Numerous studies estimate the incidence of perinatal depression at between 15-25%. That is, depression that starts either during pregnancy or in the 12 months following birth. However, perinatal depression is only one aspect of what can happen to both mothers and fathers at an already stressful time – others include post traumatic stress disorder, anxiety, managing existing mental health conditions, psychosis to name but a few.
So how can your Health Visitor help?
Our responsibilities are to families with children aged 0-5. We have 5 universal health reviews that form part of our commissioned service delivery.
- Pre natal (26 – 40 weeks)
- New baby (10-14 days post partum)
- 6-8 weeks post partum
- Development check aged 1 year
- Development check aged 2 – 2 1/2 yearsIt is during these visits that we attempt to identify any health issue with either parent that might have impact on child development. This of course includes addressing mental health, and we have various ways in which we can identify problems and act as advocates.
We are trained to explore perinatal mental health. This can be through direct questioning – perhaps you have been asked the following
- During the past month, have you often been bothered by feeling down, depressed, or hopeless?
- During the past month, have you often been bothered by little interest or pleasure in doing things?
- Or through building rapport through other visits like breastfeeding support or at baby clinic and assessing affect and levels of stress and anxiety. Sometimes the smallest conversations lead to the tougher stuff. Some days you can just be tearful and tired – we can help you identify what you are feeling.
If anxiety or low mood issues are identified, we are able to offer ‘listening visits’ which use motivational interview techniques to advocate accessing self help and other services. Some of these range from provision of simple advice with back up leaflets – Anxiety UK
Or tools to help assess how you feel, and these are usually the following
- EPDS .
Through assessment, and with your permission, we can advocate on your behalf to your GP or other health professional. We can find out and advise about counselling services. We can help you self refer to single point of access services for mental health ‘ triage’. We can involve Homestart or the local Children’s Centre to get you through the tough times. We can advise on drugs and breastfeeding, or can signpost you to people who can help further. We can look at local support groups – birth afterthoughts, bereavement services, premature baby groups.
We can talk to your family, provide post natal group sessions and promote awareness amongst other health professionals.
Do join #PNDHour on November 18th 8-9pm Via @PNDandMe & @WeHealthVisitor to discuss follow up after diagnosis and how Health Visitors can put all of above into action alongside your plan of care.
Bernie lives with her two adult children in Hertfordshire and tweets as @bernie_hughes and as part of the @wehealthvisitor team
Bernie qualified from Kings College Hospital as a registered general nurse (adult) in 1992. She gained diverse experience through staff and senior staff nurse roles in King’s Liver Unit and District Nursing, more senior roles in King’s Trauma and Orthopaedic unit and NHS Direct, and prior to qualifying as a Health Visitor, was Head of Audit and Training at a 21 bed chemotherapy day case unit in Harley Street. Senior roles have given Bernie insight into strategy and forward planning, but at her heart she has always remained focused on the people.
Throughout her nursing experience, child protection, public health and the vulnerability that mental health brings to the lives of families has been a constant seam. This led to exploring the possibility of becoming a Health Visitor and this was realised for Bernie in 2012. The role has provided her admiration for the dedication of her colleagues, the incredibly hard path that parents walk, and the often unexplainable resilience of children. An iHV perinatal mental health champion, Bernie’s interests on social media are predominantly around this subject. She is delighted to have been asked to be part of WeHVs.