with psychosis, you can also have hallucinations, whether you're hearing things or seeing things that aren't there. In her case, she said she was hearing voices. Very, very common in psychosis. And people can also have disorganized thought, like they're not clear. And that disorganized thought can also make their behaviors just not seem put together. They can do odd things. So when you have all three of those, or even two of them, That is what we're calling psychosis. And then to have postpartum psychosis, we're usually talking about 12 weeks after a pregnancy. And when I say pregnancy, that can include whether you had a live birth or even if you had a stillbirth or a miscarriage, you can have postpartum psychosis happen in those instances as well. Postpartum psychosis is relatively rare. It's about one to two women experience it out of a thousand live births. So it is rare. It is pretty rare. So we don't see it often. I've seen it a few times in my practice and my career. But it is still something that now we have more heightened awareness of because of this. Is Speaker 2 (6:22) this typically does this typically happen amongst women who have already had some kind of mental health struggles? Or does this is it just Speaker 1 (6:29) triggered by childbirth? So For many women, they do have a history of having a bipolar disorder or a psychotic disorder before. But for 50 % of people that have postpartum psychosis, that can be their first manifestation of a bipolar disorder that they might have for the rest of their life or any psychotic disorder or even a depression with psychosis. So while definitely having a mental health disorder can raise your susceptibility to this happening because pregnancy is a very stressful time for your body. You're having a lot of hormone changes. Hormonal spikes. Changes happen. Yes.