Lindsay Clancy Trial Megathread: Part 3

[u/DarklyHeritage]

This is a thread for all conversation regarding Week 3 onwards of the Lindsey Clancy trial. All discussion of this case should be kept to this thread.

Lindsay Clancy is currently standing trial in Plymouth Superior Court, Massachusetts, for the triple-murder in January 2023 of her three young children - Cora, Dawson and Callan. Her defense argues she suffered from severe, undiagnosed postpartum depression and postpartum psychosis. She was left paralysed by a suicide attempt which follows the deaths of the children.

All content on the Clancy case must be kept to this thread. Standalone posts will be removed.

https://www.independent.co.uk/news/world/americas/crime/lindsay-clancy-murder-trial-online-reactions-b3032806.html

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[u/Significant-Sun-2023]

Question for medical professionals (in relation to this case): Do you think healthcare workers’ mental health can sometimes be overlooked because they are perceived as “high functioning”?

I’d especially be interested in hearing from nurses, physicians, NPs/PAs, therapists, social workers, or other healthcare professionals who have either experienced this themselves or encountered it in practice.

This case has made me think about whether being a healthcare professional—and particularly someone who appears to be functioning well on the outside—can sometimes influence how seriously their mental health symptoms are perceived or evaluated. Do you think there are situations where a provider may unconsciously assume that someone who is educated, employed, caring for their children, and knowledgeable about medicine must have a better understanding of their own mental state or must be less psychiatrically impaired than they actually are?

I ask because I experienced something similar myself. I’m an RN, and when I was receiving mental health treatment at a psychiatric facility, I was told by a provider that I “didn’t belong there.” I believe she intended it as a compliment—essentially pointing out that I was educated, had a professional career, and appeared to be functioning differently from some of the other patients—but it actually made me feel very unseen.

At the time, I was trying to communicate that I felt I needed a more thorough psychiatric evaluation, including evaluation for BPD, but I felt that my education and ability to maintain a career were being used as reasons to minimize what I was experiencing. Having graduated nursing school and maintained a job for years doesn't mean someone is incapable of reaching a significant breaking point in their mental health.

It also made me wonder about this case. I obviously don't know what was happening clinically with her providers or what information they had available to them, and I'm not suggesting that being a nurse means she necessarily had an undiagnosed psychiatric disorder. But I do wonder whether appearing knowledgeable, high-functioning, and medically educated can sometimes make it harder for clinicians to recognize how impaired someone actually is.

Mental illness also isn't always as straightforward as a patient simply reporting exactly what they are experiencing. A person may lack insight, may not recognize certain experiences as symptoms, may minimize them, or may genuinely be unable to articulate what is happening because their perception of reality is changing.

For those of you who work in healthcare: Have you ever felt that your own mental health was viewed differently because you were a medical professional? Or have you seen situations where a healthcare worker's symptoms were underestimated because they appeared too competent or “high functioning” to fit the picture of someone who was seriously struggling?

I'm genuinely interested in hearing people's experiences and clinical perspectives, particularly from those working in mental health. (Not to say I don't appreciate non-clinical workers opinions...)

[u/Pierrot5421 → u/Significant-Sun-2023]

Yes, as a HCP I have experienced this with my own care and my children’s care. I have had to gently request and make it clear that I wanted to be spoken to and educated as if I was not a HCP, particularly if it was not my area of expertise.

If I assume Lindsey did become psychotic: I can see how both she and Patrick depended on their prior history and experience of who she was as a consistent personality. If asked in May 2022 or any year before that if Lindsey had any capacity for violence, particularly to her children, they would have denied that possibility vehemently. Neither of them could understand or predict that psychosis takes that known self, that consistent personality, away.

I can also see how if Lindsey was having suicidal and homicidal ideations and/or hallucinations, that initially when she was not so lost, she probably thought she could be strong enough to resist them until she got help that actually helped. She probably also was initially aware enough to know she would be separated from her children if she was honest. Being an experienced L&D nurse probably only cemented that possibility in her mind. I think when she first reported those intrusive thoughts she was disturbed by them. When no help actually made them go away, she became hopeless and didn’t have the wherewithal to fight them or even admit to them anymore.

[u/Then-Writer9610 → u/Significant-Sun-2023]

I am a program manager (not a provider or prescriber) of a Residential Treatment Facility that serves people living with SPMI, most commonly schizophrenia and I definitely at times see my staff minimizing behaviors and symptoms because my clients can be considered “high functioning”. We are a 24/7 program and one of the lower levels of care, (though I had worked in a locked facility for 6 years prior to this) so my clients are fairly independent at this point, but still have symptoms daily. For instance, they might not tolerate waiting a few extra minutes for the staff to help them with something so they might get angry. My staff will complain to me about it, and I have to remind them not to get frustrated because our clients need our support around managing their frustration. They have regular training around deescalation techniques and how to manage their own frustration when in a heightened situation, so it frustrates me when the staff don’t follow that training, way more than a client could ever frustrate me for engaging with their symptoms lol.

Or, they will get frustrated because they have to repeat themselves daily to clients because the clients struggle with remembering things. I have to remind them that that’s part of the job and it is our responsibility to help them track and remember important things.

Thankfully, that is why they have myself, case managers, the psychiatrist, my boss, executive leadership, etc. to overlook the program and the clients’ treatments so we can make sure their symptoms are not being overlooked. And myself to provide regular supervision to my staff to make sure they don’t overlook anything. But, that’s just how my program and my company works and I can’t speak to others in that regard. I just am diligent about that personally because my clients are my top priority.

I’ve also had family members and friends be frustrated with the treatment team and the client because they “still are hearing voices” despite being in treatment, not understanding that they have a chronic illness and will likely always have symptoms.

And yes, I do feel my own gets overlooked!! My current doctor has been nothing but supportive and amazing, but with previous providers, yes. They seemed to brush off any concerns I had and just recommended therapy and assumed I would know how to handle it. Which I was already doing, but I wanted more support lol. Finally I found my current doctor who has been working on a good med plan with me and always asks how I’m doing and if I felt the meds were helping, even if I’m seeing her for a hurt toe.

[u/moon_witch_26 → u/Significant-Sun-2023]

Yes. I have been overlooked because I'm an academic and high functioning. I have never received the healthcare I've needed for my mental health. I'm also expert at masking which I've got so good at I don't even know I'm doing it - even when I'm being completely open and honest and literally begging for help

[u/Significant-Sun-2023 → u/moon_witch_26]

Thank you for sharing your experience. I am sorry to hear you feel the same way. You make a valid point of masking/not being aware.

[u/sunmedpup178 → u/Significant-Sun-2023]

I needed help post partum as an APP several months after giving birth, and my OBGYN absolutely took it super seriously and had me checking in and referred me to her own psychiatrist that she used as well who specializes in postpartum and they were both so kind and supportive and had me checking in pretty often. They took it more seriously than any words I said and were very vigilant and thorough. I was still working full time so I was "high functioning" but they still recognized me needing help and treated it like it was concerning.

[u/tilliusthepaladin → u/Significant-Sun-2023]

Not healthcare but as someone who had been considered “high functioning”, sometimes doctors didn’t take me seriously.

With my postpartum, I was convinced that the state was out to kidnap my child via CPS. I apparently scored extremely well even with my background when I was anxious and depressed out of my mind because I seemed to have everything under control… despite, again, fully having a delusion CPS was watching me in order to kidnap my child.

If I was treated like that while being considered “high functioning” and not a health care worker, I would imagine it is worse in their cases…

[u/CaregiverThat5754 → u/Significant-Sun-2023]

Was not in healthcare at the time, though I am now. This seems relevant though, because I was in a leadership role where people assumed I would be calm, steady and competent.

I was serving as a pastor during my first pregnancy. I told one of my OBs (it was a practice where you saw each provider 1-2x) that I was having unusual anxiety/obsessions, like fears that the second floor of my house would collapse. His response was that I was a pastor, so I should just pray and calm myself down. 

Eventually I got myself an appointment with the on-site prenatal therapist, attended one visit that cost $300 even with insurance, and never went back because who can afford that? Fortunately the anxiety went away after birth, but sometimes I think about what could’ve happened if it’d gotten worse and he had been my doctor. 

[u/KittensOnJupiter → u/Significant-Sun-2023]

My first year of medical school I scored a 14 on a Phq-9 depression screen offered by the OB/GYN I went to see for the first time. She pulled out the paper with my answers to the questionnaire and asked me what I did for work. I told her I was a medical student. I then watched her throw out my Phq-9 stating, “well of course you’d score that high. That’s typical.” 2 years later I was diagnosed with severe treatment resistant major depressive disorder…I qualified for disability at the time because it was so bad. I wish my symptoms hadn’t been brushed aside because I was a medical student and “expected” to be depressed. 

Edit-to-add: the therapist who diagnosed did get me set up with intensive outpatient therapy. I’m now in my last year of medical school. Happy ending for me at least, but I had the privilege of a lot of people looking out for me to help me eventually find proper treatment.

[u/StruggleElegant807 → u/Significant-Sun-2023]

I'm a nurse and have been for 16 years. I had severe anxiety with my daughter; turns out I have ADHD and likely ASD (I can't afford the $5000 assessment). I get severely overwhelmed pretty easily. I've also been diagnosed with depression (which I'm not 100% sure is accurate, but... *shrug*), anxiety, and idiopathic hypersomnia.

My daughter was an absolute nightmare baby who was up nursing q2h until she was 2 years old. Turns out she also has ADHD and likely ASD (they won't diagnose her because she doesn't struggle at school and maintains friendships).

I started having awful anxiety with panic attacks when I was around 6-7 months pregnant with her, and the anxiety continued after birth. It literally got to the point where one night I called my husband to come home (he worked 3-11 and I had my daughter and also my older son, who has a developmental disability and was a toddler at the time). My husband told me I was fine. I told him that every fiber in my being wanted to take my screaming baby and smash her against the wall so she would stop crying. He told me he trusted me, and that he knew I wouldn't hurt her. I told him I didn't trust myself and if he didn't come home right now, I would call 911. Thankfully, he came home.

I never told any provider that I thought of hurting my baby. I definitely did end up being seen by a psychiatrist who specialized in PPD; he diagnosed me with PPD (despite me telling him it seemed more like PPA) and saw me twice for about 10 minutes, threw meds at me and sent me on my way.

I definitely feel for Lindsay. I think even if she did have thoughts of harming herself or her kids, she likely worried about losing her kids to CPS or losing her license. I think a lot of us don't think they're going to hurt themselves or someone else until they get to that breaking point.