Lindsay Clancy Confided Chilling Fear to Psychiatrist Before Killings

[00:00:00] Speaker 1: - Anything changed in that mental status exam from the September 28th meeting that you had with her? [00:00:08] Speaker 2: - Can I review it? - Yes. - There isn't anything that stands out to me right now. [00:00:47] Speaker 1: - And I think that what you put on the October 3rd date was that her insight was still poor? - Yes. - Was that for the same reasons you described earlier? - Yes. - The next time that you saw Ms. Clancy, was that on October 20th, 2022? - Yes. - And what information did you learn on that date about whether or not she was taking the Zoloft you had prescribed? [00:01:14] Speaker 2: - So she told me that she decided to start the Zoloft. [00:01:18] Speaker 1: - And did she tell you how long she had been taking it? - For one week. - And did she tell you that the previous night she had increased the dose? - Yes. - And that's what was in the original prescription, correct? To take the pills at 25 milligrams for one week and then increase to 50? - Yes. - So if that had been done, taking the seven pills, taking the pills for one week would be seven pills, and then increasing the dosage the next night would be two pills? - Yes. - So that would be nine pills? - Yes. - When she told you she increased the dose, she told you she now feels awful, is that correct? - Yes. - And what was it that was bothering her? [00:02:01] Speaker 2: - She was having increased difficulty sleeping, she had loss of appetite, diarrhea. She was feeling her mood was down. She was tearful and feeling very foggy and feeling very anxious. [00:02:19] Speaker 1: - Now, what is the lowest dose of Zoloft that you would prescribe a patient or could prescribe? - The smallest pill is 25. - And what's the highest dose of Zoloft? [00:02:30] Speaker 2: - 200. [00:02:31] Speaker 1: - Okay, so she was on the lowest dose of 25, is that correct? - Yes. - And then according to what she told you, she had increased for one night to 50 milligrams, is that correct? - Yes. - Did she also tell you she was scared to start something new? - Yes. - Is that in terms of another medication? - Yes. - So what was your discussion with Ms. Clancy when she's telling you that she's having these issues with Zoloft, but she's afraid to try something new? [00:03:00] Speaker 2: - So we discussed what to do moving forward. So we discussed whether it would make sense to switch to a different medication at that point. And at that moment, because of her negative experience with the Zoloft, she did not want to start a new medication at that point. [00:03:23] Speaker 1: - At this meeting with her, did you ask her if she had any suicidal thoughts? - Yes. - What was her response? [00:03:29] Speaker 2: - Um, no. [00:03:31] Speaker 1: - Did you ask her if she had any homicidal ideation or thoughts? - Yes. - What was her response? [00:03:36] Speaker 2: - No. [00:03:37] Speaker 1: - Did you ask her if she was hearing any voices or seeing any visual hallucinations? [00:03:42] Speaker 2: - I'm not sure if I asked that in that appointment, but she was very clearly not psychotic. - And why do you say that? - Because of how I described some of the signs of psychosis that are on the mental status exam. None of those were present. [00:04:00] Speaker ?: - Okay. [00:04:02] Speaker 1: - Um, what was her affect during this meeting? - Um, it was depressed. - And did you write that, um, that she was-- sorry, that? - What was it about her affect that made you write that she was depressed? [00:04:25] Speaker 2: - Um, she visually appeared like she was feeling sad. [00:04:35] Speaker 1: - And, um, her mood, how did she report that to you? [00:04:38] Speaker 2: - That was depressed as well, and anxious. [00:04:43] Speaker 1: - Um, what about her thought content and process that day? [00:04:46] Speaker 2: - That was appropriate. [00:04:48] Speaker 1: - And her speech? - Um, it was appropriate. - And her judgment and cognitive skills? [00:04:54] Speaker 2: - Her judgment was excellent, and her cognition didn't have any deficits. - And her psychomotor activity? - Normal. [00:05:04] Speaker 1: - Yeah, so the main change here from previous visits was that she appeared depressed and anxious? - Yes. - Although she had appeared anxious that first visit, correct? - Yes. - So, to make sure we have the timeline correct, the first visit she appeared anxious, the second visit she appeared to be doing better, the third visit she still had that poor insight when you met about the paperwork, and then this fourth visit she appears depressed. Is that correct? - Yes. [00:05:34] Speaker ?: - Okay. [00:05:37] Speaker 1: - Did she also tell you that she was worried about getting suicidal thoughts? - Yes. - Um, so that would have come directly from her, correct? - Yes. - And what was that, what were the details of that conversation? [00:05:58] Speaker 2: - So, it was one of the things that she was anxious about. It was, uh, a fear of one day having suicidal thoughts if, uh, she were to continue to feel poorly. - Okay. [00:06:15] Speaker 1: And showing you page 77 of Exhibit 219, um, I know you said earlier you weren't sure if you asked her about audio, um, or visual hallucinations, but just directing your attention to the, to the, um, interval history, if that refreshes your memory? [00:06:32] Speaker 2: - Yes. [00:06:33] Speaker 1: - So, did you ask her about audio hallucinations and visual hallucinations? - On the 21st I did. - Okay. - All right, so then there was an appointment the following day on October 21st? - Yes. - So, why did she have an appointment that following day? [00:06:48] Speaker 2: - Um, because she was feeling pretty poorly, um, after starting the Zoloft, so we were following her closely. [00:06:56] Speaker 1: - And, um, at that point you knew that she had, um, had an appointment on the third with Ms. McAllister, correct? - Yes. - And, um, do you know whether or not, um, she had followed up making another appointment or was struggling with that? [00:07:16] Speaker 2: - Um, I, she was planning on making another appointment. I don't know when that second appointment was scheduled. [00:07:25] Speaker ?: - Okay. [00:07:27] Speaker 1: - When you, that first appointment, um, where she was seeming depressed and having issues with Zoloft on October 20th, um, did you tell her to stop taking the medication at that point? [00:07:40] Speaker 2: - Yes, I did. [00:07:41] Speaker 1: - Okay. - So, did you discuss other options with her, other than medication, like natural remedies? - Yes. - And what type of natural remedies did you discuss with Ms. Clancy? [00:07:50] Speaker 2: - Um, so I mentioned things like fish oils, um, something called L-methylfolate or - Same, these are, um, supplements. [00:08:00] Speaker 1: - Okay. And is that, why would you, um, offer alternative remedies to a patient? [00:08:05] Speaker 2: - So, it was because she seemed reluctant to start a prescribed medication. - I thought she might be more open to something that was natural. [00:08:17] Speaker 1: - So, you weren't pushing her to take, um, a prescription medication, correct? - No. - Now, on October 21st, when you saw her, did she tell you that she had, hadn't been able to get any sleep the night before? - Yes. - Um, you've already said, she, she told you she wasn't having audio or visual hallucinations, correct? - Yes. - Did you ask her if she was having suicidal ideation or homicidal ideation? - Yes. - And what was her response? - No. - What was her affect that day?