By MICHAEL CASEY and LEAH WILLINGHAM

EDITOR’S NOTE: This story includes discussion of suicide. If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988.

PLYMOUTH, Mass. (AP) — Lindsay Clancy was in a deep psychosis when she strangled her three children in their Massachusetts home, her lawyer said Thursday, telling jurors that she had been a loving mother before her mental health spiraled.

“Because of the damned medicine and the lousy medical care that she got,” attorney Kevin Reddington said during closing arguments of Clancy’s murder trial, referencing the various mental health providers she saw and the different drugs they prescribed in the months before the January 2023 killings.

Prosecutors contend that Clancy acted intentionally and sent her husband out on an errand before killing her young children, rejecting her lawyer’s claims that Clancy was in the throes of postpartum psychosis, a rare mental illness linked to stress, sleep deprivation and hormonal changes following childbirth.

Clancy’s mental state is at the center of the closely watched trial that has drawn attention to maternal mental health after childbirth. The debate has stirred deep divisions among the public over whether she should be held criminally responsible.

Clancy did not testify during the trial, which is in its fifth week. Prosecutors called more than 70 witnesses, including Clancy’s then-husband, while the defense called 10 witnesses, including some of Clancy’s friends and relatives.

Multiple psychologists and psychiatrists also testified about Clancy’s mental health. Outside the court before closing arguments began, Clancy supporters wearing pink gathered to call attention to women’s mental health issues.

“I do hope that it has opened a discussion, and people realize how serious this is,” Reddington said before going into the courthouse.

Clancy, 36, has pleaded not guilty by reason of lack of criminal responsibility when she killed 5-year-old Cora, 3-year-old Dawson and 8-month-old Callan Clancy at the family’s home in coastal Duxbury before attempting suicide.

Prosecutors say Clancy understood her actions were wrong.

If convicted of murder, Clancy faces a mandatory life prison sentence. If jurors find her not guilty because she lacked criminal responsibility, she would not face prison time but could be committed to a psychiatric facility.

Testifying Wednesday as the final rebuttal witness for the prosecution, a forensic psychiatrist at the University of Virginia and a senior psychiatrist for the FBI’s Behavioral Analysis Unit said he did not believe Clancy’s account that a voice ordered her to kill the children.

Prosecutor Jennifer Sprague asked Dr. Gregory Saathoff a series of questions about Clancy’s account: Did the voice tell her where to kill the children? How to kill them? What to use? In what order? Saathoff answered no each time.

All three children were strangled with exercise bands in the family’s basement before Clancy jumped from a second-floor window while her husband went to pick up takeout and medication on Jan. 24, 2023. Saathoff said her ability to accomplish everything she did without direction indicated Clancy “had control, control of the sequence of what she was doing throughout.”

Clancy’s defense attorney asked Saathoff about Clancy’s attempts to search online for information about postpartum depression, her visits to multiple maternal and mental health providers, disclosures to her mother and then-husband that she was suicidal and feared that she would harm her children, and calls to a suicide hotline — all attempts that Reddington contends establish that Clancy realized something was seriously wrong and made a sincere effort over time to get help.

Reddington, referencing the prosecutor’s opening statement, asked whether Saathoff believes that Clancy decided to kill her children because she “no longer liked the life she thought she wanted” and was making “a selfish choice” to “manipulate her providers, seek out a quick and easy fix when she was feeling depressed and anxious.”

“I think that statement that you read really minimizes what she was going through,” Saathoff responded.

Willingham reported from Boston.