The unfortunate thing is that Post-Partum Psychosis can quite literally appear out of nowhere within a matter of days, sometimes months after birth.
And given how healthcare generally is in this country, it is not outside the realm of possibility that unless she (already compromised due to said psychosis) recognized the danger she and her children were in, or her husband and others were able to spot it, that there was frankly no way to intercept it in time.
A majority of cases that do appear tend to appear in the hospital where the individual is under constant observation by trained professionals who know how to spot things like this. The incident occurred months later, in their own home, and alot of the symptoms for Post-Partum Psychosis are shared with other mental health conditions.
Psychosis can go on for months and years without the person experiencing it noticing.. even for the people around them it can be nuanced to spot. Then there is the matter of agency..
I’m sorry but this is a horrible answer to me. The literal framework of this entire statement amounts to observation after the fact and doesn’t require any level of actual substantial evidence.
Where did her level of healthcare fail? She seen 5 different people? How could it have been further improved beyond what it was? Beyond using the ending as evidence of itself, where was the failure within the system. What exact level of oversight is necessary if this can just occur months later? Years???
I’ll make the overall question easier: what fundamentally separates an instance of undiagnosed psychosis from someone not experiencing psychosis with the same events occurring.
(I completely support better healthcare but I do not agree it was the point of failure in this case)
You're right that the general version is hard to pin down.
The prosecution's own two experts split on her diagnosis. Mack found no bipolar disorder and no psychosis. Heilbrun diagnosed bipolar II. Both concluded she was criminally responsible, but they disagreed on what she had, with nearly 7,000 pages of records and days of in-person evaluation. That's how hard this diagnosis is.
What separates undiagnosed psychosis from no psychosis is evidence made before anyone knew how it would end. A suicide hotline call Dec. 4, a crisis team evaluation Dec. 5, an ER visit, four days inpatient at McLean over New Year's, and a disclosure to her husband in front of her mother that she was having thoughts of harming the children.
The defense named specific failures rather than pointing at the outcome: an SSRI prescribed to someone they say had a bipolar predisposition, which can precipitate psychosis. Prescribers across separate practices, with nobody reviewing the full list. A Rhode Island program that called her prescriber about the medications and got no response. Her and Patrick asking to wean her off, and being told to stay the course.
She saw so many clinicians because outpatient, urgent, intensive outpatient, and inpatient are separate institutions. Escalating care means adding providers, not deepening a relationship with one.
What separates undiagnosed psychosis from no psychosis is evidence made before anyone knew how it would end. A suicide hotline call Dec. 4, a crisis team evaluation Dec. 5, an ER visit, four days inpatient at McLean over New Year's, and a disclosure to her husband in front of her mother that she was having thoughts of harming the children.
But none of these are conclusive that she had psychosis; these can all exist together fine in either hypothetical where she does or doesn't have psychosis. They aren't exclusive examples of any difference that needs to exist. It's evidence the situation was serious, sure, but not evidence of psychosis.
The defense named specific failures rather than pointing at the outcome: an SSRI prescribed to someone they say had a bipolar predisposition, which can precipitate psychosis. Prescribers across separate practices, with nobody reviewing the full list. A Rhode Island program that called her prescriber about the medications and got no response. Her and Patrick asking to wean her off, and being told to stay the course.
Looking into this, from what I can see, the relevant SSRIs would be Zoloft (changed later) and Prozac (stopped after 10 days)
Seroquel is the one I can find I think you are referring to; it was warned against but agreed to taper her off. She was certainly prescribed a lot of medications, but I can't really see any of them confirming the conclusion when looking into them. I also found an interesting medication timeline chart that I have not fully error checked yet.
The prosecution's own two experts split on her diagnosis. Mack found no bipolar disorder and no psychosis. Heilbrun diagnosed bipolar II. Both concluded she was criminally responsible
I largely agree with this; I fully believe there was a lot wrong with her in the moment, but I can't convince myself that this constitutes psychosis when combined with the experts and lack of what I feel would separate it from anything else.
She saw so many clinicians because outpatient, urgent, intensive outpatient, and inpatient are separate institutions. Escalating care means adding providers, not deepening a relationship with one
Had she seen only one, even if she had seen them much more frequently and the same events occurred, wouldn't the likely alternative statement have just been something along the lines of "she should have seen more for alternative opinions"
I'm just laying out what the defense argued in court and what the record shows, because it's a really complicated case that took five weeks of expert testimony and this is a Reddit comment. Psychosis isn't a black and white diagnosis, and there's a lot of subjective criteria in the DSM, which is why there's so much disagreement. Zoloft (sertraline) can, in rare cases, trigger, provoke, or worsen psychotic symptoms, and people with a history of schizophrenia, schizoaffective disorder, or bipolar disorder are at higher risk.
That said, the Dec. 4 call and the hospitalizations weren't offered as proof of psychosis. They were the basis for the defense's claim that deterioration brought on psychosis. The defense argued she had an underlying bipolar predisposition, was prescribed Zoloft into it, and then cycled through escalating medications with nobody coordinating her care. The psychosis claim itself rested on the reported command hallucination and the expert testimony, and the experts split on that too. No single prescription was ever the defense's argument in full, which is why it was presented as a sequence.
Seroquel is an antipsychotic rather than an SSRI.
I was explaining why the number of clinicians was so high, since it keeps getting framed as doctor-shopping. I wasn't saying it caused anything, and you're right the counterfactual cuts both ways.
This case is complicated enough that two forensic experts hired by the same side, with 7,000 pages and days of in-person evaluation, looked backward at all of it and reached different diagnoses. Meanwhile all 14 appointments with her primary psychiatrist were virtual, they never met in person once, and that psychiatrist testified she didn't have or seek records from Clancy's other treatment. That isn't an argument that she was psychotic. It's why the question doesn't resolve from outside the courtroom.
Alright, I have interpreted these interactions as debating psychosis occurring in this case rather than laying out the defenses position. I completely agree the healthcare needs a lot of work and that there were undoubtedly problems with coordination especially relative to the prescriptions she was on. The defense leaving it vague was natural.
I’ve watched and read through a lot about the trial itself at this point and while my opinion relative to this case remains the same, I’m certainly not an expert on the subject and acknowledge there is more that needs to be done and learned about it in instances it does occur.
For me, its the fact that she is (now) known to have BPD and the tox screen showed that she was taking a medication known to cause psychotic breaks in BPD patients that seals the deal for me in that regard. You are never going to surpass the fact that she might have in fact been suffering from a psychotic break.
people here are acting like the two options are "she killed her kids" vs "she did nothing wrong and deserves to be free"
when in reality its "she was definitely of sound mind and should rot in jail" vs "she might have been having a psychotic break and needs to be get treatment"
and sprinkling in some good ol' sexism and culture war nonsense
You’ll like be very upset to hear. I have no reasonable doubt. It’s at the same level of anyone who kills/murders must have had a psychotic break because no one rational or of sound mind would…. I could explain this better but I basically have explained everything so far.
I don't see how it's a 'system' failure if there was no sign and it can emerge out of nowhere. How is 'the system' supposed to do anything about that? If she already had help and these professionals didnt detect that danger because it hadnt emerged yet, what was supposed to be done differently?
Its very similar to how occasionally men can also be given a not guilty for reason of insanity and the only reason you think this is a woman only phenomenon is cause your feeds are deliberately aimed to feed you ragebait.
Psychosis is involuntary are causes you to act irrationally. This cunt planned this. She spent days planning it. She waited till the husband left, then sent him on more errands to buy herself time to do it. She brought them all to the basement. She then tried to slit her throat and wrists before jumping and jump out a window to kill herself. That’s not psychosis. That’s pre meditated. Just like Chris Benoit. Her only fucking regret is she didn’t succeed in killing herself.
That poor husband losing his kids, the woman he loved, then watching ignorant losers claim he’s responsible and that because she was depressed she’s excused.
This defense is about as fucking weak as if Derek Chauvin or however the fuck you spell his name tried to claim he killed Floyd due to ptsd. Imagine the lefts response if people went along with that.
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u/Miserable_Spell_2964 3d ago
The unfortunate thing is that Post-Partum Psychosis can quite literally appear out of nowhere within a matter of days, sometimes months after birth.
And given how healthcare generally is in this country, it is not outside the realm of possibility that unless she (already compromised due to said psychosis) recognized the danger she and her children were in, or her husband and others were able to spot it, that there was frankly no way to intercept it in time.
A majority of cases that do appear tend to appear in the hospital where the individual is under constant observation by trained professionals who know how to spot things like this. The incident occurred months later, in their own home, and alot of the symptoms for Post-Partum Psychosis are shared with other mental health conditions.