Could Clancy’s postpartum mental health history change how jurors view her case?

 On day 21 of Lindsay Clancy’s triple-murder trial, jurors heard a forensic psychiatrist deliver a critical opinion about her state of mind. Dr. Gregory Saathoff testified that Clancy was suffering from a mental disease or defect when her three children were killed, but he said his evaluation led him to a different conclusion about her legal responsibility.

Saathoff told jurors that, in his opinion, Clancy understood the difference between right and wrong and remained criminally responsible for the deaths. He said the voice she reported hearing did not provide specific instructions about killing her children, choosing a method, dying by suicide, or carrying out her own death. Despite that lack of detailed direction, Saathoff said she was able to act within a relatively short period

Psychosis, he explained, does not automatically eliminate a person’s ability to recognize right from wrong. Some people experiencing command hallucinations can understand that a perceived instruction conflicts with their values and may resist or refuse it. Saathoff said he believed Clancy had a mental disease or defect at the time, and he would consider bipolar II disorder as a possible diagnosis, but he ultimately found her criminally responsible.

Several events on January 24, 2023, shaped that assessment. Saathoff pointed to Clancy answering a phone call from her husband, Patrick Clancy, while he was running errands, reassuring him, and not revealing what was occurring inside the home. In his view, the conversation helped keep Patrick away rather than prompting him to immediately return. He also cited her apparent awareness of time, the fact that she locked the door, and her failure to confess or tell Patrick she was experiencing auditory hallucinations when he came back.

Another element involved what Saathoff believed Clancy intended for herself. He testified that she expected to die by suicide before Patrick returned and believed she intended to complete that act. Taken together, he said these circumstances supported his conclusion that she retained enough awareness and control to be considered legally responsible. He ultimately expressed that opinion to a reasonable degree of medical certainty.

Defense attorney Reddington then challenged Saathoff’s qualifications, compensation, and professional experience. Saathoff said he works for a university and also has professional involvement with the FBI, the Virginia Department of Corrections, and college students. He acknowledged that an examination closer to an incident can offer advantages, but said he did not evaluate Clancy until May 29 and June 4, 2026.

The defense also examined Saathoff’s experience with postpartum psychiatric conditions, including psychosis. He testified that earlier in his career he had treated two women with postpartum psychosis involving symptoms such as auditory hallucinations, delusions, mania, and suicidal behavior. Attorneys further explored Clancy’s history of postpartum depression and anxiety, including an Edinburgh Postnatal Depression Scale score that reached 23, above the level generally considered concerning.

According to the testimony, Clancy initially did relatively well after her son Callan was born, but her condition deteriorated toward the end of summer. By October, she had asked her mother to stay with her because of worsening anxiety, reported that anxiety medication seemed to make her feel worse, and expressed fear about being alone. Records also showed that she contacted the Aspire suicide prevention hotline twice and was referred to her healthcare providers, although she reportedly did not disclose a specific suicide plan at those times.

The defense later questioned whether stopping breastfeeding and medication changes could have affected Clancy’s mental state. Saathoff acknowledged that ending breastfeeding can produce hormonal and neurotransmitter changes that may influence mood and psychiatric symptoms, but he testified that those effects would likely have resolved by January 2023. He also distinguished serious medication side effects from being overmedicated, saying the records did not convince him Clancy had been prescribed a dangerously excessive amount. His testimony leaves jurors weighing competing evidence about mental illness, behavior, and responsibility.