Thursday, 26 August 2010

Health visitors and training for postnatal illness

The University of Leicester has released the findings of a study which shows that women are less likely to become depressed in the year after childbirth if they have an NHS health visitor who has undergone additional mental health training.

It seems the Department of Health has noticed!

Let's hope we get more health visitors and training as a result!

More details are here:

In case you have missed it Ann Girling and I offer a bespoke training which could help in this.
Here is our brochure 

Elaine Hanzak

Wednesday, 25 August 2010

The happy story of one Mum who had puerperal psychosis!

So often we hear of the awful stories around postnatal depression - mine included!

Many women are afraid to have another child after being so poorly first time round. Indeed Nick was understandably reluctant to ever want to have another child, but I would have loved to.

There are things that can be done to avoid or lessen the risks, which are higher if you have suffered before. Here is some advice I have written from what I have learnt :-

Sadly statistics show us that there is a 50% risk as opposed to 15 – 20% of developing a mental health problem after pregnancy if you have suffered one before. However, please bear in mind that every pregnancy is different and just because it happened first time is not an automatic assumption it will happen again. Yet there are ways to minimise the risk and give you more control and confidence you will be well next time as you will have less fear and far more knowledge.

It is vital to get your support team in place and ensure that in the early days after giving birth all systems are in place to allow you maximum time for rest, for yourself and your baby. Even before you get pregnant reconnect with the health professionals and family and friends involved the first time and review what worked, what didn’t and what could have been better, e.g. medication, talking therapy. Recall the early signs from last time and warn everyone to look out for them and to respond accordingly thus meaning a faster recovery. Try to plan to give birth at a different time of year to make it ‘different’ from first time. Have discussed and written plans in place for the birth and early days, for example, who will help to look after the first child. Avoid any major stressors, such as moving house. Ensure you keep physically well by eating properly, by taking gentle exercise. Make your plans to feel reassured and in control, have the support structures ready, think positively and visualise the happy pregnancy and motherhood that can be yours.

Well, several years ago I was contacted by a lady who had suffered puerperal psychosis with her first baby. Eight years down the line, fit and well and with a lovely partner she told me how they would love their own baby. Of course she was worried but got the advice from her medical team pre-conception and plans were put in place for a package of support for her delivery date and following weeks and months after the birth of the baby in May.

I am delighted to report that Grace and her twins are fantastic! She is exhausted but loving it! Big sister is a wonderful support to them all and I was so thrilled to meet up with them. The babies are beautiful and Grace has that magical 'sparkle' that she missed out on first time around.

Good luck to all the family and we hope that this will give others a glimmer of how it can be. Of course there is no guarantee that it won't happen but certainly for Grace the prevention and support package has worked for her.

Elaine Hanzak

Tuesday, 24 August 2010

Global links of friendship and developments in postnatal illness

When I had first written my draft of 'Eyes without Sparkle' I wondered if it would have a wider appeal than the UK as postnatal illness is a global problem. To that end I asked the then President of Postpartum Support International, Diana Lynn Barnes, if she would be interested in reading it for me.
There is a wealth of information on their website

Not only did she agree that my book has international appeal she wrote the foreword for my book! I was delighted! That was back in 2004. Since then we have kept in touch by email and a couple of phone calls. Diana also works tirelessly around the issues of postnatal illness and amongst her many talents runs a centre in California for mothers and families.
Diana continues to inspire me!

Over the last six years we have tried to meet on several occasions but it has never been possible - until now! Diana and her gorgeous daughter were in London and Paris for an 18th birthday treat. We finally met up at The Langham and had a delicious afternoon tea before I took them to see the delights of Covent Garden.
Although it was our first physical meeting, it felt like meeting an old friend! Here are Diana and I in the foyer of The Langham.

Diana went on to write her own excellent book through being introduced to my publishers,
'The Journey to Parenthood: Myths, Reality and What Really Matters'. 

Prior to meeting her I had met another friend, Sam Hill, who had inspired me whilst we paddled in the sea in Mallorca to actually do something with my then manuscript!

Diana will be presenting a paper at the Marce Society conference in October this year. I am so disappointed that I am unable to go this year as I have been at the previous two in Keele and Sydney, and loved meeting some of the key professionals involved in practice and research around perinatal mental health from across the world. I will be keen to read the conference reports.
Please have a read about what Marce offer.

It was an absolute pleasure to meet Diana and her daughter and I hope it isn't another 6 years before we do it again!

Elaine Hanzak

Monday, 16 August 2010

The end of mixed-sex wards? Yes please!

Following the report on the BBC today about the coalition governments pledge to end mixed sex wards I was invited to speak on BBC Three Counties radio.

The measures would mean patients sharing sleeping, bathroom and toilet facilities only with people of the same sex. This could be through single rooms or whole wards occupied by men or women only, or mixed wards in which men and women are separated in bays or rooms.
Using a curtain as a divider to split men and women on a ward would not count, however.

I applaud this move and feel it will improve the patients experiences. One of the main benchmarks for patient care concerns privacy and dignity and this is a major move towards this.

I once spent 24 hours on a mixed-sex ward and was dismayed to find that after a daytime nap, my bed clothes and nightie had moved so I was flashing a bare bottom to the man opposite me!

My late grandparents also suffered the loss of their dignity on several occasions for similar reasons and I also recall my Grandma saying how scared she was of a certain other male patient. He probably was harmless but nonetheless his very presence caused her anxiety and therefore for the rest of the family.

Staff I would assume are more pressured on mixed wards as not only can this stretch them further to be 'jack of all trades' but for added safety, privacy and dignity issues.

I am very pleased that the issue of curtains has been raised and that this is NOT enough often to have a decent level of privacy. Recently I was on a gynaecological ward and remember cringing as staff were carrying out intimate procedures on me whilst I could see the feet on the husband of the patient in the next bed to me, under the curtains!

I also feel that another MAJOR improvement for all patient experience would be to limit the number of visitors allowed at any time and also to shorten the visiting hours. They are both far too big. I remember prior to an operation being given a suppository and was literally on a commode the other side of a curtain whilst 8 visitors were at the bed next to me! Not pleasant for any of us! Another time I was very poorly and yet had to put up with literally 13 people around the bed next to me! The staff said they were powerless to prevent it.

Surely in this day and age when there are so many measures to control infection why do we allow crowds of people into hospital wards with all their germs? One of the best ways of recovery for any illness is rest so why, oh why do we inflict hours of futile conversations on people who just really need to sleep? At times as a patient you feel that visitors are literally stealing your air as the ward post-visiting can be so stuffy. And why do people assume that just because you are in hospital that they need to come and see you when you are at your very worst, when normally you may be lucky to get even a Christmas card from them?

As a patient I have always tried to take responsibility for my visitors too and like to feel that they have always spoken quietly and been respectful of others. Sadly not everyone else is as sensitive to needs of others and behave as if they were on a night out in a pub, with raucous laughter and conversation. 

I am not saying we should return to the strict times of old when even children weren't allowed to see their parents but surely we have gone too far into hospital visiting being a social activity for the masses?

I am aware that the cost issue has been used as a reason for this not being carried out. Surely if less people were treading through hospital, less cleaning would be needed so savings could be made that way! If visiting hours were shorter staff could concentrate on the needs of their patients rather than the visitors, making the nursing experience better for all concerned and improved recovery rates.

So yes please, bring on single-sexed wards but also tighter controls and policies around visiting.

Elaine Hanzak

Wednesday, 11 August 2010

NHS North West's Perinatal and Infant Mental Health Improvement Project

This is from a bulletin by MHIP:-

The NHS NW Perinatal and Infant Mental Health (PIMH) Project Steering Group and the Expert Reference Group have now met. In accordance with the project objectives some stakeholder events are now being planned. First to take place will be two Perinatal and Infant Mental Health Care Pathway Development workshops which will be held on Thursday 16th September in Preston and again on Wednesday 10th November in Warrington. The aim is to capture the current high level of activity in developing pathways. Some areas already have a Perinatal and Infant Mental Health pathway in use, others are in the process of developing theirs and others would like to start a pathway. The workshops will provide the opportunity to share practice and ideas and contribute to the overarching North West Perinatal and Infant Mental Health Care Pathway, prior to consultation.

So that we can take a snapshot of commissioning activity across the region a brief survey will be sent out at the end of August to Commissioners across PCTs, and Local Authorities. In addition, a small group of Commissioners will be asked to work with the PIMH Project Lead to develop commissioning guidance that will be published at the end of the project.

In line with improving capacity and capability in the PIMH workforce, a review of existing national and more local specialist, targeted and universal training packages is being carried out. This will enable the development of a menu of recommended evidence based approaches.

You may have lived experience of Perinatal and Infant Mental Health Services and want to know more about the project or get involved in that aspect of work, or have a commissioning role in Perinatal and Infant Mental Health and would like to be involved in developing the commissioning guidance, if so please contact Anne Sheppard on

If you would like to attend one of the two Perinatal and Infant Mental Health Care Pathway Development workshops please register an interest with .

Elaine Hanzak