APP interviews Mark Casebow, Director of Louis Theroux’s new documentary 'Mothers on the Edge'

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.

Mark Casebow

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.