What the Lindsay Clancy trial reveals about a broken postpartum mental health system

EDITOR'S NOTE: This story includes discussion of suicide. If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988.

Lindsay Clancy's murder trial hasn't just dominated headlines for its tragic story and true crime fascination. For many, it has prompted a groundswell of recognition and outrage around the barriers women face when seeking care, the lack of research on postpartum mental health conditions and little education for providers.

Clancy doesn't deny killing her children before trying to cause her own death by suicide in 2023. But her defense team argues that the former labor and delivery nurse was suffering at the time from postpartum psychosis, a rare but severe condition, and that the care she received for her illness fell short. Experts for the prosecution have testified that they came to a different diagnosis, and that she is criminally responsible for the killings.

Across social media and outside the Massachusetts court house, women have been rallying around messages like "She Needed Help," and sharing the ways in which they see their own struggles reflected in the case.

A section of supporters of Lindsay Clancy react as Judge William Sullivan addresses the courtroom during Clancy's murder trial, in Plymouth, Massachusetts, on Aug. 20, 2026. Photo by Josh Reynolds/Pool via Reuters

That's how Meghan Cliffel, a maternal mental health advocate, felt when she first read the news about Clancy. "That could have been me," said Cliffel, who experienced postpartum psychosis in 2015.

As the trial enters its final stages, Cliffel feels angry.

"It feels infuriating to watch the hyper interest in this case without any proactive support for women to prevent this highly treatable, temporary illness," Cliffel said. "Even beyond that, to set up a system of care that actually cares for mothers through this, for women through this life-shifting transition, even if you don't have a mental health crisis."

WATCH: News Wrap: Defense rests in murder trial of Lindsay Clancy

Psychiatrists and mothers like Cliffel who have recovered from the condition say that awareness-raising is not enough to prevent future tragedies. They point to barriers including a stigma around mental health and a lack of knowledge of the condition by providers.

"I really feel for these women because it would be such a scary thing to be going through, and then there's not a system that necessarily recognizes what it is going on," said Dr. Susan Hatters Friedman, a reproductive and forensic psychiatrist at Case Western Reserve University.

Why postpartum psychosis can be difficult to diagnose and treat

Postpartum psychosis affects about one in 1,000 women. It tends to develop in the weeks after birth and generally includes symptoms such as hallucinations, delusions, difficulty sleeping, agitation, irritability and confusion.

WATCH: What is postpartum psychosis? The condition at the center of Lindsay Clancy's murder trial

Watch the PBS News Hour segment in the player above.

The health professionals who spoke with PBS News emphasized that symptoms can vary and also wax and wane, making it hard to spot a pattern and more difficult to recognize the condition.

"Someone could be hearing voices and doing their laundry, talking to a neighbor, ordering food," said Wendy Davis, executive director of Postpartum Support International.

One of the most common experiences for postpartum moms is wanting to "mask their symptoms," Davis added. "They want to appear their very best. They don't want to be judged. And most of the time, they don't realize that what they're going through is even a symptom."

But postpartum psychosis is a medical emergency, said Dr. Lauren Osborne, vice chair of clinical research at the department of OBGYN at Weill Cornell Medicine. She said loved ones who suspect their family member is experiencing postpartum psychosis should seek care immediately.

"The most important thing to know is that every perinatal mental health disorder, including postpartum psychosis, is a temporary, treatable condition," Davis said.

Up to one in five women experience some perinatal mood disorder, which can include postpartum anxiety or obsessive-compulsive disorder. Most people with postpartum psychosis usually recover after hospitalization and receiving lithium and antipsychotic medicines.

Before getting pregnant in 2019, Ayana Lage suffered from depression, so she was prepared for the likelihood that she would go through postpartum depression. One in eight women experience the condition, according to the Centers for Disease Control and Prevention.

But she hadn't considered that she could experience other conditions like postpartum psychosis. She remembers hearing about Andrea Yates, the Texas mother who drowned her five children in 2001 while dealing with a severe case of postpartum psychosis. But she never thought it would be something she would have to endure.

"I think that maybe is the danger of it," she said. "That I assumed that it would never happen to me. I didn't feel the need to ever look into anything like that, or to put any real thought into other postpartum conditions."

After giving birth to her daughter in 2020, Lage stopped sleeping and started experiencing mood swings. She recalls fluctuating from being paranoid of her husband to becoming lucid and thinking it was weird to feel that way.

Eventually Lage started hearing voices, she said. God told her she would start a church and her daughter was the second coming of Jesus.

Lage's husband called her family and psychiatrist and eventually took her to the hospital.

Lage said today she tells her story to bring awareness to the condition. She has written a memoir and spoken about her experience on social media. Women have reached out to her saying they knew what to look out for after reading her story.

"People often wait or rely on the diagnosis, and the real prevention comes from being aware of the symptoms, feelings, experiences," Davis said.

Stigmas around mental health may prevent new moms from seeking support

Becoming a mother is "supposed to be the happiest time of your life," Davis said. These beliefs create a stigma that may prevent women from seeking mental health support during and after pregnancy.

Moms experiencing mental health illnesses may feel they are failing, making them afraid to tell their providers until they reach a breaking point.

Cliffel said her husband feared calling 911 while she was experiencing psychosis because he didn't want to jeopardize her custody of the children. He eventually called the police who handcuffed Cliffel before transporting her to a hospital in an ambulance.

READ MORE: As the Lindsay Clancy case highlights postpartum psychosis, a mom stricken by it shares her story of hope

Davis said "the most effective remedy" to breaking the stigma is "talking about our mental health as part of our healthcare."

Osborne agreed. She said people should know that postpartum psychosis is an illness and a complication of childbirth "just like gestational diabetes or preeclampsia."

Hatters Friedman said while it's good that people are speaking about postpartum psychosis in the wake of Clancy's trial, she worries people will equate postpartum psychosis with infantacide.

"Then people aren't going to want to seek help for it if they have symptoms, because that could stigmatize it in their mind," she said, emphasizing that the condition is treatable.

Training in reproductive mental health isn't required

It took months for Cliffel to be diagnosed with postpartum psychosis. She had been hospitalized and gone through a six-week aftercare program, where she had been told that she maybe had bipolar disorder. Then she requested to be seen by a psychiatrist who was a mother. She also happened to be an expert in reproductive psychiatry.

She said hearing her diagnosis of postpartum psychosis was "deeply helpful." She'd been feeling ashamed, but the diagnosis helped her realize "maybe I was sick."

WATCH: Forensic psychologist testifies that Lindsay Clancy has bipolar disorder

In the years since her diagnosis, Cliffel has become an advocate. She has shared her story with health care providers and facilitates support groups for women who have experienced postpartum psychosis.

Hearing other women's stories has highlighted the lack of a standard of care. She said women have to find their own way and advocate for support such as getting sleeping pills and undergoing specialized trauma therapy.

This is in part due to a lack of knowledge from clinicians, Osborne said.

READ MORE: Lindsay Clancy trial spotlights psychiatric hospital stay before she killed her 3 children

Because it's rare "many clinicians have never seen a case," Osborne said. "In addition, neither psychiatrists nor obstetricians in training are required to learn anything about reproductive mental health."

Osborne has created the National Curriculum in Reproductive Psychiatry to provide clinicians with resources. Postpartum Support International has a list of trained specialists.

Despite having existed for thousands of years, postpartum psychosis is not included in the Diagnostic and Statistical Manual of Mental Disorders, which Hatters Friedman described as "psychiatry's Bible."

This makes it less likely that doctors will learn about and diagnose the condition, experts who spoke with PBS News said.

It's "scandalous" that it's still not included, said Dr. Veerle Bergink, director of Mount Sinai's Women's Mental Health Center. "That is the starting point for everything. You first have to give something a name. You diagnose it, and then you can make treatment guidelines. You can teach psychiatric residents."

Bergink said she and other women's mental health experts worldwide are leading the effort for postpartum psychosis to be included in the manual.

The lack of good mental healthcare for postpartum women is a 'painful reality'

The U.S.'s healthcare system is full of barriers. There are long wait times and a lack of continuity of care between providers, Davis said.

"Our healthcare system is not set up to address prevention," she said.

Both Cliffel and Lage went on to give birth again without complications because they had plans in place.

Bergink said women who are at high risk of developing a postpartum psychosis, such as women who have previously experienced it or have been diagnosed with bipolar disorder, should speak with their providers to establish prevention plans.

She said it is a "painful reality" that the U.S. does not have good mental healthcare for postpartum women.

WATCH: New mothers face barriers getting the mental health care so many need

Watch the PBS News Hour segment in the player above.

"There are not enough facilities for outpatient care," she said. "There is not anything specific for women with severe mental illness after delivery, so that is a huge problem."

Hatters Friedman agrees. She contrasted the U.S. to other countries, including New Zealand, where she worked for several years. Other places, she said, have reproductive psychiatry teams and mother-baby psychiatric inpatient units.

Instead of providing good support for women and families around mental health conditions, which is the most common complication of childbirth, "we're enabling this thing to lurk in the shadows," Cliffel said.