When Bias Looks Like Trust: A Clinical Reflection on the Lindsay Clancy Case

Why listening to patients and verifying the clinical picture must coexist

By Tracey Taldon, LICSW

A Note Before Reading

This article discusses the deaths of children, suicide, severe maternal mental illness, and an ongoing criminal case. Please consider your emotional well-being before continuing.

Whether you are a mother, father, grandparent, aunt, uncle, cousin, teacher, childcare provider, pediatrician, therapist, prescriber, someone struggling to become a parent, someone who has lost a child, or someone currently raising children, the Lindsay Clancy case may touch a deeply vulnerable place.

You do not have to consume every detail of this trial to care. Take breaks from the coverage. Step away from social media commentary. Pay attention to what is happening in your body and mind. Protecting your mental health is not avoidance; it is necessary care.

At the center of this case are three children whose lives were lost, a family living with irreversible grief, and questions that no trial can make emotionally simple. Nothing in this article is intended to minimize those lives or that loss.

This Is Not an Argument About Criminal Responsibility

I am not writing to decide whether Lindsay Clancy was legally insane, criminally responsible, or aware of the wrongfulness of her actions. That determination belongs within the legal process, informed by evidence and expert testimony.

I am also not attempting to diagnose someone I have never evaluated.

My focus is much narrower: I am deeply troubled by portions of the publicly reported testimony concerning the mental health care Clancy received before the deaths of her children—and by what that testimony may reveal about professional due diligence, fragmented treatment, and the ways bias can influence clinical judgment.

Public reporting of trial testimony indicated that one treating psychiatrist did not have or seek records from Clancy’s other recent psychiatric treatment and relied on Clancy to disclose the information relevant to her care. Other testimony reportedly indicated that clinicians involved in an inpatient hospitalization did not communicate with her outpatient providers. These reports do not give the public access to the entire clinical record, and they do not, by themselves, establish professional negligence. They do, however, raise serious questions about whether the available pieces of a complex clinical picture were ever adequately brought together.

Trust Is Not a Clinical Record

Listening to patients is essential.

People must feel emotionally safe enough to disclose what they are experiencing. They deserve to be treated with dignity, believed when they describe their suffering, and included as active participants in their treatment. A therapeutic relationship cannot be built on suspicion.

But listening to a patient and independently verifying important clinical information are not competing responsibilities.

Self-report is one vital source of information. It is not always the only source that should guide diagnosis, risk assessment, or prescribing—particularly when someone has seen multiple providers, recently transitioned between levels of care, experienced repeated medication changes, or presented with worsening and difficult-to-explain symptoms.

Professional due diligence may include obtaining appropriate releases, requesting prior treatment records, reviewing hospital discharge information, confirming current and recently discontinued medications, understanding previous medication responses and side effects, communicating with other providers, obtaining collateral information when clinically indicated and legally permissible, and documenting what information remains unavailable.

The American Psychiatric Association describes psychiatric evaluation as a process that integrates the patient interview with medical records, diagnostic information, and collateral sources. Its guidance also recognizes prior psychiatric records, family members, and other treating professionals as potentially important sources—especially when the clinical presentation is complex or unstable.

Medication reconciliation is equally important. The Agency for Healthcare Research and Quality recommends developing a shared and verified medication list—a reliable “source of truth”—and incorporating reconciliation into transitions and handoffs between providers and settings.

Being a nurse does not eliminate the need for those safeguards. A labor and delivery nurse may possess considerable medical knowledge, but labor and delivery nursing is not psychiatric prescribing. A patient’s health care occupation should never become a substitute for a provider’s independent assessment, documentation, and clinical judgment.

Bias Does Not Always Look Like Disbelief

When we discuss bias in health care, we often focus on patients who are dismissed, doubted, stereotyped, or viewed with suspicion. That form of bias is real and harmful.

But bias can also look like unquestioning trust.

It can sound like:

She is educated.

She is a nurse.

She is married.

She has family support.

She has resources.

She understands the health care system.

Those qualities may lead a provider—consciously or unconsciously—to view someone as especially reliable, capable, stable, or able to manage her own care. That perception can create a different type of clinical blind spot: not excessive suspicion, but insufficient scrutiny.

I cannot know whether Lindsay Clancy’s race, socioeconomic status, marital status, or profession affected the decisions of any individual provider. The publicly available information does not allow any of us to make that conclusion with certainty.

But ethically, we must be willing to ask the question.

Would a Black mother have been granted the same degree of credibility?

Would an immigrant mother have been trusted to accurately direct a complicated medication history without providers obtaining records?

Would a low-income or single mother have been given the same access to multiple medication changes without being labeled “medication-seeking,” “noncompliant,” or “unstable”?

Would child-protection authorities have been contacted earlier if the mother had fewer resources, less professional status, or less social privilege?

We cannot prove what would have happened in a hypothetical case. We also cannot pretend that our systems operate without racial and socioeconomic inequity. Recent research continues to document persistent differences in the diagnosis and treatment of perinatal mental health conditions among Black, Hispanic, and white mothers.

Massachusetts child-welfare data also provide reason to examine how differently families experience intervention. In one FY2025 statewide quarterly profile, Black children represented 14% of DCF-involved children under 18 but 34% of children in placement. That statistic does not explain every individual decision, but it does demonstrate why concerns about unequal scrutiny cannot simply be dismissed.

No mother should be over-surveilled because she is Black, an immigrant, poor, unmarried, or unfamiliar with the health care system.

And no mother should be under-assessed because a provider interprets whiteness, affluence, marriage, education, or professional status as evidence of safety.

Both are failures of equitable care.

Consistent Standards, Individualized Treatment

Equity does not require identical treatment for every patient. Treatment must always be responsive to the person’s symptoms, history, culture, circumstances, risks, strengths, and needs.

But the clinical standard should remain consistent.

Every patient deserves a careful assessment.

Every patient deserves medication reconciliation.

Every patient deserves appropriate coordination across providers and levels of care.

Every patient deserves thoughtful risk assessment and follow-up.

Every patient deserves documentation that clearly communicates the clinical picture to the next professional responsible for her care.

When records cannot be obtained, that limitation should be documented and incorporated into clinical decision-making. When information conflicts, the conflict should be explored. When symptoms change, the assessment should change with them. When several clinicians are involved, responsibility for communication cannot be left to assumption.

The lesson is not that providers should distrust their patients. The lesson is that we should never abandon professional judgment in the name of trust.

Compassion without clinical rigor is incomplete.

Clinical rigor without compassion is harmful.

Ethical care requires both.

What I Hope We Learn

It is not reasonable to expect mental health professionals to predict every tragedy. We cannot guarantee outcomes, and hindsight can make warning signs appear clearer than they were in real time.

My disappointment is not rooted in the belief that one provider should have been able to foresee the unimaginable. It comes from the publicly reported indications that relevant records, medication histories, and communication among treating professionals may not have been fully integrated while a mother’s condition was becoming increasingly complex.

This should not become an invitation to scapegoat one clinician. Mental health care in this country is fragmented. Providers are often working across disconnected systems, incomplete electronic records, limited appointment times, administrative barriers, and difficult confidentiality requirements.

But fragmentation does not relieve us of the responsibility to try to assemble the fullest clinical picture possible.

The tragedy at the center of this case should not become spectacle. It should become a reckoning—with how we coordinate care, how we document, how we prescribe, how we assess risk, and how race, class, occupation, and social status may quietly alter the standards we apply.

Every patient deserves to be heard and respected.

Every patient also deserves to be taken seriously enough for us to do the work behind the listening.

Trust and verification are not opposites. Together, they are care.

Support Resources

Anyone in the United States experiencing emotional distress or a mental health crisis can call or text 988 for free, confidential support, 24 hours a day.

Postpartum Support International provides information and support referrals related to perinatal mental health at 1-800-944-4773. Its HelpLine is not an emergency or crisis service.