So this is it...

I was never sure if this blog would be public, or even if it was a good idea to talk about my mental health in this way. I have Bipolar Disorder. But then I figured if I had diabetes, I wouldn't be ashamed of chronicling it in a blog. And that is the problem with mental health issues.

I have a disorder that most likely I was born with, that triggered in my early twenties and will need managing my whole life. Mental health needs talking about more.

Thursday 11 April 2013

Won't someone think of the children

Last week I was on Woman's Hour, well my experience was.  It was part of a piece on mental health and parenting prompted by a call from the Care Quality Commission and Ofsted that doctors and health care professionals treating parents with mental health conditions should automatically and statutorily refer them to social services.  The report states that children whose parents have mental health problems are often poorly supported and therefore susceptible to harm.  Mental health conditions are considered to be the same as substance and alcohol abuse and are recommended to be dealt with by social services in the same way.

This recommendation is ridiculous, dangerous and insulting.  There is already an obligation by health care professionals to report anything that they think my be a child protection issue.  This requirement will not help support children, instead it will isolate women right at the point they need help and to talk.  The fact is very few women, or parents, with mental health problems are a risk to their children. Unfortunately, the few terrible instances there are of parents (usually mothers) harming their children due to mental health problems are widely covered in the media.  The reality is that 1 in 10 women will suffer with postnatal mental health problems, but the numbers that will harm their baby are tiny.  However, many women with postnatal depression and psychosis are terrified of speaking out and telling someone how they feel, for fear that they will be deemed an unfit mother and the baby will be taken away.  This is far more dangerous for the mother and baby than the mental illness itself.  Putting a statutory requirement on doctors to report women for mental illness will surely just make women more afraid to speak out about how they are feeling.

After my daughter was born and I began to become unwell, the perinatal care team were excellent in their care for me.  They understood the complexities of postnatal mental health, monitored me, and asked all the right questions.  They considered me in no way a risk to my children.  However an inexperienced Community Mental Health Nurse, without visiting me or talking to me, referred me to social services.  The anxiety and stress this caused us was enormous, and social services agreed that I was not a risk to my family.  Social services are the demon child snatchers that people often portray, but until you have been there, considering the idea that your every parenting decision, emotional state, and love of your children will be monitored, it is difficult to understand the fear.  I have always had a good understanding of social care, I have worked with them supporting families.  But when I got that phone call, in the midst of my unwell mind, I was paralysed with panic and fear.  I had always worried that people thought I shouldn't have children, because of my Bipolar, and now it was going to be tested.  A quick conversation and the worry was over. There was nothing social services needed to do or could do.

And that is another issue.  After the shock and panic had subsided I asked for their help and support.  I was on the verge of being admitted into the Mother and Baby unit, my family could do with any support that could be offered.  Except there was none.  Social care couldn't do anything for us, we qualified for nothing.  My deteriorating mental health was not a factor in deciding support for our family, income and employment was.  Because my husband works full time is a reasonably well paid job (above national average, but still quite a bit below higher tax rate) we were entitled to no help with childcare for my son, no support for mu husband as my carer.  If he had not worked then we would have been entitled to much more.  One argument  for the automatic referral to social services is that children and families receive the support and care they need.  But unless there is a planned injection of money into social care services, this is not going to happen.  They are an overstretched service as it is, unable to support all but the families most in crisis, the ones where children are in danger of harm or neglect.  If you care for your children and are trying your best, but simply need extra help in coping they cannot help as they do not have the funds. Therefore the referral is a pointless exercise which will only lead to women hiding their feelings and worries through fear of losing their children.

And as to the categorisation with substance abuse, I find this insulting and a further opportunity to stigmatise mental health conditions.  I am not disregarding alcohol and drug abuse as something that requires help from health professionals or blaming people addicted as "bringing on themselves", but mental health conditions are different in the ways in which they effect families and the sufferers and should not be lumped together in this way.  If anything the children of mental health sufferers should perhaps be seen as young carers, in the way that other children of disabled parents are. As often is the case this report shows that mental health concerns are given less support than physical health concerns.  Families coping with mental health conditions do need more support, but a automatic referral to social services is likely to be counterproductive and in fact deter women from coming forward and seeking help for their conditions. Had I thought I would be referred I would have said nothing of my feelings, my hallucinations and my need for help.  And that would have been a very bad thing.


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