Our thanks to Sasha Barber for writing for us about multiagency training sessions on perinatal mental health. Sasha is a mental health nurse with a background in health visiting and is a Fellow of the Institute of Health Visiting and Perinatal Mental Health trainer.
In 2013 I trained as a perinatal mental health champion as part of the Institute of Health Visitors champion training, whilst working as a health visitor in Gloucestershire. Fast forward 5 years and my training has been updated to encompass the latest research in perinatal and infant mental health and once again I have the opportunity to roll out the training to all agencies in the Bristol, South Gloucestershire and North Somerset area , as part of my role as the perinatal mental health nurse for Southmead maternity. With the support of NHSE, 10 multiagency training sessions have been delivered and 3 more are booked throughout the rest of the year.
When you teach on a subject that you feel passionate about the evaluations can stop you in your tracks, they can take you from a momentary high to a chasm of despair but apart from the comment on my poor selection of biscuits, I have been lucky that the eclectic group of 200 have been forgiving enough (mostly) to look past not only this but the occasional dodgy teaching method, the IT fails, the poor quality photocopying and badly stapled handouts (which I did at 2am as I juggled the demands of 4 children, full time work and the organisation involved in the training). What I found was a collective passion and thirst for knowledge around supporting families with perinatal mental health issues and a theme of “how can I make a difference” has resonated throughout each session.
I have also been struck by the number of different agencies that have attended, health visitors, midwives, social workers , GPs (hurrah), psychologists, housing officers (I was overjoyed at this), probation staff, prison officers, mental health nurses, infant mental health workers, child minders, charities and the voluntary sectors, nursery managers, obstetricians and nurses This has added such a richness to the training and an opportunity to learn about others roles which is often a barrier to interagency working.
Through group work, films, role play (me, not them), discussions around infant mental health, epigenetics, research, medication, local services and the exploration of different mental health issues I have tried to convey not only the importance of identifying the signs of perinatal mental illness but also the importance of relationships, however fleeting, however inconsequential you feel the conversation was the power of validating someone’s experience through empathy and compassion is powerful and life changing.
To tune in and listen to understand rather than respond can be a catalyst to meaningful change but what I have discovered over the years is that if those who are working with women in the perinatal period do not have an awareness or adequate knowledge they are unable to hear what is being said. I can prove this myself; If anyone asks me about diabetes I go into full on internal melt down and listen to approx 3% of what somebody has said because my mind becomes full of what if’s “what if I don’t pick up what she is telling me, what if I miss something, what if what if what if”. We are also more likely to go into our judgement and fixing mode.
“Well you didn’t attend your CBT session” “have you tried doing this …”
If you feel confident in your knowledge you are more likely to ask meaningful questions and listen to the answer… Those panic, judging and fixing voices in your head also subside as well.
The part of the day that always stops everyone in their tracks are the women’s voices themselves, I have been so lucky to have Sara, Georgia and Jodie take time to come and tell their story. They have been brave, honest and so candid and it is a rare opportunity to ask questions face to face about what we could all be doing differently. The feedback always highlights how their story will make a difference to their practice.
“I know after today I will be more confident, open and honest with mums who I have concerns about and may be suffering with poor mental health” – Health visitor
“I think my general practice will be better, I will take more time and more consideration with each patient contact” – GP
“I feel I know more about what is important to women and families” – Nursery Nurse
“I will make sure I will check in with fathers about how they are feeling” – Midwife
“I have more understanding and knowledge on recognising signs of illness and where to signpost” – Health visitor
“I feel much more aware of the distress mental ill health causes and the importance of ‘noticing’ and ‘holding’.”
But, we need to be doing more, many of those attending identified that they felt out of their depth when assessing mental health, that there was a lack of knowledge around where to signpost and little knowledge about maternal OCD, intrusive thoughts, complex trauma and how this could impact on parenting.
But for those days when you are working with a family, when you don’t feel you are enough, when you feel out of your depth and those panic voices start to shout at you… Just being there to listen and be human can be enough to rip through the fear and allow you to truly hear what is being said and when that happens, it’s an absolute gift.