As South Africa prepares to mark World Suicide Prevention Day, South African author Kim Vermaak asks whether we are listening when mothers tell us they are not okay.
Johannesburg, South Africa: The Lindsay Clancy trial has ended without a verdict, but it has left behind a question that reaches far beyond the Massachusetts courtroom. What happens when a mother tells us she is struggling and asks for help, but caregivers fail to recognise the severity of what she is experiencing?
Clancy, a former labour and delivery nurse, was accused of killing her three children in January 2023 before attempting to take her own life. Her defence argued that she was experiencing postpartum psychosis and was not criminally responsible for her actions, while prosecutors argued that the killings were deliberate. After almost six weeks of testimony and more than 38 hours of jury deliberations, the jury could not reach a unanimous verdict and a mistrial was declared on 4 September 2026.
The trial also examined Clancy’s mental-health treatment in the months before the deaths. Evidence showed that she sought help several times, reported suicidal thoughts and contacted crisis services. According to trial testimony, she was told by a crisis service that she did not meet its criteria for inpatient treatment because she did not have a specific suicide plan. She subsequently received other psychiatric care, including an inpatient admission.
For South African author Kim Vermaak, this part of the case is particularly significant as the country prepares to mark World Suicide Prevention Day on 10 September.
It is also personal.
During her own experience of severe postnatal depression, Vermaak experienced an intrusive thought about holding her baby underwater, so she could go back to sleep.
“I remember having the thought and in that moment, it seemed logical,” says Vermaak. “But I did not really want to hurt my baby. The thought frightened me because it was completely contrary to what I felt and what I wanted. It took a lot of courage to admit I was not okay, but when I did, I got help.”
Vermaak says, “People are quick to label, but slow to support. Intrusive thoughts can be frightening for new mothers, and the shame of what they are feeling makes them too afraid to ask for help.” This makes the Clancy case even more tragic, as she had already reached out for help.
“A mother can love her baby completely and still experience a thought that horrifies her. Having an intrusive thought does not mean she wants to act on it. But if a thought is frightening you, that is something you should be able to talk about and get help for.”
The Clancy case raises questions about how mental-health services assess risk and determine what level of care a person needs. It would be wrong to suggest that a different clinical decision would definitely have prevented the deaths of her children. The trial did not establish that, and the jury did not reach a verdict on her criminal responsibility.
But the evidence that Clancy repeatedly sought help deserves attention.
“We need to ask what happens when a mother says she is not okay,” says Vermaak. “Do we wait until she has a plan before we take her seriously, or do we listen to the distress she is already expressing and assess what she needs?”
Vermaak stresses that mothers experiencing intrusive thoughts or suicidal thoughts should not automatically be viewed as a danger to their children.
“Most mothers experiencing postpartum depression do not harm their children. We need to be careful that our fear of these cases does not make mothers too frightened to tell us what they are experiencing.”
But what does this case mean for South Africans?
Filicide, the killing of a child by a parent or parental figure, is prosecuted in South Africa under the common-law crime of murder rather than as a separate offence.
A 2026 article published in the South African Journal of Bioethics and Law highlights the limited South African research into filicide and calls for more consistent mental-health assessments, sentencing guidelines and stronger links between healthcare, social services and law enforcement.
For Vermaak, the legal conversation is important, but prevention has to begin long before a case reaches a courtroom.
“When a child has died, the law has to ask what happened and who is responsible. But as a society, we also need to ask what happened beforehand. Was the mother asking for help? Did anyone recognise that her mental health was deteriorating? Did she feel safe enough to tell someone about the thoughts she was having?”
These questions are at the heart of Vermaak’s book, Taming the Monster of Postpartum Depression, which combines her own experience of severe postnatal depression with the experiences of other mothers.
“I got help,” says Vermaak. “That is the part of my story I want mothers to hear. I had a thought that frightened me, but that thought did not make me a bad mother. It told me that I needed help.”
As South Africa marks World Suicide Prevention Day, Vermaak believes the Lindsay Clancy case provides an opportunity for a more honest conversation about maternal mental health.
“We need to become better at recognising when a mother is struggling and making sure she knows where to turn. Sometimes she is already telling us that something is wrong. We just need to listen.”
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Author: Kim Vermaak from Write Learn and Earn on behalf of Kim Vermaak.
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