There may be investigations and an inquest into factors contributing to the death, sometimes resulting in media publicity. The information here helps you to prepare. Click/tap any heading for information.

What is an inquest?

An inquest is needed when a person dies by suicide, their death is sudden or unexpected or occurs while they are under psychiatric services. It may take around six to nine months. There will be several people present, including everyone who was involved in the lead-up to the person’s death, as well as the local and sometimes national media. An inquest is not about determining blame but about establishing the causes of death and identifying lessons for the future. The coroner will make conclusions about the causes of death and outline recommendations about avoidable deaths which will be sent to authorities with the power to reduce risks of similar deaths.

Families should be aware that journalists may take an interest in inquests. You do not have to talk to journalists; however, some can be persuasive. If they are reporting on PP-related deaths, it might be useful to share this APP fact sheet about responsible reporting with them.

If you would like advice about talking to journalists or support to talk to the media, APP has a media advisor who can talk you through what to expect, share advice from others, support you during interviews and in obtaining read-back approval so you can check facts before they are published, and provide accurate facts and figures about postpartum psychosis. Please email us: app@app-network.org.

You can also read more about Inquests: Support at court - Coroners' courts support service.

The one thing I couldn’t bring myself to do in this whole process was attend the inquest. It was too heavy for me, and I couldn’t face knowing the details of how she died; I knew it would only make me more upset and wouldn’t bring any help or positivity. I had a day off work, I went for a bike ride, I busied myself and buried my head in the ground for the day.

Other investigations that might happen

NHS Trusts might conduct their own investigations. They might ask to talk to you and other family members for information. They tend to take a long time, and they may write to you at the end to tell you what their investigation found and what changes they have introduced.

If you believe that a person’s death was someone’s fault, then you should take specialist legal advice.

The complaints procedure is very much run to a timetable. Be sure to know when the complaint has to be made to the NHS by; the Ombudsman also will only consider complaints made within a certain timescale.

The NHS Trust should carry out a Serious Incident Investigation (‘SII’). In our daughter’s case there were three Trusts involved as mental health services were provided by a different Trust to the hospital she gave birth in. And there was also her own local hospital who were involved in drawing up her birth plan but never got involved in the SII. Make sure one Trust is leading on this.

The NHS Trust will suggest that their own risk department carries out the SII. We wish we had insisted that it should have been independent and believe this should now be the case. The SII recommended some local changes but concluded that our daughter’s death was not predictable and hence not preventable. On reading APP’s and other professional guidelines on the production of a birth plan for high-risk mothers we disagreed with this. And so we complained to the Ombudsman (PHSO) in order to try to get positive change for the future at a national level.

Before going into this you should be aware that it can be a very long and drawn-out process. Whilst we did not get the outcome we sought, on reflection I am proud we tried to get some change in our daughter’s memory. After four years we managed to get an apology from the NHS Trusts (none was forthcoming before that) but it felt hollow so long after her death.

I believe that going through the complaints procedure helped me through the different stages of grief but it certainly would not be something many would want to put themselves through. Be aware of what it might entail before you decide whether to complain or not.
It was a better and more positive experience trying to achieve change by working with APP who have been brilliant support throughout.

Making your voice heard, making complaints and obtaining legal support

If you would like changes to systems and do not feel your voice is being heard, there are steps open to you. You can talk to other families who have been down these routes via APP’s bereavement peer group - processes can be frustrating.

What you can expect from the media

You should be aware that there might be media interest in what has happened. You may or may not want awareness in the media. You might feel there are important lessons to be learned - around identifying signs and symptoms of PP, health professional training, access to support, or how services are organised. Alternatively, you might want your family tragedy to remain private, without intrusion. Whether or not you want it to be publicly reported, the media have access to some information and often report on inquests.

Whilst mental health reporting and PP understanding is a great deal better than it was 10 years ago, there are still journalists who want to write a sensationalist story for the media, without considering the needs of families.

Some reporters will just write about the incident itself, in which case you may want to prepare yourself for their stories which are more likely to be weighted with factual information rather than loaded with empathy.

The media can, in the right circumstances, be used as a force for good. APP can support you if you would like to tell your story to raise awareness of PP and the support available, campaign for better services, or raise awareness of a fundraising event you are doing. If you would like advice about talking to journalists, APP has a media advisor who can talk you through what to expect, share advice from others, help chose appropriate outlets, support you during interviews and in obtaining read-back approval so you can check facts before they are published, and provide accurate facts and figures about postpartum psychosis. Talking things through with us also helps APP to prepare to respond to any media, so please don't hesitate to contact us for a chat. Please email us: app@app-network.org.

If you are planning on raising awareness or doing something for charity, be conscious of how widely your partner’s family wants you to talk about them. It can be a fine line between doing a good deed in their honour, and being too intrusive, which may for some still feel too raw.

I was really upset with the way that the local news covered the story. They used unnecessarily graphic descriptions of my wife’s death, and it brought back some dreadful memories.

The media were very helpful when it came to spreading the word about my charity bike ride. I spoke to local radio and newspapers, which really helped to add traction to the fundraising. I spoke predominantly about postpartum psychosis rather than my wife specifically, which made it easier for her parents.

APP’s guide for journalists and media creators includes tips on how to report on suicides and infanticides relating to PP responsibly. It is available here. You can help us by sharing it with all journalists at inquests or those interested in writing about PP.

Help from APP

Talking to someone as inquests and investigations progress may feel helpful. APP’s peer support service is available at any time, not just in the immediate weeks or months following a bereavement.

Our National Coordinators, Jenny Stevenson, Ellie Ware and dads/co-parents Coordinator Simon O’Mara can put you in touch with trained staff and volunteers. Or you can join our bereavement group to chat to other dads and trained volunteers who have been where you are. Email: app@app-network.org.