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When the Clinical Record Becomes the Evidence:
What the Lindsay Clancy Trial Has Made Me Think About as a Clinician

Hannah Kilbert, LISW-S
Clinician

As a mental health clinician, watching the Lindsay Clancy trial has been really difficult to process for so many reasons. It has been heartbreaking to know the outcome, but to also watch how everything has been unfolding over the last couple of weeks. I found myself questioning myself as a clinician, because for a lot of us, especially in the perinatal mental health world, some of the issues being discussed feel close to home and happen in clients that sit across from us every day.

The trial has placed mental health treatment, clinical decision-making, risk assessment, and documentation under a giant microscope. There are so many different interpretations of Lindsay’s mental state, including whether she experienced postpartum psychosis, major depressive episodes, or other psychiatric symptoms. What stands out to me as a clinician isn’t just the disagreement among the professionals, defense, or prosecutors, it’s the realization that the notes we could be writing at the end of a long workday, could be examined by people who were not in the room, did not know the client, and do not experience the clinical moment as it actually happened.

Documentation anxiety
The question I keep asking myself as a clinician is “What would someone say about my documentation if it was me who had treated her?”

This made me pause hard for a second. We are taught that documentation protects us as clinicians, that if it wasn’t documented, it didn’t happen, but it’s so much more than that. It’s a record of what we knew, what was reported, observed, assessed, and what was recommended based on what information was given to us at that time.
The challenge is that hindsight changes everything.

When we know how a story ends, seemingly small details can suddenly appear enormous. A statement that seemed nonspecific in the moment may look glaringly significant after a tragedy. A risk assessment that was clinically reasonable at the time can look different when viewed through the lens of an outcome that nobody could have predicted.

Recent testimony in the Clancy trial has included detailed examination of providers’ recollections, mental-status observations, risk assessments, diagnoses, medications, and clinical records. For clinicians watching, it is a reminder that our documentation may eventually need to communicate not only what happened, but why we made the clinical decisions we made. We can’t document every thought or quote as a way to write defensively, but we can do it thoughtfully.

What does it feel like to watch as a clinician?
For me, one of the most uncomfortable aspects of watching a case like this is the tension between empathy and objectivity. There is SO much in the news, on social media, and it’s heavy.

As clinicians, we are trained to hold complexity and empathy. We can recognize that someone can be experiencing severe mental illness while also recognizing the devastating consequences of their actions. We can have compassion for a person suffering without excusing behavior. We can acknowledge systemic failures without assuming that every clinician involved acted negligently.

That middle ground is difficult.

The public conversation surrounding this trial often feels much more absolute: Someone missed something. Someone should have known. Someone should have done more. But clinical work rarely provides that level of certainty.

We work with incomplete information. Clients may minimize symptoms, misunderstand their experiences, withhold information, present differently from one appointment to the next, or genuinely not understand what is happening to them. Clinicians are making decisions based on the information available at that moment.

That is particularly important in perinatal mental health, where symptoms can evolve rapidly and where depression, anxiety, intrusive thoughts, sleep disruption, mania, psychosis, and postpartum psychosis can overlap or be misunderstood. The trial has brought these distinctions into public discussion in a way that many clinicians likely never expected to see play out in a courtroom.

Staying objective when the story is emotionally charged
This case also reminds me of the importance of separating what we know from what we believe. As clinicians, we must resist the temptation to diagnose people we have never treated based on courtroom testimony, news coverage, social media clips, or our own emotional reactions. We can discuss clinical concepts. We can discuss warning signs. We can discuss systemic gaps in perinatal mental healthcare. We can learn from this case.

That same principle applies in our own clinical work. Objectivity does not mean being cold or detached. It means remaining curious enough to consider multiple possibilities, documenting observations separately from interpretations, and allowing the clinical picture to evolve as new information becomes available.

Every single clinician is also a person first. We all have thoughts, opinions, bias’, and I’ll be honest, this case has been on my mind a lot; not only as a clinician, but as a mother, a wife, and an advocate. We all have to take care of ourselves and if that means taking a break from social media for a while, then that’s what needs done.

What I hope clinicians take away
I don’t think the lesson from this trial should be that clinicians need to be afraid of their documentation. I think the lesson should be that our documentation matters.
We can’t document solely to protect ourselves from hypothetical situations, and we cannot allow fear to replace clinical judgment. For myself, I really analyzed a lot of what I was feeling and processed it in ways that were helpful to me- and then I had to keep doing what I was trained and taught to do- which is to show up.

We have to practice the way we were trained to. Write what you assessed. Document relevant client statements. Record significant changes in symptoms and functioning. Document risk assessments and safety planning when clinically indicated. Explain important clinical decisions. Consult when something feels outside your scope. Refer when a higher level of care is warranted. And when you don’t know, don’t pretend that you do. Most importantly, remember that we are practicing in the present, not documenting with the benefit of hindsight.

The Lindsay Clancy trial is ultimately about one extraordinarily tragic case. But for clinicians, it also creates an opportunity to have uncomfortable conversations about documentation, risk assessment, perinatal mental health, professional responsibility, and the limits of clinical prediction.

We should allow ourselves to learn from the case without allowing it to convince us that we must practice from a place of fear.

The goal of documentation isn’t to predict the future, it is to accurately capture the clinical picture we were seeing, the information we had, the judgment we exercised, and the care we provided at that moment in time.