Trial by social media: the Lindsay Clancy case

For the past few weeks, psychiatrists have been in the spotlight, and for all the wrong reasons. The Lindsay Clancy trial has been posted on several social media platforms and is gaining public interest beyond the US. The 32-year-old former nurse strangled her three children in January 2023, then jumped from a window, sustaining injuries that left her paralysed. She has pleaded not guilty, and her lawyer argues that she is not criminally responsible because she suffers from postpartum psychosis. Lindsay then sued her psychiatrist for “failing to recognise bipolar disorder with postpartum onset and prescribing several medications.' Members of the public have been commenting on this story, some accusing psychiatrists of being incompetent and conspiring with drug companies to turn mothers into killers.
I must declare that I have not examined this patient, nor have I read her medical notes. I am simply writing a reflection on this case as it was published in the media.
What concerns me is the impact of this tragic incident on how patients relate to their psychiatrist, and how non-medical professionals would spin this to sell the products that they claim to treat mental illness without medication. I have already come across videos of people giving their opinion on the case, only to end by promoting their doggy product that ranges from treating severe mental illness without medication to offering detox from psychiatric medication; many of these products are not registered or scientifically proven.
I was discussing the above case with a group of colleagues who believed that those blaming the psychiatrist are more likely to be 'psychiatric patients who refuse to accept their diagnosis or were detained against their will and never forgiven it.' This means the opinion they share is therefore “far from being neutral.' Also, satisfied patients do not tend to post their feedback on social media. On the other hand, some of the critics of mental health services are not all wrong. We often come across patients with rushed consultations that do not allow patients to give full details of their condition. We also see unjustified changes to medication when a patient demands improvement.
This is not the first time a court case has attracted public interest; those of you old enough may recall the OJ Simpson criminal trial, which took place in 1994. Yet the question remains: should the public have a say in court proceedings?
As we know, courts derive their authority from public confidence, and confidence requires that people can watch. But watching a trial and conducting one are different things, and social media has collapsed the distance.
A jury sits under rules that exist for good reasons; evidence must be admissible, witnesses are cross-examined, and experts are challenged by other experts. But the discussion carried out in different chat groups can twist reality and possibly damage the public trust in mental health providers.
As a psychiatrist, I come across people with severe mental illness who refuse to take medication despite the fact that their symptoms are causing them distress or even putting their lives in danger; therefore, biased propaganda can even worsen this situation, and we are likely to see a stable patient relapsing because they stopped medication.
On a positive note, the Lindsay Clancy case teaches us a few lessons on how to organise mental health services to prevent similar incidents.