Who Is Allowed to Lose Her Mind?

Three children are dead. Cora, Dawson, and Callan Clancy were five, three, and eight months old.

As a pediatric surgeon and mother, my first reaction was the same as yours: How could she? How could anyone?

Then the trial began, and I watched Lindsay Clancy, a labor and delivery nurse, sit at the defense table while hundreds of supporters lined the streets, her  “Pink Rally” and the mommy bloggers posted daily from Plymouth. I decided I knew how this would end. Not because of her lawyers. Because of the crowd. Every image was of a blank-faced Lindsay Clancy. Her children had already become footnotes.

I was wrong about the ending. After five weeks, more than eighty witnesses, and seven days of deliberation, the jury split eleven to one in favor of not guilty by reason of lack of criminal responsibility, and Judge William Sullivan declared a mistrial. She will likely be tried again this fall.

I was not wrong about the crowd.

The story a jury could believe

The defense had material to work with. Five providers who never spoke to one another. Repeated crisis evaluations. Thirteen different psychiatric medications across more than thirty prescriptions in four months. An emergency room that turned her away from inpatient care.

Her lawyers told a story the public was ready to hear: a loving mother failed by a fractured system that could not even name what was happening to her. “Postpartum psychosis” still does not exist as its own diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition); it is a specifier bolted onto other conditions, which means clinicians do not have a shared language for the emergency in front of them. Her actions were framed as the tragic byproduct of a biological malfunction, not a choice.

What mother has not felt overwhelmed, desperate, and alone? That question bought her a “Pink Rally”, a defense fund, and eleven jurors.

The same courtroom, a different mother

For every Black and Brown mother watching, there was a quieter recognition: if this had been our story, there would have been no rally and no fund. And a jury would not have needed seven days.

I know this not because I am a Black woman or because I am a doctor. I know it because of Latarsha Sanders.

In February 2018, Sanders, a Black mother from Brockton, stabbed her two sons, ages five and eight, to death. Before the killings, her family watched her disappear into delusions about secret societies and rituals. After her arrest, she was evaluated and diagnosed as grossly psychotic, with a severe schizophrenia spectrum disorder. Her own lawyer argued insanity. The prosecution’s psychiatric expert agreed she was in the grips of paranoid schizophrenia.

The jury never saw it. Thousands of pages of psychiatric records documenting her hallucinations and paranoia were excluded from the trial. The prosecutor told jurors she was “evil,” that she was playing “the crazy card,” that she killed her sons to write a book about it. In December 2022, they deliberated for about four hours and convicted her of first-degree murder. Two mandatory life sentences.

The courtroom was Plymouth County Superior Court. The judge was William Sullivan. The district attorney was Timothy Cruz, the same as in the Clancy trial. Sanders was sentenced one month before Lindsay Clancy killed her children.

It took until August 6 of this year, three weeks before the Clancy jury heard closing arguments, for the Supreme Judicial Court to vacate her convictions unanimously. The court ruled that excluding her medical records was prejudicial error. She will get a new trial. Most of you had never heard her name until the Clancy verdict put it back in the news.

Medicine answered the question before the courts did

The disparity between four hours and seven days is not a legal accident. It is downstream of the same bias that operates in the clinic, where the question “who is allowed to lose her mind” gets answered every day, long before anyone reaches a jury.

Black and Brown mothers experience perinatal mood and anxiety disorders at roughly twice the rate of white women and are less likely to be screened, diagnosed, or treated. When a mother of color breaks, the system does not let her see five providers or hand her thirteen prescriptions or extend her the benefit of the doubt. Her pain is read as hostility. Her illness is flagged as a child welfare risk. Her crisis is criminalized.

Bias decides who gets a doctor and a diagnosis, and who gets a cell.

Three mechanisms drive it:

The screening gap. Black mothers are about half as likely as white mothers to receive treatment for postpartum depression, driven by unexamined clinical bias and screening tools that were never validated in our communities.

The bad-mother trap. Providers are more likely to report low-income mothers and mothers of color to child protective services for the same postpartum symptoms that earn white mothers a referral to a psychiatrist.

Clinical dismissal. Black women face two to three times the rate of severe maternal morbidity, the near-death complications of pregnancy and delivery. A large share of that gap traces to the same reflex: self-reported pain and psychological distress, dismissed.

Stop waiting for the tragedy.

The Clancy trial is not the story. It is a mirror. It shows a system that relies on twelve strangers to adjudicate a crisis that should have been caught in a doctor’s office months earlier, and that only reliably extends that second look to some mothers.

The grace Lindsay Clancy received was not wrong. The rationing of it is the scandal.

Here is how we close the divide:

Demand universal, bias-free screening.

Every OB-GYN practice and hospital system should be using standardized perinatal mental health screening on every mother, validated across populations, with a clear treatment pathway when it flags.

Diversify the perinatal workforce, and make it findable.

Fund and champion the organizations training Black and Brown midwives, doulas, and psychiatric nurse practitioners.

Patients report more trust and achieve better outcomes when their care team shares their lived experience. But training those providers is only half the problem. Lindsay Clancy saw five clinicians in four months. Most mothers of color cannot find one who will believe them, and the search itself- phone call after phone call while you are falling apart- is where many give up. That gap is why I built Inclusive Health Match: a platform that connects patients to providers vetted for cultural competence, so a Black mother in crisis isn’t starting from a blank Google search. It does not fix biased screening tools or a child welfare system that treats her illness as a threat. It does shorten the distance between when she knows something is wrong and when someone qualified takes her seriously.

Decriminalize mental illness in our communities.

Hold local courts and child welfare agencies accountable. A psychiatric crisis in a Black or Brown home should be met with a crisis response team and a medical bed, not handcuffs and a family separation.

A healthcare system is measured not by how well it protects its most privileged patients. It is how safely it catches the most vulnerable.

Empathy is not a luxury reserved for a select few mothers. It is the standard of care.

If you are a mother who is not being heard, or you love one, you can search for a provider at app.inclusivehealthmatch.com. If you are a clinician who does this work well, especially in perinatal mental health, join the network.

The next Latarsha Sanders is looking for you right now.