Opinion — 08 July 2015

I’m a psychologist, author and mother of two. I have had two postnatal psychotic episodes – the first when my eldest child was six weeks old and another episode after my second child was born two years later. If it was not for the help I received, I might have died by my own hand because of what I was seeing in my hallucinations and delusions.

Mother and baby units are not a luxury, they are a necessity. They provide a safe monitoring place where mothers can stay with their babies. Medication is prescribed and a specialist psychiatrist sees the ward every couple of days.

The first few days of admission the baby might sleep in a nursery so the mother can get some sleep. Sleep deprivation can trigger mental illness. There are also mothercraft nurses that help with everything from feeding to settling. Nurses are present 24 hours a day.

I do not remember much of the first four weeks after my first psychotic break. I could not remember sequences of activity, like putting the baby to bed or giving him a bath. I did not recall instructions either. I called the crisis assessment team when the delusions got too much and they sent two policewomen with capsicum spray to my house.untitled

The most valuable experience for me when I regained lucidity and insight was seeing other mothers who needed psychotropic medication and knowing I was not alone. My partner was also able to stay with me, an essential support in my recovery. I met some amazing mothers at the most vulnerable times of their lives.

The help I received at the John Cade unit in Royal Melbourne Hospital and Northpark mother and baby unit was invaluable.  Like most access to the health system, my private health insurance covered my stay at Northpark – considered one of the best Australian postnatal wards.

Postnatal depression happens to 1 in 3 mothers. Postpartum psychosis occurs in 1 in 1000 mothers. Mothers and babies are one of the most vulnerable groups in terms of mental health. Without mother and baby units, mothers might only have the option of adult psychiatric wards in the public system, which are notoriously hard to get into. And they wouldn’t help prevent further difficulties that mothers might face on a practical level. The advantages of a specialist unit include having the opportunity to be taught mothercraft at night as well as having a safe environment for mothers and babies.

Like most health services, mother and baby units are easier to access if you are in a metropolitan area, although there’s only one in Sydney. There is usually a wait time of up to a couple of months in the public system, and a few weeks in the private sector. This window of time can be crucial for mothers having symptoms of depression or psychosis.

The federal government this year has chosen not to renew its funding for a national perinatal depression initiative. This program helped identify pregnant women at risk of depression. This shows a lack of understanding and foresight about the nature of prevention in health programs. It is now up to the states to fund this initiative.

If Australian governments are serious about being for Australian families, it involves identification, prevention and adequate treatment for mothers with mental illness. Targeted funding for public regional mother baby units or specific programs like the perinatal program will help families at their most vulnerable.

Hoa Pham is a  psychologist and author.

This article first appeared on ‘Daily Life’ on 8 July 2015.



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