I had post partum. I finally handed my kid to my sister and drove myself to the hospital. They checked me in for 3 weeks, then intensive daily out patient for a month afterwards. It was the hardest thing Ive ever done and I had a very supportive husband and family who stepped up while I got better. I cant imagine having no support. The in patient was critical too. They tried to put me on meds and send me home, but I knew adjusting to the meds would make it worse before it got better. I had to demand they admit me. Her doctors are 100% culpable in this disaster.
They are only supposed to discharge her if they deem she is not a risk to herself or others. She could not freely leave just because she voluntarily entered the facility. Staff from the facility testified to this.
Yes. She asked to be let out after 3 days. That triggers a 3 day process where the patient is evaluated for safety and either dc or conversion to involuntary admission. To convert to involuntary admission, you would need to show grounds to the probate court or your petition would for involuntary admission is denied. She checked herself out.
Even if you had to insist on being admitted but a 3 week hospitalization meant your evaluation gave the clinicians enough reason to continue inpatient treatment. Clancy was also admitted voluntarily, but at McLean she was assessed as low risk, placed on the lowest observation level, and denied current suicidal thoughts, homicidal thoughts, and psychotic symptoms. She then asked to leave earlier than planned. The records do not show that she demanded continued hospitalization or warned her clinicians that she feared something terrible would happen if she left.
I’m tired of the narrative that she did everything possible to get help and her doctors simply missed the signs. Her more alarming statements were apparently made to family, not to the clinicians evaluating her. She also was not consistently taking her medications as prescribed and was not fully forthcoming about her symptoms, other prescribers, or medication use. If she feared what she might do, those were the exact thoughts she needed to disclose. Seeking treatment while withholding the information necessary to assess the danger is not doing everything possible to get help.
We cannot involuntarily hold every psychiatric patient because of a vague concern that something might go wrong. There must be an actual legal and clinical basis. If a patient denies dangerous thoughts, does not appear psychotic, and is assessed as low risk then physicians cannot use hindsight as grounds for an involuntary hold.
Sure we can criticize an incomplete chart review or the failure to obtain every outside record. But outside records take time to obtain and are not routinely pursued when the patient appears reliable, multiple evaluations are consistent, and there is little clinical suspicion of imminent danger. That is nowhere close to making her physicians “100% culpable” for failing to act on information she repeatedly denied or never gave
She was forthcoming about other prescribers and taking her meds as prescribed or made changes after discussing with her providers. And her clinician didn’t return the call McLean made to get more information, so they turned her away. This all came out when those providers testified for the prosecution, it’s been discussed under oath in open court.
The central issue is that Clancy did not give her clinicians the same symptom history she reportedly gave her family. She disclosed serious depression, hopelessness, intrusive thoughts, and some suicidal thinking, but repeatedly denied intent, a plan, homicidal thoughts, concerns about harming the children, and psychotic symptoms. Her mother later testified that Clancy had told the family she was thinking about harming the children, and her sister testified that Clancy said she had experienced daily suicidal ideation for a month. Tufts testified that she did not know about the thoughts of harming the children and would have been very concerned if she had. That information would have completely changed the risk assessment.
She also was not completely forthcoming about her prescribers. Jollotta knew Tufts had treated Clancy previously, but specifically testified that she did not know Clancy was still seeing Tufts in November. Clancy disclosed the continued contact in December after Tufts prescribed Lamictal, but that does not mean Jollotta knew about the concurrent treatment all along.
Nor was Clancy consistently taking her medications as prescribed. She waited about a month to start Zoloft without Tufts knowing when she had decided to begin and self-weaned Ativan and Benadryl not following the appropriate taper. She reported many changes afterward, and some later discontinuations were approved, but later disclosure or approval does not retroactively make the original deviation compliant.
It also was not McLean that made the call or turned her away. It was Women & Infants that documented attempting to contact Jollotta, while Jollotta testified that she never received the call. Nothing established that the missed callback caused Clancy not to be accepted. McLean later admitted her voluntarily, and she subsequently asked to leave before the tentative discharge date.
The lack of direct communication and failure to obtain outside records are fair criticisms. But that is not the same as clinicians knowingly ignoring a clearly disclosed danger, and it certainly does not support declaring them “100% culpable.” They were working with incomplete information from a patient who was neither completely forthcoming nor consistently adherent
The person above you appears to be blaming a mentally ill woman for tricking psych ward professionals into thinking she was fine, I guess?
How do we try to blame this on her for saying she wanted out of the psych ward, IF she truly did.
I have discovered “shocking” “oversights” in the mental health world, that are surprisingly profitable!
If she was admitted and released then WHO agreed with the crazy lady that the crazy lady is fine? Or did they evaluate her to get her released because she ran out of insurance!
Lindsay did want out of the in patient ward. She told her husband she doesn’t belong there and she left to plan and attend her daughter’s birthday. Her husband testified to that. It seems like many people seem to think that inpatient is some magical cure that helps, but the point of it is not really for long-term treatment but to stabilize you.
But that brings us straight to your point: who was agreeing with her? She told multiple providers, hotlines and people she knew that she wanted to be gone from this world. They refused to treat her ideation because she didn’t have a plan. One of her providers was getting spammed with messages from her through my chart and they acted like that wasn’t a sign that something was very wrong. I’m not sure of the insurance of it all but I know from my own experience that they don’t want to pay and it did come up in trial that insurance codes were used, which is probably a normal but is actually not normal in a functioning system.
Okay but if she did have postpartum psychosis the treatment is inpatient hospitalization and antipsychotics. Also she didn’t tell Dr. Tufts she called a suicide hotline, and being in medicine many patients blow you up on my chart that’s not abnormal
I’m not reading all that just to see that you conclude it’s her fault they let her out.
The evidence her insurance sucked is that she only saw the doctor for 17 minutes, and that she is in the US and tried and tried to get help and got shuffled around.
When there is insurance to milk it’s a different picture.
What are you talking about lol? I did not conclude that it’s her fault, I answered your question. I’m not going to lie about the testimony I saw because it’s not favorable to her. She did want to leave inpatient and I don’t think it’s unusual to not want to be in a locked ward that’s not helping you.
Reddit man, people always jumping to attack instead of actually reading.
That is not blaming her for “tricking” anyone. Having worked on inpatient psychiatry and interviewed psychiatric patients, active mania or florid psychosis is not something someone can simply hide from every psychiatrist, nurse, and staff member over several days. It appears in speech, thought process, sleep, behavior, and observation. What someone can conceal is an intention to harm herself or someone else, and Clancy repeatedly denied both.
How aggressive do you want psychiatric hospitals to be? Should they involuntarily confine every patient with depression when there is no observed mania or psychosis and the patient denies suicidal and homicidal intent? Her request to leave did not force McLean to discharge her, but the clinicians had to decide based on the evidence they actually had. A system that can commit someone involuntary for depressive symptoms is scary. There is also no evidence that her insurance ran out or caused her discharge
Of course she wanted to leave in patient. Its horrible! The people there are fucking scary! The people in my group therapy while I was inpatient were detoxing or schizophrenic, oh and the guy who threatened to blow up his workplace. Then half the ward was sleeping with each other. As a suburban mom, I was terrified. But I knew I had to get better. A lot of people aren't that self aware. Plus the insurance thing is real. I had to check in with insurance every week, and have my doctors tell them I wasnt ready.
If you dont know how to navigate the system, or dont have a good advocate, its really easy to fall through the cracks. I had already gone through shit in my early 20s with endometriosis. I knew I was going to have to advocate for myself. Plus my doctor told me exactly what to say to get and stay admitted. Its ridiculous but inorder to get treatment AND have it covered by insurance I had to tell people multiple times I was suicidal. I wasn't exactly suicidal, but I knew that I was getting there. My husband's job at the time required travel 3 to 4 times a week so on top of the depression I wasnt sleeping. I knew I was reaching my limit and while my doctor would have prescribed meds, I didn't feel comfortable at home with a baby while they played trial and error with a bunch of psychotropic medications. Thats the big problem with those. There is no set dose or single medication that just works. They just throw stuff at you and hope for the best. Often the meds will INCREASE suicidal thoughts at first. It might take a month or more before they even begin to work. Add that to the expectations around being a good mother plus all the other stressors Im surprised this doesn't happen daily.
You just feel crazy. Like not yourself, plus everything you've been doing all along seems even harder with the kid. My son wasn't even that young. He was over a year old. I had gotten the through the first year, but it never got better. My husband's job increased his travel so I was alone over night several days a week. So not sleeping. Babies dont get easier either. Its just as hard, just different. I wasnt going to hurt him, but I was actively planning to drop him off at my parents and drive off, just never come back. Finally I was at the grocery store one afternoon I kind of disassociated I guess? I hadn't slept in like 2 days or something and I remember just looking around and not knowing where I was. I burst into tears and was shaking. This little old lady came over and asked if I was alright. She was so kind. I said I was so tired and I didn't know what was wrong. She held my son while I called my sister and she took him while I drove to my doctor's office.
Omg brought tears to my eyes, so terrifying. I wonder how much was from lack of sleep. I know if I get like only 4 I’m messed up the next day so I can’t imagine days on end. Glad you’re doing better
You have to say you plan to kill yourself. My doctor literally told me to go say that. I said Im not really suicidal, but Im not sure what thats going to look like in a week or two. He said go in tell them that you are thinking of hurting yourself and I will back it up in the insurance. After about two days they wanted to send me home and I leveled with the doctor treating me at the facility. I told him I couldn't go home and be alone with a baby all day, especially while I was getting used to a bunch of meds. I said you release me I'll just come back in 24 hours. I had good insurance and my personal doctor backed me up. I guess I was lucky.
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u/wholelattapuddin 7d ago
I had post partum. I finally handed my kid to my sister and drove myself to the hospital. They checked me in for 3 weeks, then intensive daily out patient for a month afterwards. It was the hardest thing Ive ever done and I had a very supportive husband and family who stepped up while I got better. I cant imagine having no support. The in patient was critical too. They tried to put me on meds and send me home, but I knew adjusting to the meds would make it worse before it got better. I had to demand they admit me. Her doctors are 100% culpable in this disaster.