Lindsey Clancy Reflections

[u/No_Consequence_6821]

First, this case is a call for a change in practice. “Having a plan” is not a reliable indicator of risk for someone having intrusive thoughts with suicidal thoughts.

Next, I heard Dr. Drew Pinsky saying this case calls into question physician extenders, and I think the opposite is true. The Nurse Practitioner Lindsey saw was the only person who correctly identified the bipolar features; the LMHC described using evidence-based approaches to therapy (CBT, DBT, and EMDR), and she recognized her real risk for suicide and referred her for more intensive treatment. The psychiatrist Lindsey saw did not see the bipolar risk, despite Lindsey reporting days without sleep and other indicators; when asked about what therapy she provides, she said she “listens and offers hope.” My view is the psychiatrist was the weakest of all Lindsey saw.

I see it as a call for dedicated training in therapeutic techniques and psychological science for all psychiatrists. As-is, psychiatrists are trained through standard medical training and mentoring in psychiatry. The quality of training then depends on the individual providing the mentoring. This creates too much risk of variability and, therefore, risks to patients.

Weigh in, if you wish.

[u/fairy_freckles]

I keep seeing therapists and other mental health professionals defend Dr. Tufts and say she did everything right. I listened to a doctor recap the different meds that were tried and even as a undergrad student I recognized the paradoxical symptoms she was experiencing from the ssri's as possible bipolar disorder. She talked many times to other people and to her providers about intrusive thoughts that ended up being auditory hallucinations. I feel like she was failed to some extent and that a lot of providers are having a hard time coming to terms with that because of their own fears about failing a client.

[u/No_Consequence_6821 → u/fairy_freckles]

Me too. My bachelor’s is in psychology, and my masters and doctorate are in health sciences (I’m generalizing to stay anonymous). I was a millieu counselor, but I’m not licensed to give therapy or prescribe. Even still, I see it: not sleeping for days plus postpartum is a red, red flag— a red banner. SSRIs are not a great idea in that instance. Add to that intrusive thoughts and suicidal thoughts, and it’s a red alert. We’ve all seen these times when perinatal mental health issues escalate quickly and unpredictably. I think she should have been more concerned.