Lindsay Clancy trial: Former psychiatrist's testimony puts postpartum care under scrutiny
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PLYMOUTH, Mass. — Dr. Jennifer Tufts, the psychiatrist who treated Lindsay Clancy in the months before her children's deaths, spent two days on the witness stand this week, giving jurors a detailed account of Clancy's mental health treatment and answering sharp questions about her own experience.
Tufts began treating Clancy in September 2022, about four months after the birth of Clancy's third child. Their sessions continued through January 2023, when prosecutors say Clancy strangled her three children — Cora, 5; Dawson, 3; and Callan, 8 months — with exercise bands at the family's Duxbury home. Clancy then cut her wrists and neck and jumped from a second-story window, authorities allege. She survived but is paralyzed.
Clancy, 35, has pleaded not guilty to three counts of murder. Her defense argues that she was suffering from postpartum depression and psychosis at the time of the killings and therefore lacks criminal responsibility.
Tufts was called by prosecutors on Aug. 7, the ninth day of testimony. She returned to the stand Aug. 10 for cross-examination by defense attorney Kevin Reddington and redirect questioning. At several points, her exchanges with Reddington grew tense enough that Judge William Sullivan told both sides to let the other finish speaking.
According to Tufts' testimony, Clancy initially sought help because she was having trouble sleeping and felt anxious. She was reluctant to take medication, worried about side effects. At their first session on Sept. 15, 2022, Tufts prescribed sertraline, commonly sold as Zoloft, starting at 25 milligrams before increasing to 50 milligrams after a week. Tufts diagnosed Clancy with generalized anxiety disorder and adjustment disorder with depressed mood.
At their next appointment, Clancy said she had picked up the prescription but decided not to take it. By late October, she told Tufts she had started the medication about a week earlier but had negative side effects after increasing the dose. Tufts advised her to stop and suggested natural remedies instead. “It was because she seemed reluctant to start a prescribed medication. I thought she might be more open to something that was natural,” Tufts testified.
The next day, Tufts prescribed lorazepam, or Ativan, 0.5 milligrams as needed for severe anxiety. Five days later, Clancy said the medication helped with anxiety but not sleep, and that she was relying on Benadryl. Tufts later prescribed buspirone, 5 milligrams twice daily, and hydroxyzine, 25 milligrams daily, but said Clancy remained wary of taking new medication.
In November, Clancy began treatment at the South Shore Perinatal Behavioral Health clinic, where other providers prescribed additional medications. By December, she told Tufts she was having intrusive thoughts and felt close to suicidal thinking. Tufts testified that Clancy denied active suicidal ideation at the time: she felt hopeless, but had no plans, intentions, or thoughts of hurting herself.
During that stretch, Clancy was evaluated at Massachusetts General Hospital for suicidal thoughts and later admitted to McLean Hospital, a psychiatric facility.
Tufts said that in her treatment of Clancy, she never saw signs of psychosis or mania. But a note she wrote after an Oct. 21 appointment became a point of contention. Tufts' note said “not hyper, pressured speech.” Pressured speech is the kind of rapid, continuous talking that can signal mania. Reddington read the note as showing Clancy had pressured speech. Tufts said the “not” applied to both phrases — that she meant Clancy was not hyper and not displaying pressured speech. “I don't care what it says. I know what I meant,” Tufts said.
Reddington also pressed Tufts on how much experience she had in postpartum care. Tufts graduated from the University of Vermont's medical school in 2018, completed a psychiatry residency at Boston Medical Center in 2022, and had been practicing independently at Aster Mental Health for about a month when she first saw Clancy. Asked how many women she had treated for postpartum psychosis in that month, she said, “In the span of one month, I would say none because it's a very rare disorder.” She estimated she had treated “maybe a couple” patients with postpartum depression in that period and many more during her residency.
Tufts also faced questions about her bio on Aster Mental Health's website, which listed perinatal psychiatry as an area of expertise. Reddington asked if that would be negligent or misrepresentation if she had only a month of independent practice plus residency. “I do not believe that I have been negligent,” she replied.
On redirect, Tufts said she had spent about a year in an obstetrics clinic during her residency working with pregnant and postpartum patients, and had cared for many patients with psychosis during that time.
Tufts' testimony may have added context to a case that hinges on Clancy's state of mind. Her care is also under scrutiny outside the criminal trial: Tufts is named in two civil medical malpractice lawsuits, one brought by Clancy and one by Patrick Clancy, the children's father.
The trial has focused attention on how postpartum mental health conditions are recognized and treated. For the jury, the central question remains whether Clancy was so impaired by depression or psychosis that she cannot be held criminally responsible. The answer could turn, at least in part, on how much her doctors knew — and when they knew it.