Three children are dead. Their mother says she was out of her mind when she killed them. After nearly seven days, the jury hung, and the judge threw the trial out.
The Lindsay Clancy case forces two hard questions into one room. How does the law assign blame when severe mental illness may have blotted out reality? And whose suffering do we agree to call illness in the first place? For Black women, the second question is not abstract. It runs straight into a health system that has too often read their endurance as wellness and their distress as something other than sickness.
The Clancy case
Lindsay Clancy is charged with three counts of first-degree murder in the deaths of her three children on January 24, 2023: Cora, 5; Dawson, 3; and Callan, 8 months. She does not dispute killing them. Her defense argues that bipolar disorder and postpartum psychosis left her unable to tell right from wrong. Prosecutors say she was depressed but understood what she was doing and planned it. The medical experts disagreed sharply about her psychiatric condition.
After nearly seven days, the jury of nine women and three men told Judge William Sullivan it could not agree. “It is with a heavy heart that we report we are unable to come to a unanimous decision, and we will not be able to,” the foreperson wrote. One juror would not vote to find Clancy not guilty by reason of lack of criminal responsibility, the standard Massachusetts uses. The defense asked the Supreme Judicial Court for an emergency stay. The court denied it Friday afternoon, and Sullivan declared a mistrial. Whether Clancy is tried again rests with Plymouth County District Attorney Timothy Cruz, who called the first-degree murder charges “warranted” and said the decision would come soon, though not right away. Her lawyers say they will fight a second trial on double-jeopardy grounds. She remains in a state psychiatric hospital, where she has been held more than three years.
That distinction matters. A diagnosis does not by itself establish legal insanity. Organized behavior does not by itself prove a person was free of psychosis. The question in front of the jury was a legal one: did mental illness stop Clancy from understanding that her actions were wrong at the time she committed them. It was not whether postpartum psychosis is real, or whether she had once seemed loving and capable.
On CBS’s Case by Case coverage of the trial, the defense held up empty pill bottles taken from Clancy’s bedside drawer. An empty bottle is a picture, not a fact. It shows a container with nothing in it. It doesn’t show who took the pills, how many went down, or when. Ingestion is settled by what shows up in the body, through toxicology, and by pharmacy records that measure what was dispensed against what was left. Bottles illustrate a theory. Levels test it. That gap deserves real scrutiny, because the same empty bottle reads one way as a woman drowning in her own prescriptions and another way as a woman who was careful, and which reading a person reaches for often says more about what they already believed walking in.
The deaths of three children stay at the center of this. Recognizing maternal mental illness does not erase Cora, Dawson, and Callan. And acknowledging those children does not require pretending that severe psychiatric illness is just sadness, stress, selfishness, or bad mothering.
Three different conditions
People use “postpartum depression” as a catchall. Postpartum depression and postpartum psychosis are not the same thing.
| Condition | Common features | What it calls for |
|---|---|---|
| Baby blues | Tearfulness, irritability, anxiety, emotional sensitivity in the days after delivery | Support, rest, monitoring, and medical follow-up if it persists or worsens |
| Postpartum depression | Lasting sadness, hopelessness, guilt, withdrawal, loss of interest, trouble bonding, thoughts of self-harm | Prompt clinical evaluation, therapy, medication when appropriate, continued follow-up |
| Postpartum psychosis | Hallucinations, delusions, paranoia, severe confusion, mania, agitation, extreme insomnia, loss of contact with reality | Immediate psychiatric evaluation; hospitalization is usually necessary to protect the mother and children |
About 1 in 8 women who recently gave birth report symptoms of postpartum depression. Postpartum psychosis is far rarer, roughly 1 to 2 cases per 1,000 births, but it is a psychiatric emergency, because delusions or hallucinations can create a risk of suicide or harm to a child.
Postpartum psychosis does not always match the public picture of insanity. A mother can speak clearly, do ordinary tasks, and seem calm while holding a fixed delusion or hearing a command hallucination. The reverse is also true. Depression, medication, insomnia, anxiety, and intrusive thoughts do not by themselves prove psychosis. That is why this needs careful assessment, information from family members, and coordination between obstetric and psychiatric care.
The racial fault line
Clancy’s case has drawn heavy national attention. It also raises a harder question. What happens when the mother showing signs of distress is Black?
Black women enter pregnancy and the months after birth carrying added risk. That risk does not come from race as biology. It comes from unequal treatment, steady exposure to discrimination, patchy insurance coverage, economic pressure, and worse access to respectful care. The CDC reports that Black women are three times more likely than white women to die from a pregnancy-related cause. It also estimates that more than 80 percent of pregnancy-related deaths in this country are preventable.
Death is only the most visible measure. Racial bias runs through the rest of the maternal-care experience, quieter and harder to count. Pain and alarming symptoms get minimized. A mental-health complaint gets filed as ordinary stress instead of a warning sign. Providers expect a Black woman to hold herself together and manage on her own. Short appointments and scattered records keep anyone from seeing the whole clinical picture, and the practical barriers stack on top of that: no ride, no childcare, no coverage, no provider within reach, so a referral that looks fine on paper goes nowhere. Fear does the rest. Fear of being judged, of a child-welfare call, of criminal exposure keeps women from saying the worst of it out loud. And a screening that flags a problem without producing an appointment, a prescription, or a follow-up hasn’t flagged anything that helps.
In a 2011 study of low-income mothers, 9 percent of white women started treatment for postpartum depression, against 4 percent of Black women, and Black women were less likely to keep getting care once they began. Separate research has tied everyday discrimination to postpartum depressive symptoms, with the link strongest among non-Hispanic Black women.
Those numbers expose the problem with telling Black mothers to just “ask for help.” Asking is not the same as being heard. Screening is not treatment. A referral is not access. And access without trust, continuity, and care that understands who the patient is, is not equal care.
Who receives compassion?
The Clancy trial should not turn into a contest over which group suffers more. Postpartum psychosis is devastating no matter the mother’s race. A white mother’s illness is not less serious because Black mothers face more barriers.
Race still shapes how suffering gets read. One mother is called overwhelmed, sick, failed by the system. Another is called irresponsible, dangerous, unfit, or criminal before anyone gives her a real psychiatric evaluation. The question is not whether Clancy deserves less. It is whether a Black woman in her place would get the same evaluation, the same benefit of the doubt, the same continuity of care, the same public willingness to see illness instead of failure.
My book Breaking Barriers takes on the larger silence that kills: the pressure to stay strong, to pray through distress, to protect family privacy, to avoid institutions that have not always treated Black people with dignity. It frames mental-health equity as a civil-rights issue, not just a matter of personal responsibility. For Black mothers, that silence gets more dangerous, because the culture praises the “strong Black woman” and ignores the cost of asking her to be strong every hour of every day.
A Black woman can love her child and still be depressed. She can be grateful for motherhood and still need medication. She can have faith and still need a psychiatrist. She can appear capable and still be approaching a psychiatric emergency.
What must change
Maternal mental-health care has to work as a continuous system, not one appointment six weeks after delivery. Screen during pregnancy and again across the first postpartum year, not only in the days right after birth. Before anyone hands a woman a screening form, have a plan for a positive result, so it triggers a real assessment, a referral, a scheduled visit, and follow-up instead of a note in a file. Train the people she actually sees, in obstetrics, the emergency room, pediatrics, and primary care, to recognize depression, bipolar symptoms, psychosis, intrusive thoughts, and the kind of sleeplessness that is itself a symptom. Ask her directly about hallucinations, delusions, suicidal thoughts, and thoughts of harming the child, and ask without shaming her.
Build the team out with reproductive psychiatrists, therapists, social workers, doulas, community health workers, and peer-support specialists. Track the numbers by race across screening, referral, medication, hospitalization, follow-up, child-welfare reporting, and outcomes, because a gap you refuse to measure is a gap you have decided to keep. With her consent, bring in her partner and her family, since they are often the ones who notice the paranoia or the sudden change first. And treat the postpartum window as a full year, because these disorders can start in pregnancy or any time in the twelve months after birth.
The Clancy case does not prove that every maternal tragedy is postpartum psychosis. It proves this country still has no dependable way to tell sickness from failure before the worst arrives. For Black women the gap is wider and older. The same warning sign that gets one mother a hospital bed gets another a police report. Until that changes, we are deciding who is allowed to be sick.
If someone after childbirth is hallucinating, badly confused, paranoid, unable to sleep for days, suicidal, or talking about harming the child, do not leave that person alone with children. In the United States, call or text 988 for immediate crisis help, or call emergency services when danger is close.
Sources
- Judge declares mistrial in Clancy case after jurors fail to reach verdict. WBUR.
- With jury deadlocked, judge declares a mistrial in Lindsay Clancy’s murder case. NPR.
- Lindsay Clancy trial: What to know about the testimony, postpartum psychosis and more. ABC News.
- Symptoms of Depression Among Women. CDC.
- Summary of Perinatal Mental Health Conditions. ACOG.
- To Prevent Pregnancy-Related Deaths. CDC.
- Discrimination and Adverse Perinatal Health Outcomes. CDC.
- Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women. PMC.
- Perinatal Mental Health. ACOG.
- Wayne Ince. Breaking Barriers: Black Mental Health.
- CBS News. Case by Case: trial coverage of Commonwealth v. Lindsay Clancy.
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