Dr. Avram Mack, a forensic psychiatrist providing testimony for the prosecution, informed the jury about the unfortunate circumstances surrounding Lindsay Clancy’s time at the hospital where she is presently detained.

Dr. Avram Mack stated that he endeavors to conduct an independent review of cases, regardless of whether he is serving as an expert for the defense or the prosecution. He examined medical records, as well as outpatient and inpatient records from before and after the murders, in addition to criminal files, he testified.
He assessed Clancy on April 10 and April 11, 2026, at Tewksbury Hospital.
“Generally, she was friendly and cooperative,” he testified.
He noted that she consistently maintained eye contact and that there were few abnormalities in her speech or thought processes. “I would say at some point she seemed distressed at certain topics,” Mack stated.
Avram Mack says Lindsay ‘wasn’t very interested in hygiene and grooming’
Lindsay uses a wheelchair and appeared physically comfortable, he stated. Additionally, she was capable of maneuvering her wheelchair from one location to another, he mentioned.
She recounted her typical day at Tewksbury Hospital, saying that she mostly remained in bed or spent time alone, he explained. She did not engage with other patients, Mack noted. Occasionally, she was able to visit with family members and spiritual figures, such as a chaplain or priest, he added.
According to him, she “wasn’t interested in the food there,” and “wasn’t very interested in her own hygiene and grooming.”
‘Showering is embarrassing’ for her, Avram Mack testifies
The psychiatrist elaborated, stating, “Showering is embarrassing,” and mentioned that she required assistance to shower due to her paraplegic condition.
“She described feeling depressed. She described feeling miserable, not wanting to be alive,” he said.
He stated that the stressors experienced by Clancy stem from “the remorse and sadness” associated with the events pertinent to this case, her separation or estrangement from her former husband, her disconnection from society, and her physical injury.
Avram Mack opens up about Lindsay Clancy’s depressive episode
He stated that he believes Lindsay Clancy experienced a significant depressive episode during the four months prior to the time she strangled her three children.
He also mentioned that she had an anxiety disorder. However, he did not think she experienced psychosis or a manic or hypomanic episode before the tragic events.
Clancy’s defense argues that she was enduring severe postpartum psychosis and claimed to have heard a voice instructing her to kill her children and take her own life.
He enumerated several symptoms associated with mania, noting that the presence of four of these symptoms over a seven-day timeframe is necessary for diagnosis. He stated that he found no indications of mania.
Lindsay Clancy trial: Is being suicidal a manifestation of psychosis?
Mack mentioned that Clancy’s family had no known history of mental health disorders and that his diagnosis was made independently of her previous episodes of mental illness.
Although he did not conduct interviews with other family members, he did examine Patrick Clancy’s grand jury testimony, according to Mack. He testified that her family did not respond to the prosecution’s attempts to communicate with him, but he was unaware of this situation.
He further stated that some of the unusual thoughts she was experiencing were typical, including the fear that someone might take her children away.
He also expressed his understanding of her feelings of being “damaged” by the medication and did not consider her irrational thoughts to be “psychotic.” According to him, her concerns were valid as they “aligned with what she experienced.”
“Is being suicidal a manifestation of psychosis?” Assistant District Attorney Shanan Buckingham inquired. “No,” Mack replied.