Hi I would really appreciate any advice of info that anybody could give me please. I am in Northern Ireland where there is really poor help for perimental mental health issues. I had puerperal psychosis some years ago when I had my child and a few years afterwards another short period of psychosis following an operation. I responded well to medication. I was reassured by the Consultant Psychiatrist back then that if I ever had another baby in the future(because I would be at very high risk of becoming ill again) that they would give me medication after the birth in the hope that it would prevent psychosis.
When I found out I was pregnant this year I immediately contacted my GP and mentioned the plan the Consultant Psychiatrist had suggested. I thought it would be as straight forward as getting a referral to a Psychiatrist. She said she would refer me to the local crisis team and I got a letter confirming an appointment.
I arrived at the appointment expecting to meet a medical practitioner or Psychiatrist but was greeted by a social worker. She was really lovely but I explained to her that I'd expected to meet a Psychiatrist and explained my past mental health, my current pregnancy and about the suggested future plan from the Consultant Psychiatrist who had treated me both times in the past. She basically suggested that she would have a meeting with the crisis team but that she could see I was in good mental health currently so she would probably refer me back to the care of my GP. I don't think she had any grasp of how serious Puerperal Psychosis is and I really don't think she was the right person that I was referred to.
Now I don't know what to do and I'm worried that I'm asking for help in all the right places but not being heard.
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Littleloulou
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Congratulations on your pregnancy. I am sorry to hear you suffered from pp some years ago and had another episode of psychosis after. It is very encouraging to read that you responded well to medication and that your second episode was short lived.
I had pp in 2018 and went on to have another baby in 2021 without recurrence of pp, though I did get some depression that I was able to treat at home with medication and therapy.
I am sorry it has been a bit of a misunderstanding regarding your care and you have been referred to perhaps not the right team. It can be very stressful to not feel listened to and it is really the last thing you need at the moment.
APP has a guide on planning a pregnancy when at risk of pp, in which I found quite useful information:
Also, if there are no perinatal mental health teams in your area, Prof. Ian Jones from Cardiff University offers a second opinion service which your GP could refer you to:
This is my first ever reply on the forum to another mummy so it might be a bit brief and maybe useless!
My friend and previous mental health nurse changed careers and is in the perinatal mental health team now in Belfast and I asked her what would be good advice for you!
this is what she said:
The criteria for the perinatal team is “history of puerperal psychosis” so of course she meets the criteria for monitoring and prevention. The only barrier is she has to be at least 12 weeks pregnant. Otherwise she should be within the team. Tell her the midwives can refer her back also. I’d tell her to advocate for herself at the GP and get him to send another referral.
Is that any help?
There is so much support here in NI now I’m sorry there is no MBU but we are working on it every day and we are making progress!
I'm here in NI as well. Thanks for coming on the forum and sorry to hear you're getting passed from pillar to post at the moment, that must be so annoying. To be honest though, I've had more joy in terms of getting referrals and support from my local social worker than I ever have from the GP or mental health practitioner. Maybe depends who you get.
You've already had good advice from others here. It sucks that you're going to have to stamp your feet to get what you need. I struggle to do that and and find having what I want to say written down for appointments/phone calls helps, or having someone else with me.
I just also wanted to say that I had a psychosis episode with my first child, but then not at all with my second. I was in England at that time, but was kept a good eye on by the perinatal mental health team, which really reassured me. Hopefully there's a team in your area as I know there's quite a few set up in NI now.
Anyway, keep in touch and let us know how you get on. Maybe think about coming along to the NI APP Cafe Group that's held on Zoom? It's not all PP talk, and it's nice to chat with others who've been there.
Welcome to the forum. And huge congratulations on your pregnancy. You have already had some great replies, which I hope are helpful.
As others have said there is support in NI now. I'm not sure where you live in NI, but I think most areas of NI now have a perinatal mental health team that should be able to support you in pregnancy and afterwards.
You are certainly eligible for their support due to past pp, but as taramag helpfully found out, you may need to be 12 weeks pregnant before they can start supporting you. I would suggest seeing your GP / midwife and telling them that information, and asking if them, or a midwife, can refer you to your local perinatal mental health team at that stage of your pregnancy. It may be they don't know about the team because they are quite new, so you might really need to insist they look into it?
Hi I'm in NI, Northern Trust. I had pp after my 1st child in 2019,out of the blue&have been well since. I'm currently 15 weeks pregnant & am consultant led this time due to age&previous pp. I am under the care of the Perinatal Mental Health Team in the hospital. I've been seen by the perinatal mental health midwife, consultant and my midwife so far and regular appointments have been booked in with them. I will meet with the psychiatrist in due course. My midwife will offer continuity of care throughout pregnancy&for a few weeks after. Hope this helps you find out about any support available in your area.
Hi all rather than replying to you all individually I am going to do this post. Sorry if it ends up quite long. Firstly I would like to say I was actually moved by the responses I received to my post and heartened that people I have never met took the time to respond and actually sought information on my behalf. Taramag it may have been your first reply on the forum to another Mummy but it was far from useless and the advice was both helpful and reassuring.
Maria_at_App, SammySeal and Ellie_at_App thank you for the Congrats, understanding and for sharing your experiences and links to information. It is nice to know that I am not the only person in the world that PP has happened to and to know that people on this App have an understanding and awareness of the trauma that goes with it.
Paintchart20 congratulations on your pregnancy and thank you for sharing your experience and information about the Perimental Mental Health Team. We actually seem to be in a very similar situation and I am now grateful and hopeful to have a referral through the hospital to my local Perimental Mental Health Team.
Update on my situation -
Since my initial post asking for help and information I have now been referred to the Perimental Health Team through the Maternity Unit at the hospital. The people at the hospital who spoke to me about the referral have been so helpful and positive that it really has felt like a weight has been lifted off my shoulders.
Prior to that following the recent referral that my GP made to the local Crisis Mental Health Team that resulted in a meeting with a social worker I had been left in a situation were I felt great anxiety and panic and it worried me so much to the point that it was all I could think about. In some way I feel angered that the GP referred me to what seems like the wrong Team which resulted in causing me unnecessary stress and anxiety especially when I found out that the social worker tried to phone me with an update and when she couldn't get me on my mobile she used a 10 year old telephone number and although I don't live at that address anymore she shared to the person that answered the phone that she was calling from the Mental Health Crisis Team about me....I feel that was a breech of privacy/trust.
But to end on an upbeat note, today I am feeling positive about the referral to the Perimental Mental Health team and I am letting go of the anxiety and worries that the wrong referral caused me as I really am hopeful that I will be in the right hands now.
Hi Littleloulou I'm so glad you have now been referred to the perinatal mental health team, what a relief!
Wishing you all the best, know we are here for anything, don't hesitate to write again.
I also wanted you to know that we have a peer support group for women in NI that meet on Zoom once a month, if you ever wanted to join. You can email me ellie@app-network.org if you were interested. It's just a safe place to share experiences with others who have experienced pp.
Thank you so much for the update, so pleased you got the referral to perinatal services, I can imagine a huge weight must have been lifted off your shoulders knowing you will be in the right hands.
I can understand your frustration on how the situation was managed with your GP and the Crisis Team. Perhaps feeding back to your GP part of your experience may take some of the anger away? He/she may have had the best intentions towards you, but lack of awareness and knowledge seem to have played a role here. As Ellie mentions, perinatal mental health teams are reasonably new in NI.
I am sorry the experience caused you unnecessary anxiety and stress, I wish you all the best in your pregnancy and I am really glad that the experience of the Maternal Unit has been so positive and reassuring. Take care
Thanks Maria_at_APP. I may have given feedback to the GP if it was like pre-pandemic times but it's a nightmare nowadays to even get a phone appointment with the GP and l havent seen mine face to face for years so I don't imagine I will be in touch with them for a very long time. That was another reason I did not want to be referred back to my GPs care by the Crisis Team and why I was so happy to be referred to the Perimental Mental Health Team. Thanks for all the good wishes x
Insist on getting a Psychiatrist appointment and formally complain if they saw no.
Then copy the letter to your local MP. Fight for your rights, you are fighting for your family’s well-being.
I had PP after my first child but had great perinatal mental health support and a medication plan. I took Olanzapine and didn’t have any PP symptoms after my second or third child. I found it avoidable, you can too. Keep on asserting yourself and reaching out for support.
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