LIVE Updates: Lindsay Clancy trial delves into her mental health treatment

Jurors heard Friday from mental health providers who treated Lindsay Clancy in the months before the Massachusetts mother allegedly strangled her three kids in their Duxbury home in 2023. One of those providers was previously named in lawsuits alleging that Clancy was given inadequate care. Clancy's mental health treatment Testimony on the ninth day of the case focused on Clancy's mental health treatment in the weeks leading up to the deaths of her three children. Jurors heard that Clancy voluntarily checked herself into McLean Hospital early on New Year’s Day. The psychiatrist assigned to Clancy at the hospital testified that upon arrival, the Duxbury mother reported experiencing suicidal thoughts, anxiety, and an inability to sleep. Over several days, Clancy met with multiple psychiatrists, nurses, mental health workers, and social workers. Dr. Alia Goodheart said she met with Clancy for an evaluation several days later and assessed that Clancy had no plan for suicide. Goodheart said Clancy expressed that her children and her family were reasons she would not commit suicide. Jurors also heard from Dr. Jennifer Tufts, one of the defendants named in civil lawsuits filed in January by both Lindsay Clancy and her ex-husband, Patrick Clancy. Those cases accuse Tufts, other providers and hospitals of failing to properly diagnose and treat her mental illness. Tufts testified that her initial diagnosis was adjustment disorder with depressed mood and generalized anxiety disorder. She said that she recommended medication to Clancy, but that Clancy was reluctant. McLean Hospital was also named as a defendant in Lindsay Clancy's lawsuit. Arguments over a whisper in the courtroom Judge William Sullivan paused before Friday's lunch break during the emotional trial of Lindsay Clancy to admonish everyone in the courtroom to beware of making inappropriate remarks. "I just want to make real clear that there is to be no inappropriate comments or disruptive comments to be made inside of this courtroom. If anybody's found to make those, they will be immediately escorted out and barred for the balance of this," Sullivan said. Background of the Clancy case: Lindsay Clancy faces three murder charges in the 2023 deaths of her children, Cora, Dawson and Callan. She also jumped from a second-floor window, leaving her partially paralyzed. In a civil case, Lindsay Clancy alleges a "catastrophic failure" of multiple medical providers in diagnosing and treating her psychiatric condition. Her trial began on July 20. Although her legal team offered to stipulate to the deaths of the children, she has pleaded not guilty. She is being held at Tewksbury State Hospital. The jury is made up of 12 women and six men. They will not know until the presentation of the case is concluded who will deliberate and who will be an alternate. This case involves issues of mental health. If you or someone you know needs help, you can talk with the Suicide & Crisis Lifeline by calling or sending a text message to 988, or you can chat online here. Grandfather testifies Christopher Clancy, father of Patrick Clancy and grandfather of the children, was called to the witness stand around midday on Thursday. His testimony began with a description of when he first met Lindsay Clancy. Later, he described Lindsay Clancy as "very protective" of her then-husband and children. He also noted that she was close with his daughter, Patrick Clancy's sister. Christopher Clancy said he was aware of his former daughter-in-law's mental health struggles and that his son was concerned about her well-being. Before the prosecution concluded their questioning, Christopher Clancy also described the call he received from his son after the children were killed. "It was terrible," he said. Weeping in court Clancy cried Thursday during the testimony of Dr. Kimberley Springer, a medical examiner, who described images from the autopsy of Callan Clancy in January 2023. Citing the nature of these images, the court has ordered that they not be shown to the public. The images were shown on monitors visible to the jury but not the spectators in the gallery. Springer specifically narrated the images of Callan's neck, which she said displayed images consistent with ligature strangulation. She also described how strangulation causes death. The defense did not cross-examine Springer. After the testimony, the court took an unexpected break. Clancy was still crying as she was moved out of the room. Dispute over defense witnesses Lindsay Clancy's attorneys have asked a Plymouth Superior Court judge to allow three defense witnesses to testify after prosecutors objected to their inclusion, arguing the testimony is central to her defense. Her motion asks the court to permit testimony from Dr. Elizabeth Laposata, Dr. Michael Vulfovich and Dr. Donald Condie. "To exclude these witnesses would denude the defendant of significant defense witnesses and would deprive her due process of law and the ability to mount an effective defense on her behalf," the defense wrote. At the end of the day, after the jury was excused, the judge allowed attorneys to argue this motion. Defense attorney Kevin Reddington argued that each of the doctors would counter testimony being presented by the prosecution. Laposata, Reddington said, would testify that Clancy landed on her head after jumping out of the window, causing her spinal injury. Reddington also revealed that the defense is preparing an animation to show how they believe Clancy went out of the window and that Vulfovich would discuss the "suicide attempt." Judge William Sullivan did not decide on the motion but said he would consider the issues overnight. He also suggested that he was particularly reluctant to allow Vulfovich's testimony. More key takeaways from the trial are here. Former nanny takes the stand The day's final witness Wednesday was former nanny Elaine Rossi, who cared for infant Callan Clancy beginning in September 2022 while Lindsay Clancy prepared to return to work. Rossi testified she communicated with Clancy daily through text messages and a notebook containing detailed instructions about Callan's feeding, sleep schedule and daily routine. She said she occasionally cared for all three children, took Cora and Dawson to activities when Clancy said she could not drive and frequently recorded videos of Callan to send to Clancy throughout the day. Jurors watched one of those videos during testimony, showing Callan happily drinking a bottle. Clancy appeared visibly emotional as it played in the courtroom. Rossi described Clancy as a "wonderful mom" and testified she never believed the children were unsafe. She also said Clancy spoke about struggling with postpartum issues, difficulty sleeping and seeing doctors for treatment. Rossi recalled Clancy had lost weight but never observed behavior that caused concern for the children's safety. Jurors hear about medications, DNA evidence Wednesday's testimony first focused on medications in Lindsay Clancy's system and DNA evidence related to the 2023 incident at her Duxbury home. Clancy sat quietly in the courtroom as her lawyer argued that she was suffering from postpartum psychosis and was overmedicated. Prosecutors, however, said she acted intentionally when they allege she strangled her three children before attempting to take her own life. Jurors heard from a forensic toxicologist who tested a blood sample from Clancy. He said the medications found in her system were not at a toxic level. "Usually people take handfuls of pills when they're trying to harm themselves and take their own life. That was not consistent here," Dr. Justin Brower said. The defense questioned the toxicologist further. "In other words, what you're saying, the numbers alone do not tell the tale of what happened to a particular individual?" the defense asked. "Correct, they do not tell the entire story," Brower said. Jurors also heard from a forensic scientist who previously worked with the Massachusetts State Police. She discussed the DNA found on evidence in the family's basement, where prosecutors say the children were discovered. Journals become evidence Prosecutors read entries from the notebooks describing Clancy feeling overwhelmed by her son Callan’s sleep schedule. On cross-examination, the defense highlighted other entries in which Clancy wrote about wanting to get well, brain fog, guilt, anxiety and concerns about returning to work. The journal and other notebooks were introduced to the case by the prosecution during the testimony of Trooper Cory Melo, who was assigned to the Plymouth District Attorney's Office. "Completely overwhelmed, I feel like I'm drowning," Clancy wrote in a sentence read by the prosecution. On cross-examination, the defense read aloud examples of Clancy expressing stress about sleep training her youngest child, Callan; guilt over using family money while not working; and concern about her relationship with her husband, Patrick. "I want to be well," Clancy wrote in one passage read in court. Physicians, nurses describe Clancy's injuries Dr. Sejal Shah testified about working with Lindsay Clancy at Brigham and Women's Hospital, starting on Jan. 29. Shah said Clancy was initially confused and delirious after spinal surgery, but later denied suicidal or homicidal thoughts and appeared focused on rehabilitation. Clancy also asked for her health care proxy to be changed from her husband to her parents. The defense questioned Shah about Clancy’s diagnoses and medications prescribed before the killings. Shah explained some medications carry warnings about possible suicidal thoughts. Nurses Rachelle Amedee and Meghan Collins testified that Clancy arrived at the ICU at Brigham and Women's Hospital early in the morning on Jan. 25, and was assigned constant supervision. Amedee said Clancy required resuscitation that first night. Amedee said Clancy, who was intubated, was able to use a whiteboard to communicate starting on Jan. 28. The nurse said Clancy described being confused and unable to feel her lower extremities. On cross-examination, Amedee confirmed that records indicated Clancy had a known history of postpartum depression. Earlier Monday, prosecutors called emergency department doctors who described treating the children. One described receiving Cora Clancy at Beth Israel, where she was declared deceased. Others described Callan Clancy's arrival and treatment at Boston Children's Hospital, where he was eventually declared brain dead, and life support was removed three days later. The final physician testified about Lindsay Clancy's arrival at South Shore Hospital with lacerations on her neck and wrist, and a spine injury. Jury visits key locations The first week of testimony in the Lindsay Clancy murder trial ended after the judge, jury and attorneys visited locations connected to the case, including the Clancy family's former home in Duxbury. The jury also retraced the route prosecutors say Lindsay Clancy sent her husband, Patrick Clancy, on the day of the killings, including stops at a CVS and a restaurant in Plymouth. Day 4: Court adjourns after more emotional testimony, tour of Clancy family home Expert testimony expected to be crucial Retired District Court Judge Jim Barretto said the case is expected to center on competing psychiatric experts. "The defense, of course, is expected to call experts supporting its claim that Lindsay Clancy was suffering from postpartum psychosis and lacked criminal responsibility. And of course, we'll hear from prosecution – the prosecution – who's expected to present experts, uh, disputing that conclusion," retired District Court Judge Jim Barretto said. The defense is expected to argue that Clancy was suffering from postpartum psychosis and lacked criminal responsibility at the time of the killings. Prosecutors are expected to present experts who dispute that conclusion. Video below: Reporter Sera Congi describes court during 911 call Prosecutors must prove criminal responsibility The prosecution has the burden of proving Clancy was legally sane when the children were killed. To secure a conviction, prosecutors must prove the killings were committed with premeditation or with extreme atrocity or cruelty. Opening statements delivered The state laid out for the jury of 12 women and six men the alleged events that led up to the children's deaths on Jan. 24, 2023, and warned the jurors they would hear graphic testimony as she urged the group to use their common sense and life experiences as they listen to the case. Video below: Prosecution's opening statement Plymouth County Assistant District Attorney Shanan Buckingham started by telling the jury the children were strangled "meticulously." "One by one, she wrapped exercise bands around each one of the kids' necks and pulled until their little bodies were limp and lifeless," Buckingham said. The state argued Lindsay Clancy understood her actions and made a deliberate choice. "She heard a voice, a male voice, a voice that she had never heard before, a voice that she had never heard again. That voice told her it was her last chance; she had to kill her kids so she could kill herself. She immediately took action when she heard the voice with no direction or details from this so-called voice, and she killed the children," Buckingham said. Video below: Defense's opening statement Lindsay Clancy's defense team plans to use the insanity defense, arguing that she suffered from postpartum psychosis and was overmedicated at the time of the alleged crimes. In his opening statement, Reddington said his client knows she killed her children but questioned what was going on in Lindsay Clancy's mind. "After the second child she had postpartum. … You will hear evidence that was one of the issues that was important because it can lead to (being) bipolar. One of the things you don't do if someone is bipolar, you don't put them on an antidepressant, on Zoloft. It messes with your brain, and it was done in this case," Reddington said. Reddington showed the jury graphic photos of Lindsay Clancy in the hospital after she jumped out of her bedroom window in an effort to head off any move by the prosecution to make the attempted suicide appear to be fake. Video: Psychiatrist talks maternal mental health