Action on Postpartum Psychosis
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Advanced Directive

I was wondering if you were aware you could have an Advanced Directive for if you get ill again.

Basically it is a form telling the staff who are caring for you what you want to happen in the event of you not being able to communicate whilst you are ill .

it mentions who you want to be your nearest relative,who will look after any other children,or pets you may have.

It also includes which medication has worked fr you in the past and which hasn't been so helpful.

It also indicates who you want to take care of your bills and rent etc.

I found this very helpful to put in place while I was well and would recommend it.

Best Wishes Poulson

3 Replies

Thanks for flagging this up Poulson. Very useful info.

Advanced directives are so helpful for crisis planning. You can even put your preferred type of hospital on there e.g. Mother & Baby Unit (usually ok if child is under one) or psychiatric intensive care (usually higher staff ratios than general psychatric wards)

Also take a look at the WRAP wellness recovery action plan (should come up on Google) as it helps to set out all sorts of things for staying well, and what to do in a relapse.

Hope u all have a good week! N


Hi Poulson,

Yes, I learnt about Advance Directives during my excellent care from the Early Intervention in Psychosis Service (EIP). EIP looked after me once I was discharged from hospital and they stay with you for 3 years after the initial psychosis. At some point early on in my recovery, my care worker and I made a "Just in case" plan as we called it, to put into writing everything I'd want put in place if I became unwell again and it also contained a list of relapse indicators and phone numbers of people to call for help. My husband and I each had a copy.

I remember feeling quite uncomfortable writing the plan at first - facing the idea that there might be a relapse was difficult, but I was reassured that although possible it was unlikely, since I had had a postpartum psychosis which was clearly linked to child-birth, and not a more common trigger (if that makes sense?). Isn't it so confusing in those early days working out what happened to you? So many fears about it happening again and trying to get my head around what postpartum psychosis actually meant.

In the end, I took comfort from that Advance Directive as it not only made it clear who we should turn to in crisis, but it also made me feel more in control of my care. Control was something neither me nor my family had whilst I was ill.

When I became pregnant with my second child, this Advance Directive or "Just in case" plan, became incredibly important and we expanded it to become my care-plan for the second pregnancy.

So, yes, I echo Naomi's thanks for highlighting this important point. Great question Poulson!

Take care, N x


Hi Poulson, I've looked into this (and also deal with a fair bit of Mental Capacity things through work, but that's another story!) Whilst I haven't done anything formal, I have definite thoughts about what I would like to happen, should I ever become ill again after having a baby. Or even if I was to be "incapacitated", even temporarily, under whatever circumstances. I think this will start coming up more and more with people both in the Mental Health arena and generally over the years to come.

My last appointment before discharge from the Early Intervention Team, the Psychiatrist talked to me about writing a sort of "letter" to myself, setting out who I would like to do what, who I trust to make decisions for me, what medication worked for me. All pretty good ideas, especially as I listened to nothing and no-one when I was ill - I am very stubborn! At some point I will get round to writing this all down properly, but I know I have talked to my husband about it too and we have plans together of what would be best for all of us. When you are in the midst of such an awful illness, it's easy to feel lost and helpless and being prepared or having a say would really help people I think. The professionals do have an important role to play, but patients and carers being involved can help recoveries I think.


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