"Crisis and Inpatient services for postnatal illness"

About: Devon Partnership NHS Trust Honiton Hospital / Maternity Royal Devon & Exeter Hospital (Wonford) / Maternity

(as the patient),

Saturday, 4 am. I'm leaving messages on friends' answerphones about the amazing end of the world party we are going to have on the other side. I can feel it in my bones, we are almost there. Upstairs my husband and ten day old baby are sleeping and blissfully unaware of what’s going through my mind.

By 9am my husband is calling the out of hours GP and our unofficial crisis team of friends and neighbours are gathering in the kitchen, soothing me and making cups of tea. I'm speeding, careering through my mental landscape of heaven, broken bits of film, the water birth, premonitions. Twenty minutes later my friends have helped me into bed and two members of the Crisis Team are with us.

I remember such sensitivity and gentleness. Nobody is saying 'psychosis' or 'delusions' in my earshot. The staff are talking to me about sleep and rest and telling me it's so important that I can sleep so I can look after my baby. My husband tells me a year later I couldn't even remember her name that day.

I will be eternally grateful for the skills, compassion and time that the Crisis Team gave me that day. They were faced with an acutely unwell new mother and they enabled me to go into hospital without being sectioned. However the only hospital care available to me was a bed in a mixed general adult psychiatric hospital, without my baby daughter. I'm glad I didn't realise at the time that sitting in bed while my husband packed a case would be the last time I would breastfeed her.

Within the limitations of what they could provide, the acute ward staff were amazing. I know now that it probably made everyone feel very twitchy having a tiny baby visiting for bottle-feeds and nappy changes in one of the ward round rooms. Nurses gave my husband as much information as they could, but postpartum psychosis was a pretty rare thing for them to encounter. The psychiatrist always made a point of meeting privately with my husband first to discuss his needs and concerns before our ward rounds. I was discharged home within 3 weeks with an intensive home care package.

But should my postcode have decided that I would be consigned to a lonely dinner of stew and arctic roll in a hospital canteen, while in the Midlands another mum with postpartum psychosis could have a takeaway with her husband in the flat attached to the Mother & Baby Unit? Specialist crisis provision for new mothers in the UK is incredibly patchy and in these financially stretched times, many units are being forced to close.

Five years later I needed inpatient support again following the birth of our second child, after which I suffered with postnatal depression. Again I was struck by the compassion of ambulance teams and crisis workers but again our only option was a general psychiatric ward. This time I could really see the challenges for all the patients who were also parents. The tiny 'family room' facility on the ward needed to have a separate entrance so children did not enter the ward but this meant it also serving as a cut-through for cleaning staff. It was very hard for my older daughter to understand why she couldn't come and see my room. It was horrible leaving her as I went back behind the locked door.

I really believe this is something that NHS trusts need to recognise - you don't stop being a parent just because you are in crisis.

I want people to know that crisis care can be excellent and I was treated very well in my area. But I also want them to know that the provisions for families needs to be better here and elsewhere for parents and families going through mental health crisis.

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