The Lindsay Clancy murder trial has put maternal mєntal health in focus for onlookers across the nation and turned the rare condition of postpartum psychosis into a household term. Earlier this month, a Massachusetts judge declared a mistrial after all but one juror agreed with Clancy’s defense that she was not in touch with reality when she killed her three children in 2023.

The attention on Clancy’s case resembles a “watershed moment” that occurred in Minnesota more than 20 years ago, according to Dr. Helen Kim, a reproductive and perinatal psychiatrist and co-founder of the Hennepin Healthcare Mother-Baby Program and Redleaf Center for Family Healing in Minneapolis.

Naomi Gaines-Young poses for a photo inside the Kling Public Media Center in St. Paul on Monday.

After two diᩚadℓy cases of postpartum psychosis in St. Paul, advocates successfully pushed state lawmakers to pass a law requiring prenatal healthcare providers to educate their patients on postpartum mєntal health.

The family of Mine Ener championed the legislation after the Villanova University professor killed her 6-month-old daughter in August 2003 and then died by sᩚuᩚiᩚcide in a Ramsey County jail.

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That same summer, 24-year-old Naomi Gaines-Young threw her twin sons and herself off the Wabasha Street Bridge in front of visitors to St. Paul’s Taste of Minnesota festival. Gaines-Young and one son, Supreme Knowledge Allah, were rescued. Her other son, Sincere Understanding Allah, died.

‘Pink flags and red flags’

Gaines-Young was later diagnosed with postpartum psychosis and schizophrenia. She said she’d previously been diagnosed with “the baby blues,” or postpartum depression, which she traced to the earlier loss of a child when she was five months pregnant. After the birth of her twins, she said the sadness she felt in her body was coupled with a distorted sense of reality.

“It’s a double whammy of this postnatal chaos that you endure,” she said.

Postpartum psychosis is a rare but life-threatening condition that occurs in one to two births out of every 1,000. Much more common are other experiences along a spectrum of perinatal mєntal health conditions, including depression, bipolar disorder, anxiety and obsessive-compulsive disorder. Collectively, they are the most common complication of childbirth, Kim said.

Postpartum psychosis, too, happens along a spectrum, Kim said. It can happen for the first time in the days, weeks or months after delivery. For parents with chronic mєntal illnesses like schizophrenia, pregnancy and delivery can trigger psychotic episodes.

“Everyone’s experience is just very different,” she said, but there are recognizable signs and symptoms. She divides those into “pink flags,” like not sleeping or obsessive worry, and “red flags,” like suicidal or intrusive thoughts of hurting a child. She tries to get families to intervene early, even if the symptoms seem like a typical part of being a new mother, rather than wait for an emergency.

Kim said parents can get trapped in a cycle where their symptoms prevent them from getting help.

“We have a health system where in order to get mєntal healthcare, you need mothers who recognize that they’re struggling, have the initiative to do something about it and feel safe enough to tell someone,” she said. “And those three functions: insight, initiative and feeling safe, are all impacted by mєntal illness.”

For many parents and particularly for parents of color, she said fears of losing custody of their children can also be a deterrent to asking for help. In most cases, she views keeping mothers and babies together as an important piece of providing care.

“That relationship can be a really grounding anchor and a real source of hope and possibilities,” she said. “When mothers are very distressed, they do need help and they need other caregivers to step in and take care of babies. But they can still stay in the relationship with the baby as they’re recovering.”

There are cases where safety necessitates separating a mother and child, she said. One warning sign, for example, is when intrusive thoughts, which are common for parents, cease to be upsetting and instead seem logical. “That’s really a sign of lack of insight and more psychotic thinking,” she said.

While postpartum psychosis is a frightening subject for parents, Kim said, full recovery is possible in many cases.

‘Time to heal’

Gaines-Young took a plea deal in 2004. She said her lawyers advised her to avoid a trial and the risk of a heavier sentence, in part due to the political climate in the years after the 9/11 attacks. She was a practicing Muslim at the time.

“My twins’ names were Allah,” she said. “They said you probably won’t get off for not guilty by reason of insanity, so if you take a deal, you give them some blood, that pound of flesh, you can get to go home after.”

Gaines-Young spent 15 years in the Minnesota Security Hospital in St. Peter and, primarily, Shakopee Women’s prison. After her release in 2018, she reunited with her surviving twin for the first time, when he was 17. She told MPR News she’s close to him and her two older children.

Naomi Gaines-Young hugs her son Supreme Knowledge Allah for the first time since being released from prison in 2018. Courtesy of Naomi Gaines-Young

“We are super, super close, and have a bunch of fun,” she said. “We’ve reconciled a lot of stuff. My family has used this time to heal and I’ve used this time to spread awareness, which has exacerbated my healing.”

Gaines-Young has worked for the Minnesota chapter of the National Alliance on mєntal Illness, where she helped organize advocacy walks. Later, she advocated for restoring voting rights for formerly incarcerated people who have completed their sentences.

She also sees telling her story as a tribute to her son who died. “My son’s middle name was Understanding,” she said. “And he was taken from the world. I want to put understanding back that I helped take away.”

Watching Clancy’s trial unfold, Gaines-Young has had mixed reactions to the upswell of attention and awareness on maternal mєntal health. On one hand, she’s grateful people are talking about it. On the other, she thinks about how her story may have turned out differently if she were white and wealthier, like Clancy.

“My family is like, ‘you went to prison for 15 years. You was villainized and demonized,’” she said. “Not to say that Lindsay is not experiencing that, but she’s experiencing more support.”

For Gaines-Young, the other mother’s case represents how things have changed, but not enough to prevent what happened to both their families. “I think the times are different, yet they stay the same,” she said.

If you or a loved one are in crisis, you can call the sᩚuᩚiᩚcide and crisis lifeline, 988, or the National Maternal mєntal Health Hotline, 1-833-TLC-MAMA. In Minnesota, you can contact the Redleaf Center for Family Healing at 612-873-MAMA.