The Lindsay Clancy Case... Who’s the Bad Guy? Over the last two weeks, the Lindsay Clancy case has erupted into a culture war. I use that term because the debate is increasingly moving away from the facts of the case and toward one question: Who should be held accountable? There is a very strong argument that antidepressants induced the psychosis that led Lindsay to kill her children. Both defense and prosecution experts recognized a bipolar diagnosis. Her medical records documented worsening insomnia and mood shortly after SSRI exposure. She repeatedly texted family members that the drugs were damaging her brain. In the week before she killed her children, she was even frantically Googling whether psychiatric drugs could damage her brain. What seems to bother many people on the right is that, if Lindsay is found Not Guilty by Reason of Insanity, there may be no obvious “bad guy” who goes to prison. Three beautiful children are dead. Morally, that feels intolerable. So the reasoning becomes: someone must pay, and therefore Lindsay MUST be convicted. I strongly disagree. But there is a bad guy here. The problem is that the bad guy is not one person. It is 30 years of poor mental health leadership in the United States. It is 30 years of doctors failing to stand up to the pharmaceutical industry’s message that mental health problems are best treated with handfuls of drugs during 20-minute, transactional visits. For years, medical leaders allowed drug companies to sell doctors and patients the idea that depression was a serotonin imbalance that needed to be corrected with medication. That helped normalize massive antidepressant use while non-drug approaches were pushed to the side. They also taught doctors to downplay serious drug side effects. Dr. Jennifer Tuff’s notes reportedly described Lindsay as lacking “insight” because Lindsay believed the medications were making her worse, rather than accepting that her symptoms were simply caused by depression. Is it any wonder, then, that her antidepressant doses continued to be increased until she became completely psychotic, despite already having two bad reactions to SSRIs in October? In my view, this was a catastrophic failure of care. I hate the fact that three children are dead. And I absolutely believe there should be accountability. But convicting Lindsay of murder, if the drugs drove her into psychosis, does not fix the problem. That is what accountability is also about: creating a deterrent against future bad behavior. Throwing Lindsay Clancy in prison for murder is not going to prevent the next drug-induced homicide. But turning our attention to rampant overprescribing and the minimization of these drug risks might. Holding medical leaders accountable for doing an abysmal job of teaching doctors how to safely treat mental health conditions might. If we really want to prevent the next tragedy, that is where the focus needs to be.