Due to the inevitable impact upon families and communities of such tragedies, suicides, infanticides, and the inquests that follow, are often reported in the media.
Media interest may be warranted. There may be important lessons to be learned - about signs and symptoms, or how healthcare should be organised. Many bereaved family members want nothing more than to ensure this does not happen to another family.
"Suicide is the leading cause of maternal death within 12 months of birth in the UK. Cases of postpartum psychosis (PP) contribute significantly to maternal suicide statistics."
However, behind all such stories, there are grieving families coping with deep, untimely loss.
There are countless other women and families who will be deeply impacted by each story: those in the process of seeking help for PP, those battling to recover, and those many recovered women who know that it is only through good luck and good care that it is not their own story in the news.
The need for informed and responsible reporting is therefore paramount.
This page will provide journalists and media creators with tips on how to report on suicides and infanticides relating to PP responsibly.
Responsible reporting on suicide - why is this important?
Every media report about a postpartum suicide will impact:
- the family, friends and community of the person involved;
- others who have been bereaved by suicide;
- newly recovering mothers and their families;
- the entire community with personal experience of PP;
- the public’s understanding of PP.
Irresponsible reporting of suicide has the potential to:
- negatively affect the emotional wellbeing of bereaved families, including their children as they grow;
- extinguish hope, delay recovery, and pose a threat to other sufferers - whose experience may be raw and situation seem hopeless;
- propagate myths in the public - about what PP is and what it is not; about the causes and intentions that give rise to suicide. Stigma and shame silences sufferers, impacting help-seeking, recovery, social and family relationships, resulting in risk and distress for thousands of sufferers - and undoing the good work that charities like APP have been working towards for more than a decade.
What does a responsible news report look like?
- Reporting has the power to inform the public about this potentially life-threatening mental health emergency. At Action on Postpartum Psychosis, we know that early diagnosis, rapid access to the right specialist care, signposting to the right charities, and accurate information, saves lives.
- Reporting should make clear that suicide linked to postpartum psychosis is a rare, but potential, outcome. There are 1400 cases of PP in the UK each year, and 1-5 PP related suicides each year.
- Reporting should be well-informed, compassionate, and mindful of the likely impact on family members and other sufferers.
- Reporting on suicide should avoid detailing method, location or the content of suicide notes – there is information and broader advice on this on the Samaritans website.
- Reporting should concentrate on the lessons that can be learnt from the tragedy and how services could be re-organised to prevent similar tragedies occurring in the future. Efforts should be made to demonstrate that suicide is preventable and that help is available.
- It is important to note that PP is highly treatable; although the illness may be severe and shocking, causing a great change in a woman’s thoughts and behaviour from her normal state, with the right care, women make a full recovery.
- Signposting to available help and support is critical. In cases of suicide relating to PP, it is advisable to add a link to APP’s website, as well as links to NHS services and the Samaritans. e.g.
- “For postpartum psychosis information and support, visit app-network.org. For urgent care, contact your GP, midwife, mental health crisis service, or NHS 111. If PP is suspected, same day admission to a specialist Mother & Baby Psychiatric Unit should be gained. If you are concerned about imminent risk to life, call 999. If you are struggling with suicidal thoughts and need to talk to someone urgently, contact Samaritans 24/7 on 116 123.”
- In terms of language, it is helpful to avoid using the phrase ‘committed suicide’; a legacy from a time when suicide was considered a criminal act. It is better to say ‘died by suicide’ or ‘ended her own life’.
- Wherever possible, it is helpful to sensitise readers to the nature of the content, so that those who might be particularly affected can make an informed decision about whether to read on. This might include adding a trigger warning, for example: This report is about xxx, which might be distressing for some readers. Please take care when reading.
- Prior to going to press, journalists should research PP by contacting specialist PP charity, APP, before commenting in a clinical way about PP. All too often, inaccurate information about PP and suicide is included in articles. You can read more about the signs, symptoms and experience here.
- It is important not to confuse PP with the better known illness “postnatal depression” or describe it as a more severe form of postnatal depression. This confusion has dangerous consequences for public understanding and can impact women accessing the right care.
Responsible reporting on infanticide associated with PP- why is this important?
PP-related infanticide is a very rare occurrence in the UK. There are 1400 cases of PP in the UK each year - and approximately 1 PP-related infanticide in the UK each decade.
Many mothers who have experienced PP, however, will have personal stories about how, but for good care and good luck, the outcomes could have been very different
PP is a severe illness. Research estimates that some risk occurs to babies in around 35% of cases of PP - due to acting upon false beliefs, incorrect handling, severe confusion and behavioural disturbance. Once recovered, maternal care-giving and attachment also recovers. There is no evidence of any long term issues with parenting or bonding.
Media coverage around cases of PP-linked infanticide has the potential to bring PP into the public consciousness; to highlight the rapid and specialist support needed; to influence service delivery and professional training; and ultimately to protect other mothers from these tragic outcomes.
However, media coverage of infanticide is often sensationalist, extensive, medically ill-informed, and lacking in compassion. Due to the strong emotions it elicits in the public, women’s tragic stories may be used as click-bait. It is therefore essential that information is communicated with a real understanding of psychosis.
Media reports about infanticide will have an impact upon:
- the bereaved family, friends and community;
- women who are seeking help or newly recovering from PP and their families;
- the entire community of women and families who have experienced PP;
- the public’s understanding of PP.
Unbalanced and sensationalist reporting about infanticide has the potential to:
- deter new mothers and their families from seeking help for fear of being labelled ‘unfit mothers’, ‘dangerous’, or for fear of losing their children - causing risk to the wellbeing of countless other families - undoing a decade of APP’s work;
- intensify anxiety, distress and psychotic symptoms, or extinguish hope for other women recovering from PP - causing risk and delaying recovery for sufferers;
- make an awful, frightening, tragic experience of mental illness considerably worse for the women, family and community involved, increasing the risk of the woman involved in the tragedy taking her own life;
- create a climate of vilification and stigma amongst those who do not understand ‘psychosis’ - equating postpartum psychosis with criminality, rather than a symptom of a serious maternal mental illness that can happen to any woman, requiring emergency intervention;
- lead to vicious trolling on social media;
- perpetuate myths which fuel public stigma - that PP is synonymous with infanticide; and around the ‘beliefs’ and ‘intentions’ that give rise to infanticide. This stigma causes distress for thousands of sufferers - undoing more than a decade of APP public education campaigns.
What does a responsible news report look like?
- Reporting should make clear that infanticide linked to PP is incredibly rare. There are 1400 cases of PP in the UK each year, with 1 PP-related infanticide each decade.
- Reporting should concentrate on the lessons that may be learned for public education, health service organisation, and professional training. Early diagnosis, rapid access to care (ideally within 4 hours of symptoms of PP being suspected), accurate information, and appropriate signposting to care and charities, saves lives. Reporting should make clear that cases of infanticide are preventable with the right help.
- Readers should know that PP is a mental illness that can happen to all women, from all backgrounds, cultures, and professions, often with no previous history of mental illness. Women recover from PP with the right treatment. Once mums have recovered, there is no evidence of long term disturbance in mother-baby bonding or in providing safe and loving maternal care.
- Reporting should be well-informed, compassionate, and mindful of the likely impact on women, family members and other sufferers. To ensure accurate and balanced information, please contact specialist charity Action on Postpartum Psychosis. You can access our information on PP for journalists and editors here.
- Reporting should refrain from speculation on ‘intent’ and the use of emotive terms that imply rationality or calculation on the part of a person with psychosis. Psychosis affects the brain in many and varying ways - the brain has simply stopped working as it should. Hallucinations, unusual thoughts and false beliefs can be fixed, fluctuating, or fleeting but be firmly held at the time; they can be obvious and shocking, or hidden; they can affect all parts of a woman’s thinking or be specific in nature. A person with psychosis may continue to function in parts of their life or completely be unable to function. Very few, without experience of psychosis, can comprehend the beliefs, behaviours, and outcomes that are possible when the brain stops working as it should.
- Readers should be made aware that urgent specialist treatment is required for all cases of PP (normally admission to a specialist Mother & Baby Unit) to keep mothers and babies safe. The nature and severity of symptoms, often with a rapid onset, at a time when women are responsible for a new baby means that risk is significant. Intensive Home Treatment is rarely appropriate for postpartum psychosis. Admission to a General Adult Psychiatric Unit, separated from the baby for any length of time, is also rarely appropriate. Find out more about Mother and Baby Units (MBUs) here.
- Wherever possible, readers who might be particularly affected by a story should be able to make an informed decision about whether to read on. We know, from feedback from our own community, that poor reporting about PP can impact mental health and cause distress for women and families.
- The following information might also be useful in understanding postpartum psychosis: It is often partners, family members and health professionals involved in seeking help for PP. Women with PP may not understand that they are unwell. Because symptoms can fluctuate, particularly in the early days of postpartum psychosis, partners and close family may be best placed to identify out of character or concerning thoughts and behaviour.
- Risk to the safety of the baby is estimated to occur in 35% of cases of PP. Women can hold false beliefs about the world; develop strange beliefs about feeding or babycare; forget they’ve had a baby at all; be unable to stay focussed long enough to safely care for a baby; put the baby to bed in a strange place to keep it safe; believe that the baby is possessed by the devil; believe the baby has died or been replaced; believe the baby is an inanimate object. It is also the case that many mums with PP are securely-attached, maternal, and protective, despite their psychosis. However, generally, while psychosis symptoms are present, all women with PP will need help to safely care for a baby.
- In UK law, it has long been recognised that some women, who are normally safe and protective mothers, suffer temporary mental illness in the postpartum period. The Infanticide Act is a defence in UK law.
Responsible reporting on intrusive thoughts associated with PP - why is this important?
Many people with postpartum psychosis (and other forms of postnatal illness, particularly postnatal OCD or anxiety) experience intrusive thoughts - worries that they might harm themselves or their baby. These thoughts do not necessarily signal intent, but they can be very distressing for the person experiencing them.
When reporting upon intrusive thoughts it is important to remember the following:
- Intrusive thoughts are unwanted thoughts and they do not indicate desire or intent.
- It is therefore irresponsible and inaccurate to make links between cases of intrusive thoughts and incredibly rare cases of infanticide.
- However, intrusive thoughts can trigger avoidant behaviours (e.g. if a person has intrusive thoughts about water, they are more likely to avoid bathing their child alone as their intrusive thoughts will cause significant anxiety).
Contact & quotes:
Please feel free to use the following quote to outline what postpartum psychosis is:
Dr Jess Heron, CEO, Action on Postpartum Psychosis explains what postpartum psychosis is:
"Postpartum psychosis is a severe and life-threatening mental illness that can onset rapidly in the days and weeks following childbirth. It affects women of all cultures, backgrounds, and social circumstances. Women with bipolar are at high risk, but many women who develop it have no previous mental health history. We do not yet understand much about its causes - but the large biological and hormonal changes that occur during labour and lactation are thought to play a role, as well as genetics, pre-eclampsia and sleep disruption.
It is the responsibility of us all - the public, health services, the research community and charities - to ensure we get care right for this severe and life-threatening illness - to ensure that new mums do not die from this temporary and treatable illness and do not suffer needless and life-changing trauma. If a new mum is behaving strangely, seek help urgently."
For quotes, interviews and further information about PP, email: email@example.com.