Bipolar and pregnancy: decisions, decisions, decisions…

APP trustee Clare Dolman reports on her PhD which some APP members kindly contributed to.

liz bumpIf you’re a woman with bipolar disorder and you’re contemplating having a child, there’s quite a lot to consider. We now know from research (often conducted with the help of Bipolar UK members) that about 50% of women with bipolar are likely to have some sort of episode during pregnancy or postnatally. But 20-25% of women with bipolar will suffer a postpartum psychosis (PP), which is a more severe episode which requires emergency treatment and usually a stay in hospital.

Though these statistics may seem alarming, it’s important to recognise that a) there’s a 75% chance you won’t have a PP and b) if you’re unlucky and do, PP usually responds very well to treatment and you can get back to being a great mum to your baby very soon. When I suffered a PP after the birth of my daughter, it was an advantage that I already had a diagnosis of bipolar because both I and my husband knew within days of the birth that I needed psychiatric help – whereas it often goes unrecognised for a long time in women without a diagnosis, thus giving the condition more time to get worse. I had to go to hospital for five weeks and stop breastfeeding so I could restart my lithium, but I never lost the bond with my daughter and, once home, quickly re-established a routine of caring for her.

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An invaluable visit to Bluebell!

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With thanks to funding from Comic Relief, our Peer Support Coordinators, Ellie and Hannah, and Director, Jess, were able to travel to Bristol to meet with members of the Bluebell peer support team, to share ideas and hear about each other’s projects, both of which are funded by Comic Relief.

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APP Peer Support Volunteer training in Bristol!

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On 3rd February 2018, APP held another successful Peer Support Volunteer training day at the fantastic Bluebell Place in Bristol. It is amazing to have the new volunteers up and running to ensure our Peer Support Service can continue meeting demand from mums and families affected by PP, both on the PPTalk forum, and in 1:1 messaging.

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APP reflects on 'I’m Fine' PMH training in Devon

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APP were delighted to be invited to take part in the Devon Partnership NHS Trust’s ‘I’m Fine’ perinatal mental health training events earlier this year. The three ‘I’m Fine’ training days took place in various locations throughout Devon and Cornwall and were aimed at any front line staff who might come into contact with a women in the perinatal period to understand how to manage people respectfully and assist them; to recognise that when women say ‘I’m fine’ they might not in truth mean this.

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Welsh Government Report into Perinatal Mental Health in Wales

NationalAssemblyforWalesPMHOct2017APP welcomes the findings of the Welsh Government’s Children, Young People and Education Committee Inquiry into Perinatal Mental Healthcare in Wales. The report is released today and can be read in full here.

Dr Jess Heron, Director of APP, says:

"The situation for Welsh families who develop Postpartum Psychosis has been totally inadequate. Mums who become ill in Wales have had to make the decision between being separated from their baby for treatment in a General Adult Unit, where specialist knowledge and appropriate facilities are lacking, or being transferred to a specialist Mother & Baby Unit in England, miles away from their partners, families and support networks. The recommendations made here are a positive step forward for Wales, and give us real optimism for the future."

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A visit to Buckingham Palace on World Mental Health Day!

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Congratulations to Emily Slater, Director of the Everyone's Business Campaign, who received a very special invitation to attend Buckingham Palace on Tuesday 10th October, World Mental Health Day.

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APP Workforce Training launches

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Last month Jess, Ian and Anna ran the first of our exciting new APP Workforce Training days at St. Ann’s Hospital in North London. These days, commissioned by NHS Trusts from across the county, have been designed to equip medical professionals with an in depth understanding of all aspects of PP. This first group of twenty spanned a broad spectrum of professional roles within the Perinatal Mental Health Service for this area, including Midwives, Social Workers, Health Visitors, Psychologists, Psychiatrists and CPN’s.

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Fiona & Henry raise awareness & a National Peer Support Award for APP!

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'APP attended the first Annual UK Maternal Mental Health Conference which was a sold-out event, with over 250 people converging on Imperial College, in London on 13th September 2017.  I was looking forward to seeing others involved in APP, including our Trustee & Vice Chair of MMHA, Clare Dolman, Regional Rep & Media volunteers Kathryn Grant, Fiona Putnam and Eve Canavan, and those from other organisations involved in Perinatal Mental Health.  It was a day full of passion, with so much expertise in the room, and a prestigious line-up of speakers from the UK and beyond.

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A visit to Preston North End FC for Lancashire Care Trust Perinatal Mental Health event

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n the 3rd August 2017 Lancashire Care Trust invited a range of stakeholders, including people with lived experience, to a discussion day to work through pathways, priorities and good practice to ensure their new eight-bed perinatal mental health inpatient unit for Cumbria & Lancashire, and the experience of care, as effective as possible for everyone. 

APP's Peer Support Coordinator, Hannah, was delighted to attend alongside Dr Giles Berrisford (APP Chair) and recounts her visit to Preston North End Football Club...

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'It was a rainy, grey day as I drove over to Preston North End football club for the Lancashire Care Trust Perinatal Mental Health (PMH) event – hardly summer weather, but this is the UK after all, and being from Yorkshire, I have to say it was also due to being on the “wrong side” of the Pennines!  APP had been invited earlier this year to become involved in the development of one of four new Mother & Baby Units (MBUs), with Lancashire Care Foundation Trust being the provider for a new unit in Chorley. The event was held as a discussion day to work through pathways, priorities, challenges and good practice to make the unit and the experience of care as effective as possible for everyone, so I was really keen to hear more about it and see and hear from other key stakeholders.

I was also really pleased to be meeting two APP volunteers at the event, Jane and Gillian, who both experienced PP and are from the North-West. It was great to be able to link them with other professionals at the event as being some more local contacts for APP – we all left having given our details to be involved in the continued engagement work ahead of the new unit opening in 2018. There were others with lived experience there too and it was nice to be able to give some APP literature to people directly affected, as well as the professionals in the room. We consistently get really good feedback about our peer support and Insider Guides, so it meant a lot to know what a difference it can make. There were also representatives from other voluntary and community organisations and I hope we all did a good job in getting the APP message out. Feedback from the group work in the afternoon particularly mentioned Gillian’s input and how the things she talked about and the support that professionals can give had really impacted on them. Well done Gillian!

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The morning was a very full session of speakers, introduced by the Trust’s Chief Executive, who had special dispensation to attend her Board meeting late – such is the priority for PMH and the interest and engagement from all involved. This was also reflected in the number of psychiatrists in attendance, both general and specialist perinatal, as I counted at least 6 from as far afield as the Midlands and Morpeth! Dr Giles Berrisford, Associate National Clinical Director with NHS England (NHSE) for Perinatal Mental Health, and APP’s Chair of Trustees, had been caught in traffic on the M6 so we swapped time-slots and I talked about my experience of PP and my involvement with APP, which seemed to be well received. The social media activity was also great to see, with some really touching comments.

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Giles’ presentation about the National Perspective followed, and we also heard from Leeds and Manchester about their services and shared learning about both in-patient and community services, as the new MBU will also offer Outreach. Dr Gillian Strachan, Consultant Psychiatrist with Lancs Care and a current PMH Bursary Holder with NHSE, kept the morning moving to time and we also heard about the development so far of the MBU.  There was also an interesting presentation from the architects and designers about their vision for the Chorley MBU, and their engagement with other stakeholders including those with Lived Experience of PMH. The MBU & Outreach will cover Cumbria as well as Lancashire so it was especially valuable to hear about challenges such as travel and rurality, something I know from my experience living in rural North Yorkshire.

Lunch was an opportunity for further networking which everyone seemed to take advantage of; with the room overlooking the football pitch, there was also a few mentions of people feeling that they were being disloyal to their team by being there! The group work in the afternoon, focussing on questions which were approached by people working in different teams, also produced lively discussion and feedback. Before long we were all headed home to various teams, towns and homes in the North-West (and me back to Yorkshire!) with a renewed passion and determination to make sure that women and their families have access to the best PMH care, as locally to them as possible. Thank-you to all at Lancashire Care Trust for having APP as part of your event and we look forward to further involvement and the MBU opening in 2018!

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APP discuss Perinatal Mental Health services at the Welsh Assembly

19800629_1547921858614816_2427648579280450680_oAPP were invited to the Welsh Assembly this week to give evidence to the Children, Young People & Education Committee about Perinatal Mental Healthcare in Wales.

APP’s Director, Dr Jess Heron and North Wales Regional Rep, Sally Wilson attended for APP and Charlotte Harding (who is also APP’s S Wales Rep) attended with Barbara Cunningham on behalf of PMH Cymru.

The aim of the inquiry is to consider how Perinatal Mental Health services are currently provided and how the Welsh Government can improve services for mothers, babies, fathers and families. The Committee wanted to find out how services link together, including specialised perinatal mental health services, maternity services, general adult mental health services, inpatient mother and baby units, parent and infant mental health services, health visiting, clinical psychology, and midwifery services, GPs and the extended primary care team, role of the third sector and local support groups, and private providers of services.

Jess and Sally explained the critical need for a Mother & Baby Unit in Wales. They gave evidence about the importance of high quality training in PP for all health and social care professionals that come into contact with pregnant and postnatal women. They explained to the committee the importance of peer support to women and families affected by PP, and outlined how this could be provided in Wales.

You can read APP’s Wales report here and watch via Senedd TV here (around 2 hours in).

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