The Lindsay Clancy case has forced people to have an uncomfortable conversation about mental illness, criminal responsibility and sympathy.

And I keep coming back to one question: When does mental illness explain someone’s actions, and when does it actually excuse them? Because if we’re going to have this conversation, we can’t change the standard depending on how sympathetic we find the person accused.

Think about some of the most infamous killers in American history.

Jeffrey Dahmer murdered 17 boys and young men. He was evaluated extensively by mental-health professionals, and experts disagreed over his diagnoses and whether his disorders made him legally insane. Richard Ramirez terrorized California during his killing spree and was eventually convicted of 13 murders, along with numerous other violent crimes. Ted Bundy confessed to 30 murders, mostly of young women and girls, although his actual victim count may have been higher. Mental-health professionals offered different assessments of Bundy over the years. Gary Ridgway, the Green River Killer, pleaded guilty to murdering 48 women, although he later claimed to have killed many more.

These men were not psychologically healthy people. You don’t repeatedly murder human beings and have a normal relationship with violence, empathy and morality. But society generally doesn’t look at Dahmer, Bundy, Ramirez or Ridgway and say, “They had mental-health problems, so we shouldn’t hold them responsible.”

We look at the victims. We look at the lives they took. We look at whether they understood what they were doing.

And that last part matters.

 

Mental Illness and Legal Insanity Are Not the Same Thing

This is where I think the conversation surrounding Lindsay Clancy sometimes becomes confused.

Having a mental illness does not automatically mean someone is legally insane.

Millions of Americans live with depression, bipolar disorder, schizophrenia, postpartum depression and other serious conditions without committing murder. A diagnosis by itself cannot be the end of the conversation.

The real legal question is much narrower: What was that person’s mental state at the time of the crime, and did it meet the jurisdiction’s legal standard for criminal responsibility?

That is something courts, experts and ultimately judges or juries have to determine based on evidence. And Lindsay Clancy deserves that same legal process.

Clancy is accused of killing her three young children — Cora, Dawson and Callan — in Massachusetts in 2023. Her defense has centered heavily on her mental condition, including claims involving postpartum psychiatric illness. Prosecutors have disputed parts of the defense’s characterization of her condition and have argued that evidence surrounding the killings demonstrates planning and awareness.

Those competing claims belong in a courtroom. But outside the courtroom, I’ve watched something else happen.

I’ve watched the conversation become overwhelmingly centered on Lindsay. Her mental health. Her suffering. Her medications. Her treatment. Her state of mind. Her tragedy.

And sometimes I find myself wondering: What about Cora, Dawson and Callan?

Three children died. Whatever ultimately happened inside their mother’s mind does not make their deaths less horrifying.

 

Compassion Doesn’t Require Us to Abandon Accountability

I believe we can have compassion for someone suffering from severe mental illness while still demanding an honest examination of responsibility. Those ideas aren’t mutually exclusive.

If evidence establishes that Clancy was experiencing a psychiatric condition so severe that she legally could not understand the nature or wrongfulness of what she was doing, then the law has mechanisms for dealing with that.

But that conclusion should come from evidence.

Not social media sympathy. Not because she’s a mother. Not because her story is heartbreaking. And not simply because the words “mental illness” appear in the case.

Because once we establish that mental illness alone excuses killing, we create a standard that becomes extremely difficult to apply consistently.

Dahmer had serious psychological abnormalities. Bundy was evaluated repeatedly. Ridgway underwent psychological examination. Other notorious killers throughout history have had documented psychiatric disorders, personality disorders, brain abnormalities or traumatic histories.

Yet we still ask whether they were responsible for their actions. Why shouldn’t we ask the same question here?

 

These Cases Are Different — And That’s Exactly the Point

I’m not saying Lindsay Clancy is Jeffrey Dahmer. I’m not saying postpartum psychosis is equivalent to the disorders associated with serial killers. I’m definitely not saying someone experiencing psychosis has the same motivations as someone who stalks victims for sexual gratification or repeatedly kills over years.

Those are completely different psychological circumstances.

My comparison is about the principle of accountability, not an argument that the defendants are psychologically identical.

Mental illness exists on an enormous spectrum. That’s why “she was mentally ill” cannot by itself answer the question of criminal responsibility.

The severity of the illness matters. The symptoms matter. Intent matters. Awareness matters. Planning matters. Behavior before and after the crime matters. Expert testimony matters. The law matters.

And most importantly, the victims matter.

 

Don’t Let the Accused Become the Entire Story

Maybe this is what bothers me most about cases like this. Sometimes society becomes so fascinated with understanding the person accused of killing that the victims slowly become background characters in their own deaths.

Jeffrey Dahmer became internationally famous. Ted Bundy became the subject of movies and documentaries. Richard Ramirez became a household name. Gary Ridgway became known around the world.

Meanwhile, most people couldn’t name five of their victims.

I don’t want that same thing happening here. Cora Clancy. Dawson Clancy. Callan Clancy. Those names should matter just as much as Lindsay’s.

Mental illness deserves compassion. Postpartum psychiatric illnesses deserve serious attention, better treatment and greater public understanding.

But victims deserve compassion too.

And accountability should not disappear simply because the person accused of a horrific crime has a mental-health diagnosis. Mental illness can sometimes legally eliminate criminal responsibility when it reaches the extraordinarily serious threshold established by law.

But mental illness and legal insanity are not interchangeable terms.

That’s the distinction we have to protect.

Otherwise, where exactly do we draw the line?