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Posted by Elaine Hanzak on 16 Jul 2014 /
3 Comments
I have been asked to speak on BBC WM tomorrow just after midday. I will comment on the article in the Daily Mail today that reports on the NICE guidelines recommending G.P’s ‘Discuss with all women of present and future childbearing potential who have a new, existing or past mental health problem the use of contraception and any plans for a pregnancy.’
Personally I disagree strongly with the comment made by Roger Goss of Patient Concern who said: ‘What’s it got to do with the GP? It’s intrusive. They should mind their own business. Depression is a very vague concept and I’m sure all of us have suffered from it to some degree. I wonder how they expect G.Ps to choose their targets.’
Mental health is part of health! There is a great and needed push for parity of esteem (equal attention for physical as well as mental health).
Many women, their babies and families have suffered unnecessarily BECAUSE their previous mental illness was not asked about either before or once pregnant. This includes more severe illness because of confusion over medication and/or not having a care plan in place for the people involved.
If I had gone on to have a second child after my puerperal psychosis, I would have been very concerned if this had not been mentioned by my doctor. I would have sought advice prior to another pregnancy so I could have made the pathway of motherhood healthier and happier for all concerned.
If a lady had a physical health issue that may have an affect on a baby she was to carry would Mr Goss say a GP was intrusive if they mentioned that? For example, diabetes or high blood pressure? Many women worry about the impact of medication on their unborn child, thus leading to more anxiety. If they are given the correct information right from the start, this can be a huge benefit to minimising any risks of perinatal mental illness. Surely if a woman is more confident in the knowledge and system that is possible for her to become a mother, then this has to be a good thing?
Many women who have spoken to me about their journey of perinatal mental illness have told me how significant the role of their GP was. Some are absolutely incredible and have taken every possible means to ensure they have had the best care. Sadly, others have been dismissed as over-reacting to motherhood, for example. I am aware of how stretched G.P’s are and the huge array of conditions they have to treat and support. Any documentation that encourages a greater awareness of antenatal and postnatal anxiety and depression has to be a good thing.
I am delighted that perinatal mental health is one of the latest clinical priorities to be covered by the Royal College of G.P’s over the next three years. They recognise that:
‘Perinatal mental health affects at least 10% of women and is one of the leading causes of maternal deaths in the UK. It can also have a damaging effect on children’s health and well being. However, early identification, adequate management of the condition and prompt and informed access to relevant services can make a substantial difference in terms of prevention and outcomes.
The programme will focus on raising awareness among G.Ps, professional training and multi-disciplinary working as well as commissioning.’
The programme will focus on raising awareness among G.Ps, professional training and multi-disciplinary working as well as commissioning.’
The main issue here as far as I am concerned is ensuring that G.Ps then have the appropriate perinatal mental health specialists network available. Look back at my blog from last week regarding the Maternal Mental Health Alliance shocking maps of service provision.
What we can do is play our part in getting this high on the political and health agenda. Have you written to your MP yet? I have made an appointment to see mine!
Elaine
3 Comments for Would you consider your GP to be intrusive if they asked about your mental health?
Elaine Hanzak
m: 07762 148183
e: elaine@hanzak.com
I remain convinced that if my past experiences of depression had been discussed more openly while I was pregnant I wouldn’t have suffered so badly with postnatal illness afterwards. I remember asking my midwife to keep an eye on me after my baby was born. No one did.
Although I sometimes get irritated at my gp assuming my mental health history is causing whatever ails me when I see him, I’d rather have it this way around than have something missed and fall back down into depression etc.
Hi Elaine, great topic and from my point of view Emmas doctor was in your list of the ‘greats’, however:
1) his recommendations for Emma to be immediately hospitalised (in any fashion) was ignored
2) if he had drawn on past history of Emmas notes he should have seen a trend in a few areas – weight, previous period of depression (perhaps he did but we aren’t sure as he didn’t have all the notes)
3) drs should be part of an integrated care team – your doctors is familiar and always your go to person, they should all be encouraged to support mental health and to be responsible for their patient during their journey
The poet Sylvia Plath suffered with depression. Her suicide, leaving two young children, was a tragedy that could have been avoided. Mental illness is an illness. Our understanding and treatment is progressing from the experimental medication days and the indifference of GPs experienced in the 1960s when Sylvia took her own life at the age of 32. Elaine your mission will save lives in many ways.