One thing I don’t get about the case is people saying everyone failed her. Her husband made a ton of money, she had great health insurance and lots of health care from what I can tell. She had a nanny, family to help her out. She had a background in medicine.
There are people with none of that. Society fails them all the time. I don’t understand the argument that society failed someone who had so many guardrails. Maybe that’s what they mean, even with all the guardrails you can still lose contact with reality and do something terrible.
I haven’t been following the case very closely, so I have no idea how many times she asked for help and was blown off though. Like if she asked to be admitted in-patient due to PPP and was turned down or sent home.
It does make sense to them, but supposedly the delusions that happen during psychosis are fairly consistent across different kinds of psychosis (mania, schizophrenia, post partum, drug induced, etc).
Delusion of control: False belief that another person, group of people, or external force controls one’s general thoughts, feelings, impulses, or behaviors.[7]
Delusional jealousy: False belief that a spouse or lover is having an affair, with no proof to back up the claim.[7]
Delusion of reference: False belief that insignificant remarks, events, or objects in one’s environment have personal meaning or significance. “Usually the meaning assigned to these events is negative, but the ‘messages’ can also have a grandiose quality.”[7]
Erotomania: False belief that another person is in love with them.[7]
Religious delusion: Belief that the affected person is a god or chosen to act as a god.[11]
Somatic delusion: Delusion whose content pertains to bodily functioning, bodily sensations or physical appearance. Usually the false belief is that the body is somehow diseased, abnormal or changed.[7] A specific example of this delusion is delusional parasitosis: Delusion in which one feels infested with insects, bacteria, mites, spiders, lice, fleas, worms, or other organisms.
Delusion of poverty: Person strongly believes they are financially incapacitated. Although this type of delusion is less common now, it was particularly widespread in the days preceding state support.[12]
She had delusions of control, where she felt something was controlling her. If you tell someone their beliefs are false they will just reject that. But psychotic delusions tend to be a mix of these 11 themes, that’s my understanding.
That’s the tragedy. She had access, more than most, was trying to get help, begging for help, and …
Full disclosure here. My wife had three episodes of severe postpartum mental illness, none including psychosis, but very severe. She was not herself during those times. Planning options of suicide was more my worry but she could definitely plan. We had safety plans. We made regular assessments. And I was constantly scared shitless. First episode was while I was in internship. We often had her and our baby in our hospital call room when I was on call rather than leave her and him alone. Out of episode an entirely different person
First episode was over 40 years ago. And system wide really nothing is better now.
As a pediatrician at the time I had nothing in my training about this illness. One of the things I am most proud of in my career is that after living through this I succeeded in getting an article into the standard pediatric continuing education publication in the importance of pediatricians screening for postpartum mental illness, demystifying, and referring for help. Not just for the mother’s sake but for the kids’ sakes as well.
Yes decades later we screen better. I overstate that nothing is better. But this was a system fail.
How this individual begging for help, who should have been admitted as a danger to herself and others, in other countries would be a literal “mother baby unit”, was left not only to manage as an outpatient, but by herself with her children is … both mind boggling and unsurprising at the same time.
The crack is not narrow; it is a fucking crevasse.
It is clear that she had access to help. However, this help may have failed her. Let me clarify what the defense is arguing given her mental health treatment. First of all, she is currently being treated for bipolar disorder. In contrast to unipolar depression, bipolar disorder can include manic episodes which can include psychosis. Manic patients can fail to sleep, overspend, become hyperreligious , and act irrationally. It is well known that given standard antidepressants to bipolar patients can precipitate mania.
She presented with signs of depression (even calling a suicide hotline) and was given standard antidepressants. When she claimed that they caused her increased anxiety and insomnia she was given sleep medication. A second psychiatric practitioner took her off the antidepressant but prescribed another one of the same class. When she continued to complain of insomnia and agitation they added more antianxiety medication. She voluntarily committed herself to a mental hospital because she said she needed help. They proceeded to add an antipsychotic that in low doses is used for sleep. Although bipolar disorder was considered, she was never tried on appropriate medication for it. As soon as she said she was not actively suicidal, she was sent home from the hospital.
In the end, though, I look at cases where mothers deliberately killed their children and these mothers try to cover it up, claim someone else did it etc. There just aren’t cases of people deliberately planning to kill their children then planning to cover it up by claiming insanity because they know they will be in a mental institution indefinitely. In addition, they might try to fake some injuries to claim that they were victims of crime also but they don’t do things that can kill or permanently injure themselves. Contrast this case with the Susan Smith case where she tried to cover up her crime, and acted rationally with a plan and a motive. This is much closer to the Andrea Yates case.
Many of those seeking a guilty verdict seem to me to be stuck on the fact that she killed her children which is an inexcusable crime so she must be punished. Just try to imagine that you are convinced that something terrible is going to happen to your children and the only way to save them is to get them to heaven before that happens and that you can join them there and you all will be safe together in the afterlife. You are not trying to rid yourself of your children to make your life better; you are trying to get all of you to a safe place together. Then you get treatment for your psychosis and realize that you killed your children that you loved and are now paralyzed for life. It would be horrific but more importantly, if properly treated she would not be a danger to others. What good does it do to lock her up in prison? She needs mental health treatment. The US is focused on prison for punishment rather than looking at what benefits society the most, such as locking up those likely to commit more crimes if freed. I’m not saying to let her go free. But confine her to a mental institution where she has the possibility of getting better.
I believe this is going to happen regardless of the outcome of the trial. It is my hope that she won’t be sent to a prison where she gets very little treatment. Honestly, being paralyzed now, few prisons are capable of dealing with her anyway.
Whatever happens, I don’t think she will choose to live for very long.
One thing about this situation is that it doesn’t seem like she needs psychiatric treatment. She was in a psychotic state at that moment, but it’s unlikely that she’s going to be in that state ever again. I’m not sure what the point would be to put her into a mental institution. Her case is different than someone like Nick Reiner. In his case, he is mentally ill in a way that will likely not get resolved. His condition will need to be managed by medication and constant supervision. But Clancy is not like that. Her situation was a one off. As long as she doesn’t get into the postpartum depression state, she is fine. It’s kind of like someone who gets in an impaired state with drugs or alcohol and commits a crime. The person may never commit that kind of crime when their head is clear, but if they take certain mind altering substances, they may have thoughts, behaviors, and actions that they normally wouldn’t have.
Even though she may not been in control of her actions at the time, there was a long period of time before that where she could have gone down a different path. She could feel herself losing control. At some point along the way, she would have had enough control to change things. It’s somewhat similar to how we treat DUI crimes. If a drunk driver kills someone, we don’t absolve them of the killing because they were too impaired at the time to be in control of their actions. We hold them accountable because at some point between the first drink and the last, they had enough mental capacity to stop drinking. I don’t think we can hold someone like Reiner to that standard since his brain wiring may not be capable of making that kind of decision. But assuming that Clancy is otherwise without mental illness, she should have been able to stop herself at some point from getting to the point she did.
Regarding John Hinckley, I recall that a proposal was made to allow a verdict of “guilty but insane.”
I don’t know how that proposal ended up, and wonder whether or not any state or the federal government has adopted it. I imagine that it would give the authorities the power to confine the guilty person until they had been cleared by several qualified psychiatrists.
They really aren’t. I’m the medical attending at one such hospital, and it’s actually a nice place. There’s none of the stereotypical Hollywood horror movie stuff like straightjackets, electroshock therapy, burly orderlies that hold patients down while they get injected with drugs to make them drooling zombies, a back room where lobotomies are performed, etc. The units aren’t dimly lit halls, but are rather large circular areas with the individual rooms being smaller (but still quite spacious) semicircular spaces that open onto the main unit. There’s all kinds of available recreation including a gym, an in ground pool, and a large courtyard where the patients can watch the squirrels frolicking and be merry (along with all sorts of other wildlife including sandhill cranes and monk parakeets - if it wasn’t for patient privacy concerns I’d be taking pictures there every day). The only major problem I see is that patients sometimes get discharged too soon due to insurance / funding reasons.
And that’s my concern when someone is sentenced to a mental health facility when found not guilty by reason of insanity. That they will be released and then decompensate again once out due to no longer being in a controlled environment.
I’m glad it’s nice where you work. And no one has said anyone is doing the things you listed.
However, we heard many cases involving attacks by inmates on other inmates resulting in some pretty horrendous injuries or even deaths. Amazing the things that can be turned into weapons where someone is determined to do harm.
Also, in the facility where we had jurisdiction, such things as involuntary feeding tubes and padded leather helmets were employed after the court made a determination that such interventions were warranted and necessary. If restraints were required to accomplish these tasks, then they were employed. As were the “burly” orderlies. These commitments were in no way voluntary or paid by insurance.
Where I live now, I regularly drive past a fairly new facility. It sits like a concrete block in the middle of a large acreage, surrounded by outer razor wire fencing and very tall inner wire chain link. The windows are tiny and slot-like. Doesn’t look like a very pleasant place to pass one’s time, although I’m sure it’s nice enough inside in the common areas.
A voluntary inpatient psych ward where you work is a vastly different thing than a public funded involuntary state or regional facility ( what used to be called asylums). The latter are almost indistinguishable from prisons. People judged innocent by reason of insanity go into the latter, razor wire and restraints, forced medication and all.
What would happen to her if she went to this kind of facility? She doesn’t need therapy or meds. She’s not mentally ill in a way that needs treatment. Would she still be treated as a psych patient and given forced meds?
I entered this thread with the operating assumption that she was psychologically normal before the post partum psychosis kicked in.
But is that assumption true? At least some of what folks cited upthread seemed to be saying she had mental problems, specifically bipolar, before she delivered the kids. If so, it’s a decent bet those problems continue today. And may have been worsened by the postpartum psychosis. And certainly won’t have been helped after that by the dead kids, the fall/jump out the window, the paralysis, and now the trial(s).
So: Is there any reliable info out there about her mental condition well prior to the kids being born, or recently?
I know of nothing reliable about her having any psychiatric diagnosis outside of the postpartum period but I can share some known statistics.
Postpartum psychosis most commonly occurs in women without any previous psychiatric diagnosis but when there is a previous psychiatric diagnosis it most commonly is bipolar disease.
In the converse women with bipolar disorder are at a roughly 17% risk of developing psychosis in the postpartum period. The condition is otherwise rare: about 0.1 to 0.2%.
Women who have postpartum psychosis have a roughly 50% chance of being diagnosed with bipolar disorder in the future (and low rates of schizophrenia). Plus minus depending on the study.
Translate that to these specifics with having killed her children, paralyzed herself, while in the psychotic state … as you see fit.
A lot of times, it’s having the kids that triggers it.
I had a friend when I was a teen. She was always a little different, just a socially awkward girl with some offbeat interests.
After her first kid, she started to get pretty strange, but nothing that would raise concerns. After her second, she lost it within several months, and she’s been confined to a nursing home as a bipolar schizophrenic for the past 25 years.
I was made aware of this fact a couple of years ago, so I called her, and we talked for a long time. She became distraught at one point, when she recounted that her kids had both died in prison.
I spoke with her daughter later on, and she had no recollection of having died in prison. (“Mom said what? Oh. My. God.”)
I call her now and then, and it’s almost like talking with my old friend again (except she’s hyper-religious now). Then a delusion slips in, and things go off the rails for a few minutes. I assume she’s properly medicated.
True words. It’s hard to understand until it happens to you or one of yours. In this time women’s health is not taken seriously until the unthinkable happens. With the way things are society/polititics wise at this point I don’t see any of it getting better.
I mentioned above my daughter’s struggle with postpartum preeclampsia. An easy to diagnose physical illness that while not common is more likely than postpartum psychosis. She had every symptom and was treated like she was was wasting their time. I can just imagine what would have happened at that hospital if she’d been suffering like Clancy. A bum’s rush to the exit with a head pat and a call your doctor honey.
She could have died. If Clancy had been admitted and treated appropriately her kids would still be alive and her life wouldn’t be a future of imprisonment of some sort, and constant anguish for her actions. I wouldn’t be surprised if she finishes the suicide attempt at some point in the future. It’s so tragic and it didn’t have to be that way.
Just to be pedantic - not quite a recognized label. Could be bipolar type I with psychotic features, or schizoaffective bipolar type? The difference is the timing of the delusional episodes in relation to the mood episodes.
Not that it matters. Tragic. And point intended to be illustrated made.