Bijan Sheibani’s short film ‘Morning Song’ is now available to watch on Film4. It follows the story of Yasmin, a mum with postpartum psychosis, on her journey for treatment in a Mother & Baby Unit.
Bijan Sheibani is best known as a theatre director, directing ‘Dance Nation’ by Clare Barron for the Almeida, ‘The Brothers Size’ by Tarell McCraney for the Young Vic, ‘Barber Shop Chronicles’ by Inua Ellams for the National Theatre, and writing and directing ‘The Arrival’ for the Bush Theatre.
Bijan’s mother suffered from postpartum psychosis after his birth. He worked closely with Action on Postpartum Psychosis (APP) as he researched his film, spending time with APP’s Director, meeting partners and women with lived experience. He visited both the Birmingham Mother & Baby Unit and the Exeter Mother & Baby Unit, while it was being built.
Speaking to Film4, Bijan said: “This film was very much about trying to get as close to someone’s experience as possible.” “My ideas can start quite vague and as something that I’m figuring out or thinking about... if an idea is really good, you’ll never figure it out. And that’s why it needs to be turned into a piece of art, so that everybody can look at it together and wonder.”
Director of Action on Postpartum Psychosis, Dr Jess Heron, reviews the film:
Bijan Sheibani's film ‘Morning Song’ is a 15 minute Short, but it is a case of ‘Multum in Parvo’ (much in little). In the film’s silences, in the withholding, in the lack of dialogue and intimate, raw close ups, Bijan captures the essence and enormity of the experience of postpartum psychosis. He has crystallised, in a masterful, quiet drama, something of the experience of all women and partners who suffer the desperation of this temporary postnatal illness.
The film does not have answers, yet with the deftest of touches, through shots of slight smiles, the gentlest of baby sucklings, or the balm of water, he manages to convey hope and healing. Similarly, he shows the kindness and understanding of those charged with Yasmin’s care; the regenerative power of sleep and safety; and optimism, in the yearning gaze of the most perfect baby.
Bijan’s film is remarkable; many mothers (and their partners) who have been through postpartum psychosis will feel: this was my truth.”
It's World Mental Health Day this Saturday and this year’s theme is Mental Health for Everyone. We'd love you to help us raise awareness of the importance of maternal mental health. We'd like to show funders and governments how much we value maternal mental health charities and maternal mental health services.
To support World Mental Health Day on Saturday 10th October 2020 you could share something of your story, explaining why you value maternal mental health charities or services, tagging in @ActiononPP and using the hashtag #WorldMentalHealthDay.
You could also tag in any other service or charity that you wish, plus your MP or a funder. For example, you could tag:
- Your local MP. Find their Twitter account names here.
- Nadine Dorries, MP, @NadineDorries: Minister of State for Patient Safety, Suicide Prevention and Mental Health.
- Dr Rosena Allin-Khan, MP, @DrRosena: Shadow Minister for Mental Health.
- Luciana Berger, @lucianaberger: LibDem spokesperson for Health, Wellbeing and Social Care and new Chair of the Maternal Mental Health Alliance.
- Vaughan Gething, @vaughangething: Welsh Minister for Health.
- Joe FitzPatrick, @JoeFitzSNP: Scotland Minister for Public Health, Sport and Wellbeing.
- Robin Swann, @RobinSwannMoH: Northern Ireland Minister for Health.
- Comic Relief: @comicrelief.
- The National Lottery Community Fund: @TNLComFund.
World Mental Health Day: Do one thing for better mental health today
The theme Mental Health for Everyone is especially important this year because of the huge impact the coronavirus pandemic has had, and continues to have, on perinatal mental health. This year we’re joining in with MIND’s campaign to Do one thing for better mental health. This could be for your own mental health; the mental health of a loved one; sharing a campaign message; donating to a mental health charity; or helping to raise awareness that mental health is a national priority.
Here are some ideas for things you could do:
- Consider what you can do today for your own mental health: connect with a friend, take an online class, do something relaxing, reach out for support or to meet and talk to others, for example via APP's peer support services.
- Join one of APP’s virtual communities to support your wellbeing. In APP’s Running, Walking & Cycling Club members share details of the activities they are planning and offer inspiration and support for keeping fit and active. APP’s Book Club is a relaxed and friendly space open to all to chat about books on any topic. Join us for a virtual meet-up on Tuesday 3 November at 8pm where we’ll be discussing Laura Dockrill’s book ‘What Have I Done?’
- Get in touch today to find out more about our regional online café groups or about joining a volunteer group (you could become an APP Regional Rep, Peer Support Volunteer, Storytelling Volunteer or Lived Experience speaker).
- Take time to check on family and friends. It’s more important than ever to be kind to yourself and others. Grab a cup of tea, pick up the phone and ask ‘how are you?’. See some ideas for little treats for a new mum recovering from PP on our Facebook page.
- Share APP's latest campaign messages: Re-post our #MumWatch graphic (pictured below) - raising awareness of the signs and symptoms of postpartum psychosis so that everyone knows how to seek urgent help if a new mum seems strange. During this time of increased isolation for new mums it is vital that partners and friends know how to identify symptoms.
- Share our urgent call for Mother and Baby Units (MBUs) in Wales and Northern Ireland, where there are none. Email firstname.lastname@example.org to get involved in our Wales campaign to support the development of an MBU and sign the petition by APP Rep, Oorlagh Quinn, for government commitment to an MBU in Northern Ireland.
- Remind everyone on World Mental Health Day that postpartum psychosis (PP) is an illness affecting 140,000 women across the globe every year and that we won't stop until all women and families affected by PP receive the care and support they need.
- Organise a fundraising event - it could be a Facebook Fundraiser, bake sale or sponsored run. Or you could set up a monthly donation as a gift to APP.
Need help on the day?
APP’s forum and peer supporters are here to help if you’re finding the day difficult: www.app-network.org/peer-
#MaternalSuicidePreventionWeek, 7th-11th September 2020
Join Action on Postpartum Psychosis (APP) in getting involved in #MaternalSuicidePreventionWeek by helping to raise awareness of Postpartum Psychosis.
Over the past 10 years, APP have been working to reduce the risk of maternal suicide, by training peer supporters, developing information, training health professionals and raising awareness of Postpartum Psychosis. So much has been achieved, but we are not there yet.
Please help by sharing APP’s #MumWatch campaign
For #MaternalSuicidePreventionWeek we’re talking about the signs of Postpartum Psychosis, so that we can all look out for them and take action to prevent suicide in new mums. Please help by sharing the following campaign text and image widely:
Feel like your partner or friend is not themselves?
Be the friend they need - help make an urgent appointment with their Doctor, Midwife or call 111. If you think there is imminent danger, call 999. With help they will recover.
#MumWatch #MaternalSuicidePreventionWeek @ActionOnPP
If you have been bereaved following Postpartum Psychosis
Our peer supporters can signpost to sources of information and support.
Please get in touch to find out how you can get involved with APP’s work by emailing email@example.com
Please donate to help support our life-saving work
1 in 3 people who use APP’s peer support say they might not be here today without it. Peer support can be life-saving.
Please donate to support our work >
Thank you to Mother London for supporting APP’s #MumWatch campaign.
As the coronavirus pandemic continues, we know that pregnant women and new mothers have questions about what will happen to their care and how they should access services.
Action on Postpartum Psychosis (APP) has compiled information for: pregnant women with a history of postpartum psychosis / bipolar; women and families in crisis or who are developing psychosis; and for those recovering from PP at this time.
This is a fast-moving situation. Health trusts/boards across England, Wales, Scotland, and Northern Ireland are continuing to make changes to their services. We will update this guide as information becomes available.
Click the below images for specific information:
Action on Postpartum Psychosis
Help with a research survey
We are working with colleagues at the National Centre for Mental Health to understand better the impact COVID-19 is having on people with mental health conditions. To find out more about how to participate in the NCMH COVID-19 survey click here
Keep up to date with our plans for Maternal Mental Health Awareness Week!
Join us each day between Monday 4 May - Sunday 10 May. Here's what we have planned:
Catch up on Monday's topic - "What is Postpartum Psychosis?" here, where you can watch Sally and her husband Jamie discuss their experience of the early signs and symptoms of postpartum psychosis with Ian Jones, Professor of Psychiatry and Trustee of Action on Postpartum Psychosis.
From World Mental Health Day, you can also watch APP in conversation with Catherine Cho, author of 'Inferno: A Memoir' here. Hear Catherine discuss her PP experience with Jessie from Action on Postpartum Psychosis.
Thursday's topic - "What support is there for partners, families & friends of women affected by PP?" is available here, where Kat and her husband Tom discuss their experience of postpartum psychosis with Giles Berrisford, Perinatal Psychiatrist and Chair of APP and with Ellie, Peer Support Coordinator for APP.
You can also watch Saturday's Facebook Live "#Honest Conversations" with Laura Dockrill, Dr Jo Black and Jessie here.
If you have been affected by anything in these films, need any support, or want to meet others, visit: https://www.app-network.org or contact us on firstname.lastname@example.org for more information.
Today we join with charities to call on Government to urgently support the wellbeing of babies, toddlers & their families during the Covid-19 crisis. Pregnant and perinatal women need support now more than ever.
Read the statement here: https://parentinfantfoundation.org.uk/our-call-on-government-to-keep-babies-safe/
This information has been updated, click here to read our latest information on Postpartum Psychosis and Covid-19
We know that pregnant women and new mothers have many questions about what will happen to their care and how they should access services during coronavirus outbreak. Action on Postpartum Psychosis (APP) is trying to compile up-to-date information for pregnant women at high risk of PP; women and families in crisis or who think they are developing symptoms of psychosis; and for those recovering from PP.
This is a fast-moving situation and health trusts across England, Wales and Scotland are continuing to make changes to their services. APP will update this guide as information becomes available.
(i.e. those who have had a previous PP or who have a bipolar disorder diagnosis):
1. What will happen to my antenatal psychiatric appointments or preconception advice appointments?
- In England, Scotland & Wales, there are plans in place for routine home visits and out-patient appointments to continue, but they will be done by telephone or video conferencing. We will add information from Northern Ireland when we have it.
- Perinatal Psychiatrists say that birth planning for women at high risk of PP will in most cases be offered remotely but will still be thorough and comprehensive.
2. How do I get medication during this crisis?
- In England, Scotland and Wales, medication plans for women known to be at high risk can be made with perinatal psychiatrists in advance to ensure there is plenty of time to get prescriptions filled.
- Women who are remaining on Lithium throughout pregnancy will continue to need the same degree of medical vigilance. Antenatal care is still “open for business” and obstetrics/ maternity and perinatal mental health will work collaboratively to ensure the safest possible antenatal care remains uninterrupted.
- In Scotland, medication prescribing remains with GPs on recommendation of mental health services.
- You can phone your GP prescriptions line / psychiatric services and they can send prescriptions directly to your local pharmacy for collection. We will add more information here as we know more.
3. What impact does Covid-19 have on pregnancy, foetal development or risk of postnatal illness?
- Our best knowledge to date is that Covid-19 doesn’t seem to cause problems with pregnancy or transmit to the foetus, so it is believed that having CV-19 is unlikely to impact on your baby’s development. Most pregnant women who develop the illness will experience mild or moderate cold or flu-like symptoms. Pregnant women with other health conditions should be extra cautious as they may be more unwell than other women. Pregnant women have been placed in the ‘vulnerable group’ as a precautionary measure as not enough is yet known about the virus. The Royal College of Midwives and The Royal College of Obstetricians and Gynaecologists have produced some excellent guidance for health professionals and women, which is being regularly updated here and here.
- We do not yet know whether anxiety or stress due to the crisis will impact on rates of maternal mental illness. We know that managing stress in pregnancy and the postnatal period is important. You can find excellent advice from Mind about managing anxiety and isolation here and from the Mental Health Foundation here.
- APP are here for you. If you are a pregnant women with previous experience of PP, you can talk to an APP peer supporter by visiting our forum or registering for email or video support here. We are looking at other services we can provide for women and families with our network of peer supporters and clinical experts during this anxious time.
Women and families in crisis or developing symptoms
You can find APP’s general resources about symptoms of postpartum psychosis here and getting help here. You can find more information on common early symptoms here. You can find APP information guides about PP for women and partners here.
1. If I develop symptoms of PP, how will assessment happen?
- If you believe you are developing symptoms of postpartum psychosis (or your partner, family members is) you need to act urgently via the normal routes: telephone your GP, maternity services, or 111. If you believe you or someone in your household is in imminent danger, call 999. In most areas, urgent home visits are still being completed, but initial contact may be via video call (particularly if the person also has a cough or high temperature).
- In Scotland, A&E mental health presentations are being diverted directly to mental health sites. Crisis/Out of Hours staff will work in assessment centres with extra resources, seeing people from A&E and other urgent referrals. Glasgow is currently looking to complete urgent referrals, where the specific team has capacity, at the assessment centres which are more likely to be set up for assessment of patients who may already be infected. Other areas of Scotland are likely to be making similar arrangements.
2. Are Mother & Baby Units staying open?
- In England and Scotland MBUs will remain open and are doing an enormous amount of work to minimise any risk of infection on inpatient units (There are no units in Wales; Welsh admissions are normally transferred to MBUs in England.)
3. How are MBU’s managing coronavirus?
- MBUs are following general NHS inpatient guidance on barrier nursing and staff will be using personal protection equipment (PPE) for patients with coronavirus symptoms. MBUs have set up isolation areas to care for women separately.
- As we write, MBU visiting is still in place. Traditional visiting hours are not being restricted in order to avoid peak numbers. However, visitor numbers are being limited for any individual, restricting visitors to close family and no children. Units will have different advice for this – some units will restrict visits to one named family member per patient. We believe this advice may change today, and visiting in-person may be restricted.
- Patients will be supported to use facetime and telephone video calling more. Peer Support, including that delivered by APP, will be available via video call.
- NHS guidance on visiting during the coronavirus crisis can be found here.
You can find APP’s general resources on recovery here.
1. How will I get medication? How will I be monitored and supported during recovery?
Urgent home visits will continue. Most route appointments will happen via video call. There is a possibility that other professionals will reduce their routine home visits but this is not entirely clear at the moment and this is an evolving situation.
2. How can I manage my anxiety, depression, isolation during recovery if home visits do not happen, and we are meant to be socially distancing?
UK wide, online resources and peer support will be incredibly important for recovering women. There is already a wide range of online resources and more are being produced each day. The links below contains further resources, recommended reading and support and will be added to.
3. Social distancing and isolation mean my usual family support, and especially grandparents, are not available. Where can we find help?
APP will continue our national peer support services throughout the outbreak. Our Forum is available for you to talk to other women and partners: www.app-network.org/peer-support/
We also offer one to one peer support for anyone in the UK, where you are paired with an APP coordinator with lived experience, or a volunteer peer supporter. We can give this one to one peer support via private messaging on the forum, or via video call. If you would like to access this support, email email@example.com.
Action on Postpartum Psychosis
Links and more information/support:
APP offer support for those affected by postpartum psychosis or at risk of PP, due to bipolar disorder. For telephone, email or Facebook support for postnatal depression and anxiety, see: https://www.pandasfoundation.org.uk/
For general advice about managing mental health, isolation and anxiety:
- Government Advice: Looking after mental health: https://www.gov.uk/government/publications/covid-19-guidance-for-the-public-on-mental-health-and-wellbeing/guidance-for-the-public-on-the-mental-health-and-wellbeing-aspects-of-coronavirus-covid-19
- NHS: Dealing with a mental health crisis: https://www.nhs.uk/using-the-nhs/nhs-services/mental-health-services/dealing-with-a-mental-health-crisis-or-emergency/
- Recovery College Online: https://www.recoverycollegeonline.co.uk/your-mental-health/coronavirus/
- MIND: www.mind.org.uk/information-support/coronavirus-and-your-wellbeing/
- The Mental Health Foundation: www.mentalhealth.org.uk/publications/looking-after-your-mental-health-during-coronavirus-outbreak
For advice specific to perinatal mental health during Coronavirus:
- RCPsych: Covid-10: Mental health before, during and after pregnancy: https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/perinatal-care-and-covid-19
For more advice about Coronovirus:
- Coronavirus (COVID-19): latest information and advice on GOV.uk
- Information about the virus and how to protect yourself on NHS.uk
- Royal College of Psychiatrists advice for Perinatal Services
- Maternal Mental Health Alliance update
- Bipolar UK coronavirus update for pregnant women with bipolar disorder
Lauren Walsh, Trainee Clinical Psychologist, Staffordshire University, is working with APP to conduct a a research study that is researching the experiences of women from Black Asian and Minority Ethnic backgrounds who have experienced Postpartum Psychosis. Lauren aims to recruit 8-10 women by December 2019.
The study would involve meeting with a researcher for a semi-structured interview for approximately 1 hour. You will be asked about your experience of Postpartum Psychosis, and particularly your experience of accessing care. You would need to be living in the UK to take part. You can also find out more via the poster here.
If you are from a non-White or mixed ethnic background, have experienced Postpartum Psychosis, and would like to take part or find out more about this study, please get in touch: firstname.lastname@example.org
Rachel Jack, Trainee Clinical Psychologist at Teeside University, is looking at how Postpartum Psychosis affects partners’ relationships with mother and baby.
Rachel says: "There is a growing body of evidence showing the effect of postnatal psychosis on mothers, however there is only limited research regarding the impact on partners and particularly the impact on their relationships.
In order to consider relationships following maternal mental health, the current research believes they should be viewed as more than a mother-child relationship, and instead include the partner as part of a mother-partner-child relationship. It is suggested that partner’s report a shift in their role and a change in parenting styles following postnatal psychosis. Additionally, it is thought that perhaps children may also be impacted in some way, posing an important role for partners at this time. There is, however, a lack of understanding on how partners’ relationships with mother and baby may be affected or impacted.
This study therefore aims to explore how postnatal psychosis affects partners’ relationships with mother and baby. I am looking to recruit partners of mothers who have experienced postnatal psychosis within the last 10 years. The study involves a telephone discussion, at a time convenient to you, lasting approximately an hour. If you are interested in taking part, please email me on T7127956@live.tees.ac.uk and I can send you out some more information."
You can also view the poster for more information here.
Dr Jess Heron interviews Mark Casebow, Director of Louis Theroux’s new documentary, Mothers on the Edge.
It was lovely to meet you during the process of filming for the new documentary. We are delighted that Louis is helping to bring this issue into the mainstream. It’s only the second documentary that has managed to navigate the many ethical & practical issues involved in making a documentary like this, so it’s a huge credit to you and Flo to have successfully navigated this.
Did you know about Postpartum Psychosis before you started filming?
No, I don’t think I had ever heard of PP before starting this project. I had some basic knowledge about postnatal depression, but I was pretty ignorant about perinatal mental health to be honest.
What was important to you in the making of the programme?
Mother and Baby Units are such an unfamiliar world to most people. The idea was for Louis to experience what it’s like for patients in crisis, and also their families and the staff who try to help them recover.
Despite people being much more open about their struggles with mental health issues in recent years, it still feels like there is a particular taboo or stigma around discussing mental health issues brought on by having babies.
It was really important for us that everyone taking part was happy with the way we have handled their stories, and I hope that they feel that participating in a documentary has been a positive thing to have done during such a difficult time in their lives.
Was there anything that surprised you?
Many things were surprising - like most people I had never set foot inside a psychiatric ward. You carry lots of preconceived and often inaccurate ideas about what they are like. But mostly I was surprised by the honestly and bravery of the women and their families who allowed us to film them at an extremely vulnerable time in their lives.
You met up with the APP team during the filming process - how was this helpful?
It was really helpful to understand more about the condition from recovered women and also from an academic perspective, and to hear more about care and campaigning nationally. It was useful to hear about the messages that women and families who have experienced this illness would like to share with the public.
Hearing about your work helped us to appreciate how much women can benefit from talking about their experience with people who have been through something similar during their recovery, and we saw that on the MBU's themselves with patients often forming really strong friendships there.
We hoped we could show peer support in action at an APP café group, but unfortunately it was not possible in the time frame.
What do you hope the impact of the programme will be?
I hope that the documentary will do something to help to reduce the stigma around PP and other mental health crises that can happen after having a baby. I also hope it will raise awareness of these issues more generally and show people the extraordinary work done by mother and baby units.
Are there any ambitions you had for the programme that were practically or ethically unfeasible?
We knew that filming patients as they were experiencing acute PP was difficult for a number of reasons and we would only be able to proceed cautiously and with the consent of the family and clinicians. We also knew would have to seek consent again from patients when they had recovered and had capacity to participate in the filming.
As expected it did prove very difficult to start filming with patients whilst they were most unwell, but we also made a positive decision to not just focus on the acute phase of the illness and to follow patients during recovery and the difficult transition to living back at home.
What would you most like to change in the future for women and families affected by PP?
The Mother and Baby Units we filmed in were all filled with dedicated staff, I feel like they are a real NHS success story and I hope that this comes across in the documentary.
Like all public services these units are juggling scarce resources with high demand. I hope soon what is still a patchy national service will become available to all women who experience PP no matter where they live.
It was also clear that community mental health services are really overstretched in some areas and this can make the transition home more difficult for many women and their families.
Hopefully more funding will also be directed towards recovery, and to support services like those APP provide for women and their families once they get back home.
Louis Theroux’s documentary Mothers on the Edge will be broadcast on Sunday 12th May 2019 at 21:00.
Visit the BBC Louis Theroux Programme page for more information.