Catherine Cho’s powerful memoir is released today, 18 March, in paperback from Bloomsbury Publishing.

‘A haunting, eloquent evocation of becoming a stranger to yourself.’ Observer

When Catherine left London for the US with her husband James, to introduce her family to their newborn son, she could not have envisaged how that trip would end. Catherine would find herself in an involuntary psych ward, separated from her husband and child, unable to understand who she was, and how she had got there.

In an attempt to hold on to her sense of self, Catherine had to reconstruct her life, from her early childhood, to a harrowing previous relationship, and her eventual marriage to James.

The result is a powerful exploration of psychosis and motherhood, at once intensely personal, yet holding within it a universal experience – of how we love, live and understand ourselves in relation to each other.

Catherine Cho gave birth to her son in 2017. Six months later, she would find herself in an involuntary psych ward, separated from her husband and child. Catherine was diagnosed with a rare form of postpartum psychosis that affects 1–2 in 1000 women.

Anyone wishing to buy a copy of the book can order directly from the publisher or from all good bookstores. 

Catherine recently wrote a moving piece for the i Paper about her experiences. Read the full article here.

A new report from the Maternal Mental Health Alliance and Centre for Mental Health calls for Ministers to fill the pre-Covid gaps in specialist perinatal mental health services

During and after pregnancy, women have faced greater likelihood of poor mental health during the pandemic, including anxiety, depression, loneliness and suicidal thoughts, according to a new report commissioned by a coalition of leading maternal mental health organisations. 

Women of colour and women from poorer economic backgrounds are more likely to experience mental health problems during and after pregnancy, according to the research. 

The rapid review of evidence commissioned by the Maternal Mental Health Alliance (MMHA), and conducted by Centre for Mental Health, for the first time compiles all available evidence into one place. This shows that access to crucial services reduced for pregnant women, new mums and babies across the UK, especially during the early stages of the pandemic. While health and care staff worked hard to deliver safe care, significant gaps emerged. Women also experienced a reduction in informal support from friends, relatives and networks of other women sharing their experiences.

Extra pressures include anxiety about giving birth during lockdown without partners present, fears of losing jobs, heightened levels of domestic violence, bereavement, worries about catching Covid-19, and concern about new infants catching the disease. 

The MMHA, a network of over 100 national organisations, together with lived experience champions and clinicians, is calling on Ministers to fill the pre-Covid gaps in specialist perinatal mental health. In addition, the wider system surrounding these services, including health visiting and maternity, needs to be protected and enhanced. Furthermore, up-to-date monitoring and research of maternal mental healthcare should be commissioned. It also says that without sustained funding, many Voluntary and Community Services will not survive, despite the increased demand from women for their services. 

Luciana Berger, chair of the Maternal Mental Health Alliance (MMHA) said:

‘Today’s report should serve as an ear-splitting warning siren about the dangers to women’s maternal mental health and potential risks to the wellbeing of their babies. The pandemic has placed additional challenges on new and expectant mums getting the care and support they need, taking many already-stretched services to the point of breaking. Women of colour and women from disadvantaged backgrounds have been particularly impacted, and Ministers must address this injustice with urgency.’ 

Sarah Hughes, chief executive of Centre for Mental Health, which carried out the research, said:

‘The Covid-19 pandemic has been a mental health challenge across society, but it has not affected everyone equally. It has placed especial pressure on women during pregnancy and after they’ve given birth. And it has made inequalities that were always there in plain sight even more pronounced. We need to take this opportunity to review and reframe what support women should expect for their mental health during the perinatal period, and to make sure that we prepare for any future crisis to avoid another loss of support at a crucial time in people’s lives.’

Aleema Shivji, Comic Relief Executive Director for Impact and Investment said:

‘The pandemic has put an unprecedented strain on the nation’s mental health and it is sadly no surprise that, as this report proves, pregnant women and new mums who face enormous challenges, have sadly been worst affected.  It’s clear that more work is needed urgently to help tackle the shame and stigma attached to maternal mental health for mums to feel recognised, supported and able to ask for help. At Comic Relief we have prioritised funding mental health services for over 25 years, but it is clear this is still needed now more than ever.’

Dr Jess Heron, CEO, Action on Postpartum Psychosis said:

‘At APP we welcome this report that clearly evidences the needs, gaps and inequalities in maternal mental health and calls for immediate action. Postpartum psychosis is a psychiatric emergency in all cases - and one that needs specialised treatment and support.

‘For many mothers during this pandemic, isolation and fear has been magnified - women have battled illness and recovery without the support of wider families and communities. Essential frontline professionals have been redeployed, and services and health professionals stretched to breaking point. As a charity, we’ve heard examples of staff and services going the extra mile to overcome huge challenges presented by the pandemic but, for some, experiences of birth have been needlessly traumatic. Some women at high risk of PP have had to give birth without their partner present, despite knowing of their high risk of developing this rapid and severe onset of mental illness.’

Today’s report Maternal mental health during a pandemic was commissioned by the Maternal Mental Health Alliance and conducted by Centre for Mental Health, and covers all four parts of the UK.

Anybody in need of support or information regarding postpartum psychosis can find a wealth of information here.

This Time to Talk Day (4 Feb 2021), we’re calling for more targeted awareness campaigns to support Black and Asian women in response to inequalities in maternal mental health.

According to a report from MBRRACE, mental health conditions remain the leading cause of pregnancy-associated deaths between six weeks and one year after giving birth (30%), and maternal suicide is the leading cause of death over the first year after pregnancy. However, there is a striking gap between the mortality rates for Black and Asian women, with Black women four times more likely to die in pregnancy than white women, and Asian women twice as likely.

Postpartum psychosis (PP), a severe and debilitating mental health problem that affects 1400 women in the UK each year from all backgrounds, plays a key role in this shocking statistic.

Our CEO, Dr Jess Heron, said: “We are saddened that the national mental health campaign, Time to Change, is having to close its doors this year, so we feel that, as a charity, we must continue to tackle stigma, and encourage conversation about severe postnatal illness. Our research with women from Black and Asian backgrounds who have experienced postpartum psychosis shows more needs to be done to reach communities with information, to tackle stigma and self-stigma. Women describe barriers to accessing services. Health professionals and charities need to reach out to different communities in response to their unique challenges. With Black and Asian women significantly more affected by pregnancy mortality, perinatal mental health charities must have tailored services and campaigns.”

As such, at APP we have decided to use this year’s Time to Talk Day to share the stories of volunteers from Black, Asian and Minority Ethnic communities who have experienced PP.

Plus, Shaheda Akhtar, one of our Peer Support Facilitators is offering talks and presentations to community groups and health professionals and is keen to encourage more women from Black, Asian and Minority Ethnic communities to access information about PP. She says: “I want to start the conversation about PP and work with organisations who are already doing lots of great work in their communities – either in terms of mental health more broadly or dedicated women’s groups.

“We have volunteers trained in peer support and they are keen to support women using their own personal experiences from the perspective of a Black or Asian woman. Cultural identity and faith identity are important, and many of the women I have spoken to have expressed how both played a significant part in their PP experiences.”

Shaheda is also looking to contact more health professionals who work in maternity services or perinatal mental health from Black, Asian and Minority Ethnic communities to get involved in awareness raising campaigns. Shaheda added: “A psychiatrist or nurse who understands a community’s culture or faith will have a powerful impact in delivering our messages about what PP is and how women and their families can get help.”

Catherine Cho, author of Inferno, shortlisted for the Sunday Times Young Writer Award, which recounts her experience of postpartum psychosis says: “Maternal mental health, particularly in Black and Asian communities, has an added layer of cultural pressure and shame. It's often viewed as something that should be kept quiet and hidden away. I hope that by opening up the conversation around perinatal mental health, we can show that these experiences do not have to be feared or kept in the dark." 

To read Catherine’s story, you can buy her book, Inferno, from all good bookstores and online with Waterstones.

Anyone representing a faith or community group who would like to arrange for a talk from APP, or any maternity/perinatal mental health professionals who would like to get involved, should email Shaheda at shaheda@app-network.org or message her on Twitter @Shaheda_APP

A huge thank you to APP Volunteer Gemma for organising pamper packs to be delivered at Mother and Baby Units (MBUs) at Christmas.

The packs included make-up items from Boots UK and Soap & Glory to help mums feel special, books from Book Trust for story time with babies and leaflets about APP’s peer support for mums and families. Gemma organised the packs as a way of giving mums a little bit of “me time” to help their recovery, alongside the invaluable help and treatment the MBUs provide.  She also hoped that the Nursery Nurses and other staff would find the books useful in encouraging mother and baby bonding.

Gemma has been a volunteer with APP since 2018, and has also held a fundraiser for APP. She says “I suffered with postpartum psychosis in 2017.  Through this I gained an understanding of severe anxiety and depression and wanted to train as a peer supporter in 2018 in order to support others through their recovery journey. I also support the Birmingham project through attending the cafe group and really enjoy making a positive impact on others’ recovery. Last Christmas I returned to my own MBU in Stafford and was able to thank staff and provide a small amount of pamper packs. This year I wanted to reach every MBU in the UK over Christmas, as this period can be so difficult. I feel this is such an important step for mums not only to promote relaxation and self-care, but more importantly to raise awareness of APP, the support available and the ways in which they can get in touch.”

We have received some lovely feedback from MBUs across the UK. Staff at the Rosewood MBU in Kent said “Thank you so much for the donations we have received today, the self-care packages and books are lovely, and I know something that will really support the mums’ recovery, especially while we have a few isolating. It could not have come at a better time. Also thank you for the leaflets which are really helpful to give to families and provide them with insight and knowledge that their loved ones will get better.”

Staff at the Thumbswood MBU in Hertfordshire said “Thank you very much for your support and showing the generosity towards our MBU. We have distributed the pamper packs to our mums and they were very thankful. I think it was a fabulous idea during this difficult time.”

Staff at the Livingston MBU, Scotland said “Our team was blown away with your generosity and hard work. We were all wondering what the delivery was and initially thought it was toner cartridges we were waiting on. As you can imagine we all got so excited and felt overwhelmed with the kindness you showed and gave to our mums.”

Thank you Gemma, for all your hard work in organising and delivering the packs to the MBUs.

Today (Tuesday 19 January) we’re proud to celebrate our 10-year anniversary as a charity.

 To celebrate the day, and to drive increased awareness and action going forward, we’re absolutely thrilled to announce our first ambassadors: poet, author and illustrator, Laura Dockrill, who experienced postpartum psychosis in 2018, and her husband, Hugo White, a musician and record producer, formerly of The Maccabees.

Jess Heron, CEO, Action on Postpartum Psychosis said: “We’ve precipitated a sea-change in services, support and awareness of postpartum psychosis in the UK over the last ten years, but we know there is still so much more to do. Working with Laura and Hugo will enable us to amplify our voice and reach people we might not otherwise be able to reach. Ambassadors play a hugely important role in getting the message out there and we’re absolutely delighted to have two passionate, experienced and influential individuals flying the flag for all the women and families who have been impacted by postpartum psychosis.”

APP is a collaboration between inspirational women with lived experience, world-leading academic researchers and specialist health professionals. Over the past ten years, we have grown rapidly and now provide an award-winning national peer support service, comprehensive patient information, training for frontline professionals, a network of regional volunteers, awareness raising media work and the facilitation of research into the causes and treatments of the illness.

Laura Dockrill said: “Experiencing postpartum psychosis was bewildering and frightening. We had no idea what was happening and the symptoms left me feeling confused, afraid and, at times, suicidal.

“Jess and the team at APP reached out to me while I was in recovery, bringing with them a boatload of love, warmth and hope, sharing information, and introducing me to an amazing network of women that I have been engaged with ever since.

“I know from personal experience just how vital APP’s work is, and that’s why I’m so proud that Hugo and I will become ambassadors. I hope I can help to reach others who may be struggling because, as I now know, there is always hope and light - we just need to show people how and where to find it.”

Postpartum psychosis is a severe and frightening postnatal mental illness that affects 1,400 women and their families every year in the UK – from all backgrounds. Half of cases are ‘out of the blue’ with women having no history of mental illness. Symptoms include hallucinations, delusions, mania, depression, restlessness, anxiety, confusion, and unusual behaviour  - which can manifest within days of childbirth and escalate very quickly. Most women need to be admitted rapidly to a Mother and Baby Unit for inpatient treatment. However, with the right care, women can fully recover.

Hugo White said: “Postpartum psychosis is a traumatic experience for all involved - it’s totally devastating seeing the person you love in such pain. That’s why I’m keen to support APP’s partner peer support work. Having someone to talk to who really gets what you’ve been through, or what you’re still going through, makes a huge difference.”

As of today, we currently manage seven regional peer support café groups; a support forum that has over 2,800 lived experience users sharing experiences and receiving support; three NHS partnership contracts providing direct support to women in Mother and Baby Units; over 70 active regional volunteers; and we have reached almost 10,000 multidisciplinary health professionals through lived experience talks and training. We’ve also facilitated a wealth of in depth research on postpartum psychosis and will this year be finalising our second report into the need for, and impact of, Mother and Baby Units, as well as releasing our own report into the impact of APP over the past 10 years – due out in the Autumn.

APP has been a research network since 1996 and a charity since 2011. It is hosted and supported by the University of Birmingham Medical School, The National Centre for Mental Health in Cardiff and The Birmingham & Solihull Mental Health Trust.

Action on Postpartum Psychosis has collaborated with British soap opera Hollyoaks to help create one of the soap’s biggest storylines for Christmas 2020 and into the new year.

This sees the character Liberty Savage (played by actress Jessamy Stoddart), become ill with postpartum psychosis following the birth of her child in September.

The Hollyoaks production team talked to mental health experts and women with first-hand experience of the illness to help create a realistic storyline for Liberty. APP Director, Dr Jess Heron, and APP Coordinators with personal experience of postpartum psychosis, Hannah Bissett and Dr Sally Wilson, have worked closely with the Hollyoaks team since February. APP’s team have commented on draft scripts and reviewed footage to help shape the postpartum psychosis storyline. Members of APP’s support network and clinical experts have also met (virtually) with actress Jessamy Stoddart to share their personal stories.

The Hollyoaks postpartum psychosis storyline has been building since September, when character Liberty Savage gave birth. Liberty has been showing signs that all might not be well, and things will reach crisis-point in December, when she will be admitted to hospital over Christmas.

Catch up on Hollyoaks episodes here >

APP Director Dr Jess Heron said:

Although Liberty’s story can't represent the story of all women who have postpartum psychosis - every experience of the illness is unique - APP hopes that the Hollyoaks portrayal will go some way to raise much-needed awareness of this illness, help reduce stigma, and help those who develop postpartum psychosis get diagnosed and treated more quickly, ideally in a specialist Mother and Baby Unit.

For media enquiries concerning the Hollyoaks storyline on postpartum psychosis, please email media@app-network.org

Read personal experiences of postpartum psychosis here >