Lindsay Clancy messaged one of her caregivers less than two months before she killed her three young children in 2023 to say she was having "intrusive thoughts I never had before," "feeling completely hopeless" and worried about becoming addicted to some medications.
Rebecca Jollotta, a psychiatric nurse practitioner at South Shore Health Perinatal Behavior Health Program, testified at the trial Tuesday she exchanged messages with Clancy regularly on a patient portal throughout in late November and December 2022. Much of their conversations revolved around Clancy reporting trouble sleeping, depressive symptoms she was having and her search for the right mix of medications to treat her symptoms.
Several times Clancy indicated to Jollotta either that she had not taken the full dose of a prescribed medication or that she wanted to reduce a dosage or change her prescription based on what she felt were intolerable side effects. Clancy also worried about being addicted to some medications like Ativan, but Jollotta said she was not.
___
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.
___
Struggle to find the right medications
“I really don’t like the way I feel on the Remeron and I know that I can’t stick with taking it,” Clancy said in a December message asking to switch from the antidepressant, which also is used to treat anxiety and insomnia, to a previous prescription mix. “I started having very intrusive thoughts that I never had before.”
Jollotta tried to assure Clancy that having intrusive thoughts is common with someone diagnosed with postpartum depression and anxiety and encouraged her to give the Remeron more time to work since she had only been on it a few days.
“This could be some postpartum anxiety. And I wanted to familiarize her with the symptoms, so that she had them written down and she could report them to me,” Jollotta said.
Jollotta, who is among several providers that Lindsay and her former husband Patrick Clancy have sued over her care, repeatedly came up with alternative treatment plans for Clancy including a range of different medications, behavioral therapy, support groups and meditation. But she acknowledged that it was up to Clancy whether she chose to follow her advice.
“I’m only making recommendations based on my education experience, training and what I’m seeing in terms of symptoms,” Jollotta said. “The patient has the autonomy.”
During their virtual and in-person visits, Jollotta said, Clancy never talked of having a plan to harm herself or her children. She also never showed signs of psychosis or mania.
But Jollotta acknowledged that Clancy did report having thoughts of suicide. She also suggested that Clancy might have underlying bipolar disorder — due to her days of going without sleep. But Patrick Clancy denied that was the case.
Suicidal thoughts
In mid-December, Jollotta had a call with the couple and was told Clancy had her “worst day” and was “having persistent, intrusive thoughts of suicide.” Jollotta suggested she consider a higher level of care such as that offered by Massachusetts General Hospital. She settled on the Women and Infants Hospital postpartum program in Rhode Island t but was soon discharged — with advice to stop taking one of her antipsychotic medication.
Jollotta, who was going on vacation, said she was concerned that Clancy had been discharged from the hospital, telling her in a message that she could “could benefit from the groups and added support separate even from medication changes.”
She was worried the hospital wanted Clancy to go off Seroquel, the antipsychotic medications. Clancy was advised this could lead to “worsening of mood, worsening of sleep,” but she insisted on going off the medication. Jollotta agreed to slowly reduce the dosage.
During cross-examination Clancy's attorney Kevin Reddington argued that Jollotta was not familiar with the care Clancy received elsewhere.
Jollotta never talked to one of Clancy's psychiatrist, Dr. Jennifer Tufts, nor did she access Tuft's medical records. She did not know how many times Clancy saw Tufts, noting that she only thought Tufts treated Clancy in September.
“Would it surprise you if I told you that she saw Dr. Tufts 14 times” during a four-month period ending in January, Reddington said.
Jollotta never talked to anyone from the Rhode Island hospital that admitted Clancy, nor did she have access to the records of McLean Hospital, a psychiatric facility that Clancy admitted herself into on New Year’s Eve.
“If you're treating a person through all of this stuff that we've talked about and it’s now apparent that things have decompensated so bad that they have voluntarily admitted her to a locked ward in a mental institution, is it important to Rebecca Jollotta to find out what the diagnosis and treatment was of their patient?” Reddington said.
Jollotta agreed it was but acknowledged that she never did find out.
Killer, or someone who was mentally ill
Clancy, 36, has pleaded not guilty to murder charges in the deaths of Callan, Dawson and Cora Clancy, who ranged from 8 months to 5 years old. They were found in the basement of the family's home in coastal Duxbury, Massachusetts, where their mother was lying in the yard. She had jumped from a second-story window, and she remains paralyzed from the waist down.
Prosecutors argue that the former labor and delivery nurse was an intentional killer who contrived to get her husband out of the house and then strangled the children with exercise bands on Jan. 24, 2023. Prosecutor Shanan Buckingham has urged jurors not to view the trial as "a public debate about women's mental health and how the medical system treats women."
Clancy’s attorneys do not dispute that she killed the children. But they say she should not be held criminally responsible because she was mentally ill, believing she heard voices ordering her to take their lives and her own.
The defense says she was in the grip of bipolar disorder and postpartum psychosis, a rare postpregnancy condition that can alter a woman's sense of reality. A forensic psychiatrist diagnosed Clancy with those conditions after the killings.