Episode Transcript
[00:00:00] Speaker A: Welcome back to Spill the Tea Unfiltered.
[00:00:02] Speaker B: Hey, guys.
[00:00:04] Speaker A: Hey, everybody. And today we're back with Suzanne Fortnum, our licensed professional counselor who comes on the podcast for us. And we have a very on topic topic today, don't we?
[00:00:16] Speaker C: Yeah, we sure do. Hi, guys.
So today we are actually going to be discussing not the Lindsay Clancy trial, but the mental health piece tied to the Lindsay Clancy trial.
So I just want to give everyone a little bit of a disclaimer because this episode might be triggering for people.
This episode discusses mental health, postpartum mental illness, intrusive thoughts, psychosis, suicide, and the deaths of children. So please take care of yourself while you're listening. The information shared in this episode is for informational and educational purposes only and is not intended to diagnose or treat any mental health condition or replace individualized care from a qualified healthcare or mental health professional.
So while we'll be discussing clinical concepts raised by Lindsay Clancy's case, I have not evaluated Lindsay Clancy, and I want to be clear that I am not diagnosing her. Nothing discussed in this episode should be interpreted as.
As clinical opinion about her diagnosis, criminal responsibility, or the appropriate verdict in her case. If you're concerned about your own mental health or the mental health of someone you love, please seek support from an appropriate mental health care professional. Postpartum psychosis and any situation involving immediate risk of harm to yourself or someone else requires emergency information.
So I.
One of the reasons why we discussed having this episode is that the Lindsey Clancy trial has generated intense public discussion.
[00:01:59] Speaker A: Yes, it has. It really has.
[00:02:01] Speaker B: Yeah.
[00:02:01] Speaker A: Everybody, I mean, everybody. It's all over TikTok. It's all over everybody's socials.
Everybody has an opinion, for sure.
[00:02:10] Speaker C: They sure do.
[00:02:12] Speaker A: So, and I think that was the one thing you and I talked about when we discussed doing this episode was, you know, it's important to know the difference between, like, postpartum psychosis and postpartum depression and just also like, anything in between. Like, I think a lot of people are just like, you know, oh, well, she just has postpartum depression and she killed her kids. And it's like, well, I don't think it's that simple.
[00:02:33] Speaker C: Right. It's so much more complex than this. And, you know, in part of our conversation to do this episode, we really wanted to use this case to discuss the larger clinical and systemic issues that we have in our healthcare system, particularly related to mental health, because this case has really brought that to light.
[00:02:54] Speaker A: Yeah. Yeah, it has. And women's health, period.
[00:02:59] Speaker C: Yes, yes. And so that's where my professional lens is really appropriate for this. So you guys generally know me as coming on and talking about the relationship piece.
Another area that I focus is on women's mental health. So my practice is primarily women.
I focus on mental health and health issues across the lifespan for women, including pregnancy, postpartum concerns, ocd, anxiety, trauma, infertility, and pregnancy loss. So this case really hits home for the demographic of clients that I see.
[00:03:41] Speaker A: Yeah. And I mean, you know, as someone who has never and will never be pregnant, God willing, I will not have to deal. Yeah, both of us, Both of us.
We hopefully will never have to risk dealing with this. But I myself have had several friends that have had a lot of postpartum depression and. Or just issues in general.
And some went to and got help, which was great. And then some still refused. And I think to this day, the ones that still refuse are still struggling with some stuff because they just never wanted to go get the help. Or they were like, this is normal. You know, this is just part of being a woman, because that's what we're made to believe.
[00:04:25] Speaker C: Yeah. You know, I think that that is spot on. I have actually had women come to see me and they're children, are school aged, and I take a very comprehensive history over the first few sessions. And one of the things I want to know is like, when did anxiety start or when did OCD symptoms start? When did depression start? And I have seen this pattern with women of it often or sometimes starting after the postpartum period or late in their pregnancy, and they never addressed it. So then we address what was going on for them at that point and how that is still playing out for them today. And I have seen anxiety and depression significantly decrease by looking at it through that lens.
[00:05:20] Speaker A: Yeah. Yeah. And I think that that's. I mean, I think it's important, like, people need to.
Some people still today don't understand what therapy is and what therapy can do for you and how helpful it truly can be. And I think even sometimes, like when you're in it, like in the beginning, like for me being in it in the beginning with you, I don't think I realized how much it was helping till, like later. And then I was just like, oh my gosh, like, you know, the intrusive thoughts I used to have or the anxiety I used to have isn't where it is. And there's some. At some point it clicks like, no, this works, but people have to actually want to do it and stick with it. And I think that that ends up being an issue for a lot of people. So I, you know, I'm glad that there are women out there who, you know, that have come to you, even if their kids are like older, to be able to go back and be like, hey, these were issues that you had and you may not have realized or you may have just brushed it under the rug because that's what our health system says to do.
[00:06:17] Speaker C: Right. Or nobody connected the dots for them. Which like brings us to the larger question or one of the larger questions of today's episode is how can someone repeatedly be accessing mental health care and still become progressively sicker?
[00:06:36] Speaker A: Yeah, yeah, that's pretty crazy. So Lindsay, you know, she was on a massive amount of medications. According to everything the, you know, during the trial that we've watched.
[00:06:47] Speaker C: Right. We saw multiple clinicians, multiple treatment settings, medication changes, significant sleep disturbance, suicidality, intrusive thoughts, her family observing changes, and all of the clinicians all receive different information. So to me, that suggests a managed care system issue.
[00:07:14] Speaker A: Yeah, I was gonna say it seems like she was failed everywhere, all the way around. She was completely failed by every system.
We'll get into husband later. But everything like she was just failed all the way around. So what's crazy to me is how it seems like some of the people who treated her, especially, particularly one particular person that treated her wasn't even like she was like a baby psychiatrist. Like it's, it's like I, I don't like with a case that's this big of a deal. It seemed like she wasn't even prepared to deal with this big of a case.
[00:07:50] Speaker C: Well, and you know, I think that that's a significant problem in this field. So I did corporate behavioral health for 10 years. I actually started as a baby therapist working in a like inpatient mental health facility. And that's where people get their experience. But you have brand new clinicians working with some of the sickest population.
[00:08:20] Speaker A: Yeah. Which is, it's like a double edged sword. Right. Because you're like, I'm glad people are going into this field because we need more of it. Right. But at the same time, it's like if they're not prepared, especially for a level like Lindsay's case where she's been thrown all around and she was treated a million times with different stuff. And you know, it's crazy to me what it appears as someone who is a layman, so not saying anything against any of the providers or anything, but as a layman, what it appears and what I've seen on socials is that people are like, why was she on so many different meds and constantly being changed all her meds? Like, that's going to mess with somebody's brain chemistry.
[00:09:00] Speaker C: Right, right.
And I think in this case in particular, and this is not unique to Lindsey, this is a problem of the system. It's a system failure is that any provider can make a reasonable decision regarding medication, regarding safety plan, regarding supports based on the information available to them, while the overall system fails to integrate the complete picture because there is a struggle for providers to have the time to do the coordination of care piece.
[00:09:41] Speaker A: And how does one solve such a thing? Is there a. Is there a way to solve it? Like what, you know, what could the system do to make it smoother or better? Is there anything.
[00:09:52] Speaker C: I think it's looking at the system overall for mental health. I think a lot of it comes down to reimbursement rates.
[00:10:02] Speaker A: Right.
[00:10:03] Speaker C: Like if you are a provider taking insurance, you have your block of time, like medication management, you bill for that 15 minutes, you have 15 minutes with that patient. I have had clients say to me, I hate going to see my psychiatrist because I don't feel like they're really asking me what's going on. They're like, do you feel like the medication is working? And they're like, well, I don't know. I think I feel better.
Okay. You suicidal? You homicidal? Thoughts to harm yourself? Nope. Okay, see you in three months.
[00:10:38] Speaker A: Yeah. So. And that's. Is that solely because of insurance? Like, is there a reason why they're not having longer than 15 minute sessions?
[00:10:47] Speaker C: It depends what the provider is able to. To bill for and what insurance is willing to. To cover. So for.
I'm not a medication provider, but I know that a lot of med providers structure their day so they're billing, allotting 15 minutes per individual patient and then they're on to the next patient because that's what they need to do to keep a practice running and sustainable. When you're dealing with reimbursements, otherwise, you're looking at finding a provider who you pay out of pocket for. And sometimes you can get reimbursement reimbursed by your insurance company and sometimes you can't. It depends on your plan.
[00:11:30] Speaker A: And a lot of people can't afford that. They can't afford the out of pocket. And even then some people with insurance can't afford it. Which is a whole nother issue when it comes to mental health is a lot of times the people who need it the most are the people who can't, that don't have insurance or can't afford to get it. So that ends up being an issue overall. But when you see somebody like in Lindsay's case, somebody who had insurance and who should have been, you would think, well taken care of. And then to see the system as a whole just completely fill her. Yeah, it's sad that insurance, between our own failures in our healthcare system and then also the failures of insurance, because insurance is a whole nother beast of issues.
There's. We need a whole system overhaul. And of course, all that gets into, you know, politics and all this other stuff. And it's just like, I think people haven't really, especially when it comes to women's health and postpartum, haven't cared.
Mainly because it's. Women haven't cared or, you know, weren't. It was on the back burner. And I'm, you know, I do love Lindsay's attorney. Like, he.
[00:12:40] Speaker C: Oh, my gosh, me too. He's great.
[00:12:42] Speaker B: He is fantastic.
[00:12:44] Speaker A: He is a beast. Like the quarter thing, did you see
[00:12:47] Speaker B: the videos with him in the quarter?
He was going back and forth with the prosecutor and they're like, you know, they're at the end and they're talking about. They're doing like, they're closing and he has this quarter and he's set this quarter on. And she's like, oh, I'm going to take this quarter, because that didn't happen. But everything she's saying didn't happen, actually did happen.
So it was funny because he did that on purpose to make her look dumb.
[00:13:09] Speaker A: Yeah, he's so good. I would hate to be a prosecutor against him.
[00:13:13] Speaker C: I would hate to be a prosecutor against him too. I. I love just listening to him single speak in the courtroom.
[00:13:20] Speaker B: Screenshot.
[00:13:21] Speaker A: Oh, yeah, the screenshot was funny.
He bring out this huge screenshot of the.
[00:13:25] Speaker C: Yes, yes.
[00:13:27] Speaker B: The judge said. The judge said something about like, I know you have a smaller copy. He's like, yeah, how do you think I made this?
[00:13:33] Speaker A: Yeah, I can't. He's just so sarcastic and it's so funny. But I, I love that he truly seems to want to pave a way for like a better mental health and bring awareness to mental. So not only is he backing Lindsay, he's actually bringing forth the like, hey, this is a failure issue of a system.
[00:13:50] Speaker C: Right, right. And everything that he touched upon in the trial are managed care realities. So we talked about insurance networks, but, like, let's also consider separate health care systems. She was in multiple facilities probably owned by different entities. So are those systems talking to each other?
Electronic records that do not communicate. And so if the providers aren't communicating, the records aren't communicating. Who is communicating?
Short medication management appointments, which we have already touched on. Provider shortages.
This field has a high burnout rate.
[00:14:36] Speaker A: I can imagine, because you're. You're literally taking on other people's mental, like, I don't want to say all, but their mental health. Like, you're taking on all of their mental health, illness, like illnesses or anything, and, and bringing that on yourself, which I know that's why a lot of people who are in this industry also have a therapist. But then it's like, you know, a therapist seeing a therapist, eventually it's just gonna run, run its course. It can be a very, very hard field to stick to.
[00:15:01] Speaker C: Right, right.
And like, other reasons for that are like provider wait lists. Right. To get into a practice, you have people, like, beating down the door, particularly if you take insurance.
And then something else that I think is really relevant when you have all of these different systems and they're not talking to each other is that patients are having to repeatedly tell the same story, which can be traumatizing for them.
[00:15:35] Speaker A: Yeah, I can't even imagine, especially with what they've been through, like, just to be like, okay, now tell us again. And it's just like, why? Like, I don't.
[00:15:45] Speaker B: You.
[00:15:45] Speaker A: Can you read it from the other person? Like, I don't want to have to go through this again. And, you know, I think that's another issue. Like, I feel like people should really find a way for, you know, insurance or for providers to be able to talk to each other, get the records so they don't have to go through it again.
[00:16:03] Speaker C: Right. And so ultimately we have here. Ultimately what we have here is a system where everybody or everyone can be holding one piece of the puzzle, but nobody is holding the puzzle. So you got all these pieces, but how does the puzzle come together to really treat the whole person?
[00:16:23] Speaker B: Yeah.
[00:16:23] Speaker A: And it sounds like it is a whole system mess.
[00:16:27] Speaker C: It is, it is. And it's a mess that we're not going to fix. But I think it's important that we're calling attention to it in today's episode.
[00:16:36] Speaker A: Yeah, absolutely.
[00:16:38] Speaker C: So another thing that I also think is important that we call attention to today is that postpartum with quotes is not a diagnosis.
Postpartum mental health conditions can include depression, anxiety, ocd, bipolar spectrum illnesses, psychosis. Symptoms may overlap, but postpartum itself is not a diagnosis. And that's what we keep hearing around this case. Oh, it was postpartum. It was postpartum. But like, we have heard so many experts testify in this case, and I don't think we have consistently landed on one single diagnosis.
[00:17:17] Speaker A: Yes. And I think that's an issue. Like, what. Why. Why is everyone diagnosing her separately or differently? Like, what is. What is going on with. With that? So, and I think it's important to know the differences, you know, particularly between OCD and psychosis, because I think that that's something that keeps getting overlapped.
[00:17:39] Speaker C: Yes, there is so much overlap in that.
And let's talk about that for a couple minutes. So with postpartum ocd, people have intrusive thoughts. Intrusive thoughts can be frightening and graphic. So they can be fear of dropping the baby.
A really common one is images involving knives or using knives to harm the baby, fear of drowning the baby, fear of suddenly losing control.
These intrusive thoughts are not necessarily indicative of psychosis. They also don't mean that somebody wants to harm their child or has a plan to harm their child. And that's an important distinction. So having a thought does not equal wanting the thought. Having a thought does not equal intent. A mother with postpartum OCD is often horrified by the thought and takes steps to avoid situations she fears. And we call this being ego dystonic. So the simple definition of this is this thought does not feel like me. I don't want it. It conflicts with my values.
And the distress of the thought itself tells us something really clinically important about the person's relationship to the thought.
[00:19:13] Speaker A: Yeah.
And I think that's important because people are like, oh, well, if they're having those thoughts, they're gonna do it.
[00:19:20] Speaker C: Right.
[00:19:21] Speaker A: And that's not with postpartum ocd. That's not always the case.
And even, like, intrusive thoughts, I would almost say, which I was not postpartum in a postpartum situation at all for myself, but I would almost say that's what I would say. My situation was, is I was having intrusive thoughts to the point that I was getting scared that I was going to do something. And I. What you just read was perfect for me. It was the.
That I was, like, horrified by it because I was like, these don't match. This does not match my values, so I need to do something. And that's when I called you and was like, we've got to do something. Like, this is not good.
[00:19:58] Speaker C: Right.
[00:19:59] Speaker A: So. And it seems like that for postpartum ocd, that's what a lot of the women have come, that you've probably seen or just like studied and stuff. That that's what ends up happening is it's. I'm having these thoughts, they're just popping up out of nowhere. This is not normal and I know it's not normal. Help me.
[00:20:15] Speaker C: Right. And there's an evaluation process to that.
There are screenings that can be given to assess for OCD beyond what's called the Edinburgh. We've heard about the Edinburgh, which is a postpartum assessment during this case a lot.
But there are other. There's the ocir, which I often use in addition to clinical interview and keeping a thought log, which I then have the patient sent to me prior to a session.
And I analyze for different patterns and consistency and frequency around the thoughts to come up with that diagnosis. And what you were describing for yourself of like, these thoughts don't align with me.
That means that you were experiencing ego dystonia.
And that's what we look for when we're diagnosing postpartum ocd or OCD in general.
[00:21:14] Speaker A: Yeah. So that's. It's. I think that's good to talk about because I do know, like, people all the time are just like, oh, well, it's just postpartum ocd. And it's like, well, no. Or they'll just immediately call it psychosis because they. Because in their mind, if you're having intrusive thoughts, then it's psychosis.
[00:21:32] Speaker C: Right.
[00:21:33] Speaker A: And it's like, well, well, no. So explain to us what psychosis is.
[00:21:39] Speaker C: So when somebody is psychotic or experiencing postpartum psychosis, they often are what we call ego syntonic.
So one of the things that we want to focus on is reality testing.
So does the person recognize, my brain is producing a frightening thought, I'm having thoughts of wanting to harm my child and that frightens me. Or does the person believe that this is happening? Or are they experiencing command hallucinations? So hearing voices, telling them to engage in harm. That's a significant difference between being ego dystonic versus ego syntonic. So possible psychotic symptoms are hallucinations, delusions, severe paranoia.
So this could be like someone's coming to harm the baby.
Confusion, disorientation and loss of reality testing. However, and this came up in the trial as well, in terms of completing like day to day tasks, somebody could be experiencing psychosis, but also be able to move through typical activities that they would normally do, like driving the kids to school, for example, and still be having these Thoughts. And so, again, this is where clinical evaluation and diagnostics is really important.
A key takeaway for this is if you suspect postpartum psychosis, it is a medical emergency. It is not something you wait for the next appointment. It is not something that you see. If it goes away, you need to go to the emergency room for an assessment.
[00:23:45] Speaker A: And did anyone actually diagnose her with psychosis?
[00:23:50] Speaker C: I don't believe from all of the testimony that I saw that there was a diagnosis of psychosis prior to the incident occurring.
[00:24:05] Speaker B: So with her, like, I mean, because her husband had left to go to the store, do you think that prior to him leaving to go to the store, would there have been signs that she was in psychosis that maybe he could have recognized or, like, that somebody should be looking out for?
[00:24:22] Speaker C: I think, like, continuing deterioration. She had shared with him that she was afraid of hurting the children.
Right. So even if I'm looking at this through an OCD lens, backing up, right. If someone's telling me that they are afraid that they're going to hurt the children, I'm coming up with a plan.
[00:24:44] Speaker A: Yeah.
[00:24:45] Speaker C: For that, right?
[00:24:47] Speaker A: Yes.
[00:24:47] Speaker C: Because we have to reduce that level of distress. Even if they're saying, I'm committed to safety, I'm not going to hurt the children, this thought scares me. We're going to put a safety plan.
I'm going to put a safety plan in place if that's somebody that I am working with.
An important nuance to this, and I think, again, I did not treat Lindsay. I am not diagnosing her, but from a lot of the testimony that I heard, she still appeared relatively organized and can complete tasks while she was still serious. While she was seriously psychiatrically ill.
Yeah.
[00:25:31] Speaker A: And she also heard stuff, right? Like what? Didn't she hear things?
[00:25:35] Speaker B: She heard voices.
[00:25:35] Speaker A: Yeah.
[00:25:36] Speaker C: Yeah.
[00:25:36] Speaker A: So she. She was definitely in like.
Again, I'm not a doctor, but it appears from what we've heard, that she was in a psychosis state.
[00:25:44] Speaker C: Right.
[00:25:44] Speaker A: So I feel like, again, everything failed her.
And I feel like they're. They.
She definitely needed to be, like, in a hospital.
[00:25:58] Speaker C: Right.
And one of the things that we know now and that most of the providers have agreed upon is that she does have bipolar disorder.
Bipolar can also have psychotic features.
[00:26:17] Speaker A: So she wasn't. Was she not diagnosed with that before the trial? Do we know?
[00:26:22] Speaker C: I think she was diagnosed before the trial.
I don't know if I recall correctly, there was an appointment in December where she went to see. She went to see a new provider. I can't remember which provider it was. And that provider suggested that she might be bipolar, and Patrick immediately said, she's not bipolar.
[00:26:45] Speaker A: I got it. I can't.
Yeah, we'll get to him.
Is it.
[00:26:50] Speaker B: I do have a question. Is it normal for, like, you to advise a family member to take medication from the patient and put it away?
[00:26:59] Speaker C: Oh, the car thing, that's part of safety planning. So if any instance where I feel like somebody might be harm to themselves or others, I'm gonna work on a safety plan. With harm to others, there's duty to warn, which is, you know, could be for another episode.
If part of the thinking is, like, I might overdose on my medication, or the person is hoarding medication, which I have seen.
Removing all medications from the house, keeping them in a locked safe, disposing of medications, that the patient is no longer taking all important steps to ensure safety.
[00:27:49] Speaker A: Okay, that's good to know, because I think that was one thing that, like, as a layperson, we were like, why is it in his car?
[00:27:56] Speaker C: Yeah.
Well, and to me, that's not, like, complete removal. If she has access to the car and she knows the medication is there. Right. That's a risk.
[00:28:06] Speaker A: Yeah, I thought.
[00:28:08] Speaker B: One thing that I thought was alarming was just how quickly they were shifting medications with her. When they were reviewing it, it was like she was on one medication. Then a couple days later, they were switching it again. And then a few days later, they were increasing that dose. It was like they weren't giving time for, like, it to get into your system is what it seemed like. But, like, you know, obviously, I'm not a doctor. I don't know anything, but it just. That, to me, seems strange.
[00:28:32] Speaker C: So a lot of times with psychiatric medications is it takes four to six weeks to get to full therapeutic range of the medication. And so if there's a constant changing of medications, you're not getting to, like, the. The full therapeutic value of the medication. And if you're making a lot of medication changes.
So I will be the first to say that I'm a big believer in keeping people out of the hospital. I think inpatient should be reserved for safety stabilization and medication management. And so that's where the medication management piece is particularly relevant in this is if you're making such major changes in medication, a safe place to do that is at an inpatient facility.
[00:29:25] Speaker A: Yeah. Yeah. It definitely seems like from everything, from the testimony, that would have been the best and safest place for Lindsay to be while they were figuring this out, because they're like. Like Amber just said, like, the amount of medications that we heard that she was, like, constantly getting switched was wild.
[00:29:40] Speaker C: Yeah.
[00:29:41] Speaker B: And some of them were really strong, light ambience. Very, very strong.
So.
[00:29:47] Speaker C: And Seroquel is so sedating.
[00:29:50] Speaker A: Yeah. And that, you know. Well, that gets us into some of the conspiracy theories because, you know, how are you gonna do things when you're sedated, but whatever.
Right.
So.
[00:30:02] Speaker C: So this part of the episode, I think it's really important to drive home the significance and value of support.
And for a person to have support, it should not be dependent on getting the diagnosis.
[00:30:21] Speaker A: Right.
[00:30:22] Speaker C: So we can be uncertain about a diagnosis and still be certain that someone needs more support. And in a case like Lindsay, from all of the testimony, it was clear that she was rapidly deteriorating and needed support.
[00:30:39] Speaker A: Yep.
[00:30:40] Speaker C: And all of the diagnosis we diagnoses, we've discussed so far require significant support post, whether it's diagnosed in a postpartum period or otherwise. Depression support, anxiety support, OCD support and treatment.
Bipolar disorder, support and treatment. Psychosis. Emergency evaluation.
[00:31:03] Speaker A: Yeah. So that's where it seems like the number one person who lived with her would have seen the most and, like, I don't know, pushed their partner to get, you know, be like, no, this is an emergency. We're getting you some help.
[00:31:16] Speaker C: Right, right, right. And I think, like, to address some of the conspiracy theories or thoughts, we're not asking, why didn't Patrick predict that his children would be killed? He didn't have crystal ball. Right. But we can ask, what does meaningful partner support look like when someone you love is psychiatrically deteriorating?
[00:31:41] Speaker A: Yeah.
[00:31:41] Speaker B: Right. Yeah.
[00:31:42] Speaker A: Yeah. And it definitely does not look like what he did.
[00:31:46] Speaker B: I couldn't imagine, like, if somebody came to me and they said, you know, I'm afraid I'm going to hurt myself. I'm afraid I'm going to hurt the kids. And I'm like, yeah, I'm just going to go to the store. See you later.
[00:31:56] Speaker A: Hey, I'm going to go on vacation with my lover.
[00:31:59] Speaker B: Yeah.
[00:32:01] Speaker A: So, like, because I think we're going, you know, I. We're not here to get sued. So we're not going to say that he 100% was having an affair. But from the timeline, it sure looks like Patrick was having an affair.
And so instead of worrying about your wife at home and helping her, you're out there running willy nilly, putting your dick in places it doesn't need to be.
[00:32:24] Speaker C: Well, and he wasn't. From all of the testimony that I have seen, he was away a lot when she was. His mother said in her testimony that when she was dropped off at an inpatient facility, he left to go on a ski trip.
[00:32:42] Speaker A: That, to me, is the most wild. Tell me you're not a good partner without telling me you're not a good partner.
I'm gonna drop my wife off at inpatient, and I'm gonna peace out, leave my kids, and go on a ski trip with who knows who.
[00:32:56] Speaker B: I think he took his daughter. Didn't he take his daughter?
[00:32:58] Speaker A: I don't know.
[00:32:59] Speaker C: Yeah, I think he did take his daughter.
[00:33:00] Speaker B: He took one of them, but he left the two youngest ones, which would probably be the more, like, the more complicated ones to take care of. So it just didn't seem like he showed the support that she needed during that time if she was struggling as bad as she was. And obviously, he knew that she was struggling because she's going to all these doctors, she's getting all these medications. He knows about the medications.
So at that point, like, while I can understand you have to work to support your family, like, the support outside of that just didn't seem to exist.
[00:33:32] Speaker A: Yeah. It seems like you would cancel for something that serious. You would think you would cancel a trip like that to be able to stay home, to be near your wife, and to, you know, take care of the house and the household.
[00:33:43] Speaker C: But here's another important piece from the mental health perspective as well. When you're treating somebody at that level, like an inpatient hospitalization, level of care is the family support is important.
Partners often see things clinicians do not. So family participation is really important in getting a full history, because a lot of times when somebody is admitted to an inpatient unit, they're there for, like, three to seven days and maybe less if insurance puts them out before that, because they're not meeting medical necessity based on the insurance company criteria. So clinicians need to gather this information quickly. And partners may see things with sleep functioning, fear behavior at night, parenting capacity changes between appointments that providers can't see or know.
[00:34:44] Speaker A: Yeah, Yeah. I think that that's a really important thing. And you would think a loving, caring partner would want to do that because you would want your spouse to get better. Right. Like, that would be ideal. You have three children with this person. You would want them to be well.
[00:35:02] Speaker B: So especially being the mother of your children.
[00:35:06] Speaker A: Yeah. Like, Right. Even if you are having an affair, you would hope that there's some level of respect just from that.
Right.
But I. I definitely think not only the system failed Lindsay, but he did too. Like, he. As a partner, he failed he did not do what he could have, and he did not help in the ways that he probably should have when it came to her and how to. How to be there for her, because, you know, he was the one that she should have been able to rely on the most.
[00:35:38] Speaker C: Right, Right. And what support actually looks like are things like protecting sleep, reducing childhood demands, helping with meals and basic needs, attending appointments, communicating major changes to providers, knowing crisis resources, monitoring significant deviation from baseline, and taking suicidal statements seriously. And if you're absent from all of that, that. Also going back to this idea of everyone was holding a piece of the puzzle, but nobody was holding the entire puzzle.
This is another example of that.
[00:36:22] Speaker A: Yeah. And even the first few things you said, I'm like, that is. The first thing that thought that popped in my head was like, that's the bare minimum. Men should be doing that anyway.
Like, you should be reducing childcare demands anyway because it's also your child. So why does it always fall on the woman? Like, it drives me nuts. Like, helping with, you know, the meals and the basic needs. Like, yeah, that's the bare minimum. He didn't even do that.
[00:36:48] Speaker C: Right.
[00:36:50] Speaker B: Like, oh, don't you recall in his testimony he hired a nanny?
[00:36:54] Speaker A: Because God forbid he does it himself.
[00:36:56] Speaker C: So I was gonna say, but they also let the nanny go. They reduced support.
[00:37:01] Speaker B: Yeah.
[00:37:01] Speaker C: As she was deteriorating.
[00:37:04] Speaker B: She was deteriorating and he just let the nanny go.
[00:37:06] Speaker A: Right. What was his reason? Did he say, I don't recall in
[00:37:09] Speaker B: the testimony, what his reasoning was behind it. I think it was because she was no longer working.
[00:37:15] Speaker A: Yeah. So, like, leave the, like, the psychosis in charge of everything.
[00:37:19] Speaker C: That's the. The person who is, like, deteriorating and saying that, like, she has thoughts of harming her children to then be fully responsible for them and all of their care is not a supportive strategy.
[00:37:36] Speaker A: I think that's why a lot of women are upset, too, is because, like, we're upset at the system.
Don't get me wrong, because the system has been failing women for years. But a lot of women are really upset with him because we can't. Like, we. We don't have a choice in the system. There's nothing we, as an individual person can do with the system. But that's your life partner supposed to be your supportive life partner who apparently was off running around, having an affair, but then also just wasn't there. He wasn't there. He wasn't. So even if. Even if he didn't get with her till after, let's just. Those are some big air quotes that let's just say he still wasn't there. Like, he wasn't there for her. He wasn't supportive. He wasn't helping with the kids. He wasn't giving her anything. In fact, like, I missed that part of the testimony. And so he hired somebody to help and then got rid of them and so made it worse on her. Like, he is. If one thing we can say, he is a horrible husband.
That is what I will say.
[00:38:32] Speaker C: I mean, support was definitely not there. And even I forget who testified to it might have been him. That she didn't want his parents to, like, come over. He told them not to come over and help. It was because she didn't feel comfortable with them being there. But if somebody is deteriorating that quickly or even deteriorating over a period of time, they are not well enough to make that decision. And at some point, the support person needs to overrule 100% that person.
[00:39:15] Speaker A: 100%. Like, I'm. It's just. It's. I mean, I don't want to say it's like a child, but it's kind of like a child. You're like, nope, I'm doing what's best for you, and you're gonna listen, and we're gonna do this like, you don't have a choice in this matter. Right.
[00:39:27] Speaker C: This is what the plan is going to be, and this is how we're gonna expand our support system. Because it's a lot for one person, like a spouse to carry, particularly in a case like this one where she was so ill that you need to look at, like, who else can be part of that support system? But he also needed to actively be part of that support system to determine that they needed more help.
[00:39:57] Speaker A: Yeah, 100%.
[00:39:58] Speaker C: So what do we need to learn from this?
[00:40:02] Speaker A: A lot.
[00:40:04] Speaker B: Don't get married.
[00:40:05] Speaker A: Yeah.
Big snaps over here.
[00:40:09] Speaker C: I joke.
[00:40:10] Speaker B: I joke.
[00:40:12] Speaker A: You know, I'm not.
[00:40:13] Speaker C: Marriage is hard.
Marriage is.
[00:40:16] Speaker A: Marriage is hard.
And your partner can make a difference in life or death, apparently so.
[00:40:22] Speaker C: Right.
[00:40:23] Speaker B: I think what we can learn from this is if you are a partner of somebody with mental illness, to take it serious and ensure that you are being that supportive partner and asking important questions that are like, you know, what can I do to help you? Like, how are you feeling each day?
You know, also asking their medical professions, what does that safety plan look like?
You know, if we need to have one?
[00:40:49] Speaker A: Don't deny that your partner has bipolar disorder. If a doctor suggests she does.
[00:40:53] Speaker C: Right. Or any diagnosis, literally.
Yeah.
[00:40:56] Speaker B: Maybe believe the professional behavior.
[00:41:01] Speaker C: Right. Like, from this case, there we can see that there are so many things that need improvement. We need better perinatal mental health education.
Not after pregnancy.
During pregnancy, we need education for partners and families, Better screening and follow up. More perinatal mental health specialists. Better communication among therapists, prescribers, OBs, and hospitals.
And I will tell you, like, I wholeheartedly believe this, but I don't know the solution to this. In a managed care system or in our managed care system here in the US we need better continuity after hospitalization and clear escalation plans for families. Because the other thing. And I could have missed it, but I never heard a clear escalation plan for, you know, if the thoughts increase, if the suicide suicidality increase, if she suggests a plan, if she hears voices. These are the things that need to happen. I. I didn't hear that in any of the testimony.
[00:42:12] Speaker A: Yeah, I didn't either.
[00:42:13] Speaker C: And then I think the biggest thing is that we need less responsibility placed on someone who is seriously ill to coordinate their own care.
[00:42:25] Speaker A: 100%. 100%.
[00:42:28] Speaker B: I mean, if they're gonna take their rights from Brittany, then by all means.
Poor Ria.
[00:42:33] Speaker A: Yeah, I know. I love Brittany, too.
[00:42:37] Speaker B: I can't move past the fact they took her rights, but then they still had her work working. Like, if she can't make competent decisions for herself, why is she still able to earn money? Like, why do you have her out here on the stage in Vegas then?
[00:42:48] Speaker A: Yeah. Yeah, there was. I just think that. I'm pretty sure, like, I. I'm thankfully blessed with my parents. My parents. My parents would have intervened. Like, 100. They would have been like, nope, we go into the hospital, like, we're doing something. So this is not an option. Yeah. And I mean, again, nothing on her parents or his parents, but I'm like, did they not see it either?
Like, was no one communicating this? Did they not see it was Patrick not telling her parents? Like, hey, these are things.
[00:43:17] Speaker C: Your daughter. She's your mom. And Patrick, that she had thoughts of her harming the kids together, then why,
[00:43:24] Speaker A: like, so then her mom failed her too.
Yeah, because I'm like, that's your mother. And, you know, again, you're a grown adult, but at the same time, if you're. If the husband's not gonna do anything, then you would hope that a mother would step in and be like, okay, we're going to help take care of this. You know, in some way.
[00:43:41] Speaker B: I think a lot of times people don't take mental health as seriously as they should.
[00:43:45] Speaker A: 100.
[00:43:46] Speaker C: I wholeheartedly agree with that. And that's another major problem with our healthcare system.
[00:43:53] Speaker B: I'm sure her mom was like, you know, you've always been this great person. You're bubbly, like, you're gonna snap out of this.
[00:44:00] Speaker A: Yeah. And I mean, society as a whole, Right? Like, society as a whole, a lot of times people are like, oh, they're just using mental health as an excuse, as a crutch, attention seeking. You know, it's just all these excuses because people are just like, if they don't have an issue, then they think that others shouldn't either.
And so they can't understand it. And so it's just like, oh. And unfortunately, every once in a while, you do get people who do those things. Right. So then it's the same thing with, like, a rape case. Like, there are women who have claimed to rape who were not, and then it makes it harder for those that were.
So same thing with mental health. If you have somebody who's using it as a, you know, oh, look at me.
And then if that comes out that they actually didn't have any issues, then you have. People who have had issues have to compete with that.
[00:44:48] Speaker C: Right, Right. And it can make care so much harder to access at that point.
[00:44:56] Speaker A: Yeah.
[00:44:56] Speaker C: And that's why we need to protect against stigma.
So intrusive thoughts do not automatically mean someone is dangerous.
Postpartum OCD is treatable.
Women should be able to disclose frightening thoughts without assuming they will automatically be labeled as dangerous.
At the same time, hallucinations, delusions, severe confusion, significant loss of reality testing or rapid deterioration. We can put all the other things aside. Hallucinations, delusions, severe confusion, loss of. Significant loss of reality testing and just say, rapid deterioration during the postpartum period require urgent evaluation.
[00:45:48] Speaker A: Yes. Yeah. And again, I think a lot of women are scared, like, oh, my kids are going to get taken from me. Right. And so they don't want to go and get the help that they may need, because that's the first thing, and that's part of the issue. And that needs to not. They need to not have to worry about that situation. And because they need to be able to get the help that they need without worrying that their families are going to get torn apart.
[00:46:09] Speaker C: Right.
[00:46:09] Speaker A: So that's definitely another system issue.
[00:46:12] Speaker C: It's a system issue.
And I think sometimes that comes down to, like, the provider you're dealing with, too. Right. Like, if you go in and you tell your OB that I'm having these thoughts, or you fill out the Edinburgh postpartum screening, which one of the questions is like, do you have thoughts of harming yourself?
Some providers may send you directly to the emergency room. Others might do a diagnostic evaluation. But, like, how scary is it for a new mom to feel like she needs to answer yes to that question on the Edinburgh, but also be afraid that something is going to happen where her child might be taken away or she might be separated from them because she is struggling?
[00:46:59] Speaker A: Yeah, right. Yeah. I can't even imagine that fear and that level of, like, not knowing what to do because it's like you want the help, but you also don't want to lose your child. And you shouldn't have to choose between the two.
[00:47:12] Speaker C: Right, Right. And I think that's another, like, important piece of this and really tragic element to what happened is that Cora Dawson and Callan died.
[00:47:28] Speaker A: Yep.
[00:47:28] Speaker C: And while this conversation around mental illness and is incredibly important to have, their lives shouldn't disappear inside the discussion either. So we can acknowledge both maternal psychiatric suffering and also that they lost their lives.
[00:47:49] Speaker A: Yeah, yeah. At the end of the day, I think that's the, you know, people keep forgetting that or just, like, stop acknowledging it. And like, yes, at the end of the day, three beautiful young children lost their lives that shouldn't have and lost it in a horrific way. Right. And so, you know, that's something that definitely needs to, like, stay in the forefront of everybody's mind while we continue to talk about mental health, because we want to prevent, hopefully, future situations from children from dying.
[00:48:23] Speaker C: So just to wind us down, a postpartum mother should not have to know exactly what is wrong with her to be taken seriously when she says something is wrong, when she says, I'm not okay or I am struggling.
We can be uncertain about what a diagnosis is and still be absolutely certain that somebody needs and deserves support and care 100%.
[00:48:53] Speaker A: And I think that's the most. One of the most important things when it comes to mental health for postpartum, that people need to realize.
[00:48:59] Speaker C: I wholeheartedly agree.
Before we wrap up, I just wanted to share some resources for listeners. So the first one is Postpartum Support International or PSI Helpline.
You can call 1-800-944-4773 or text HELP to that number. The PSI Helpline provides information, encouragement, and connections to perinatal mental health.
It should be clear this is not a crisis hotline, though.
If you are experiencing severe symptoms, again, you need to go to the emergency room and be evaluated.
And then if you or someone you know is experiencing a mental health or suicidal crisis in the United states, call or text 988 to reach the suicide and crisis lifeline.
If there's an immediate danger to a parent, baby, child or anyone else or symptoms, possibly suggest postpartum psychosis, seek immediate emergency medical care and call 91 1, yes.
[00:50:09] Speaker A: And we will put all of those resources in the description in the bio to this episode. You know, we love on the podcast talking about mental health. And whenever this case brought it to the forefront, we were like, this is something really important that needs to be talked about. And so I'm glad that you were able to come on today to tell us the difference between OCD and psychosis.
I.
I'm just, I'm glad that we are finally talking about this and on a national level because I feel like for so long it has been completely ignored.
And it's unfortunate that for it to make a national level, three children had to die.
[00:50:51] Speaker C: Right. And I think with the getting ignored or it not getting the attention that it deserves, it's because part of it is because we would just refer to it as postpartum, which again, is not a diagnosis.
[00:51:03] Speaker A: Correct. Yep. So that's harmful to say. So we gotta stop saying just postpartum and, you know, actually have the diagnosis in there. Well, thank you, Suzanne, so much for coming on the episode today.
[00:51:15] Speaker B: Thank you.
[00:51:16] Speaker C: You're welcome, guys. Always a pleasure.
[00:51:19] Speaker A: Yeah. And if anybody has any questions or comments, you feel free to DM us. Our DMs are always open. We will talk to you next week.
[00:51:29] Speaker B: Bye, guys.
[00:51:29] Speaker A: This episode is proudly brought to you by the law firm Ryan and Rouse. If you or a loved one have been injured or need legal help for changing family circumstances, contact the personal injury and family law attorneys at Ryan and Rousetoday and at 256-801-1000 or visit them online at www.alabamalaw.com. when your future is on the line, don't go at it alone.
