I’ve spent a good portion of my career working with people experiencing serious mental illness. I’ve also spent years working in correctional settings, so the intersection between psychology, criminal behavior, and personal responsibility has always fascinated me.
That may be one reason I’ve found myself following the Lindsay Clancy trial so closely.
The Massachusetts mother is on trial for killing her three young children, 5-year-old Cora, 3-year-old Dawson, and 8-month-old Callan, in January 2023. Her attorneys do not dispute that she killed them. Instead, the central question of the trial is whether Clancy was legally responsible for her actions at the time.
Her defense argues that she was experiencing severe postpartum psychosis and had lost touch with reality. Prosecutors argue that, although Clancy clearly struggled with significant mental-health problems, she understood what she was doing and deliberately planned the killings.
That distinction has turned this trial into something much bigger than a murder case.
It forces us to wrestle with an incredibly uncomfortable question:
When does mental illness explain someone’s behavior, and when does it change how responsible we believe they are for it?
Mental Illness Doesn’t Automatically Mean Lack of Responsibility
One of the misconceptions I frequently see when cases like this become national news is the assumption that being mentally ill automatically means someone doesn’t know what they’re doing.
It doesn’t.
Millions of people live with depression, anxiety, bipolar disorder, schizophrenia, and other serious mental-health conditions without ever harming another person.
Even experiencing psychosis does not automatically determine someone’s legal responsibility.
That’s part of what makes the Clancy case so complicated.
Clancy had been seeking mental-health treatment for months before the deaths of her children. She saw multiple providers, was prescribed psychiatric medications, and admitted herself to McLean Hospital for inpatient treatment only weeks before the killings.
But the experts who have evaluated her don’t agree about what those facts ultimately mean.
Defense experts have testified that Clancy was suffering from postpartum psychosis, including hallucinations, and was unable to appreciate the wrongfulness of her actions. A prosecution expert has challenged that explanation, arguing instead that Clancy understood what she was doing and killed the children because she believed they would suffer after her planned suicide.
Same woman. Same history. Same horrific outcome.
Different psychological conclusions.
And that’s worth paying attention to.
What Exactly Is Postpartum Psychosis?
Part of the public discussion surrounding this case has also revealed how little many of us know about postpartum mental health.
Most people have heard of postpartum depression. Postpartum psychosis is different.
It is a rare but serious psychiatric emergency that can involve delusions, hallucinations, severe confusion, paranoia, dramatic mood changes, and a loss of contact with reality.
It’s important to say something else clearly:
Postpartum mental illness does not make mothers dangerous.
The overwhelming majority of women struggling with postpartum depression, anxiety, or other mental-health conditions will never harm their children.
We should be able to discuss an extreme case without creating unnecessary fear or stigma around mothers who are already struggling and may be afraid to ask for help.
In fact, if there’s a broader lesson here, I think it should be the opposite: when a new mother says she is struggling, we need to take her seriously.
Explanation Is Not the Same as Excuse
This may be the hardest part of the conversation.
Sometimes when we try to understand why someone committed a terrible act, people hear that understanding as sympathy or even justification.
But psychology asks us to tolerate more complexity than that.
We can grieve three children whose lives were taken.
We can acknowledge the unimaginable suffering of their father and family.
We can also ask whether their mother was experiencing a psychiatric illness so severe that her perception of reality was fundamentally altered.
Those ideas can exist in the same room.
Understanding behavior doesn’t erase its consequences.
But if mental illness truly affected someone’s ability to understand reality or appreciate the wrongfulness of an act, then our justice system has to consider that too. That’s precisely why standards for criminal responsibility exist.
The Part of This Case That Troubles Me Most
Beyond the question of guilt, there’s another part of this story that I can’t ignore.
Clancy was asking for help.
Her medical history presented at trial shows months of contact with mental-health providers before the killings. She reported anxiety, depression, difficulty sleeping and suicidal thoughts. She sought different providers and eventually inpatient psychiatric care.
That doesn’t tell us what the verdict should be.
But as a mental-health professional, it makes me wonder about something larger:
How good are we at recognizing when someone’s mental health is moving from “struggling” to “dangerously unstable”?
Mental-health care isn’t perfect. Clinicians make decisions using the information available at a particular moment. People can appear relatively stable during an appointment and deteriorate later. Symptoms can change. Patients don’t always disclose everything they’re experiencing.
There isn’t always an obvious villain or an easy missed sign.
Sometimes tragedy happens despite people trying to help.
That’s an uncomfortable reality too.
Compassion and Accountability Don’t Have to Be Enemies
I’ve noticed that public conversation about this trial often seems to demand that we choose a side.
Either Lindsay Clancy is a monster who murdered her children or she is a severely ill mother failed by the mental-health system.
Human behavior is rarely that simple.
I don’t know what was happening inside Lindsay Clancy’s mind when her children died. Ultimately, the jurors hearing all of the evidence will have to decide whether the legal standard for criminal responsibility has been met.
But I think the rest of us can take something important from the conversation.
Mental illness can profoundly alter how someone thinks, feels, perceives danger, and experiences reality. At the same time, having a mental illness does not automatically remove personal responsibility.
The difficult work is figuring out where one ends and the other begins.
And maybe that’s why this trial has captured so much attention.
It isn’t simply asking us what Lindsay Clancy did.
We already know what she did.
It’s asking something much harder:
How should we judge a person when we aren’t certain how much of their mind was available to them when they did it?
There may never be an answer to that question that feels completely satisfying.
But it’s a conversation worth having.
If you or someone you know are struggling with post partum mental health, please reach out to the National Maternal Mental Health Hotline: 1-833-TLC-MAMA (1-833-852-6262)
Licensed Mental Health Counselor 