Postpartum psychosis is a severe mental illness affecting on average two new mothers in the UK every day. It requires emergency psychiatric care –– and yet a lack of mother and baby units means many mothers struggle to get the kind of treatment they need. Emily Flanagan reports

HANNAH Bissett, 36, had a straight-forward pregnancy and was looking forward to what should have been happy times as a new mother. She gave birth to her first baby after an emergency c-section in 2009.

Everything went well until Hannah began having irrational thoughts and behaviour. Her community midwife referred her to her GP, but her condition worsened and she was referred to a psychiatrist. But she was incorrectly diagnosed with postnatal depression.

Her condition quickly deteriorated and she was sectioned in a general psychiatric ward, separated from her baby. It was then Hannah was finally correctly diagnosed with Postpartum Psychosis (PP).

She then spent two distressing weeks in a general psychiatric ward until a bed became available in a specialist mother and baby unit.

“I was confused as there was no history of mental illness in my family. Developing PP was a complete shock and extremely traumatic,” says Hannah, who lives in Dalton, near Thirsk and now campaigns for better understanding of the condition through the organisation Action on Postpartum Psychosis.

After returning home three months later Hannah suffered extreme anxiety and lost a lot of confidence which took time to rebuild.

Though far less common than postnatal depression, Postpartum Psychosis is deemed a psychiatric emergency requiring urgent treatment.

Dr Giles Berrisford, chair of Action on Postpartum Psychosis (APP) and consultant perinatal psychiatrist said for most people it strikes without warning and affects many women who have never experienced a mental illness before.

“Postpartum Psychosis is less common than postnatal depression or baby blues, but it is a much more severe illness.

“It can have a rapid onset, usually within days of delivery and may escalate quickly – within hours or days and requires urgent psychiatric treatment,” says Dr Berrisford.

The early symptoms of PP can often be difficult to spot in mothers struggling with the exhaustion of parenting a newborn baby.

According to APP the causes are unknown, but the dramatic hormonal and biological changes that occur at childbirth are thought to be involved. The symptoms can be very frightening for mothers and their families and can include extreme elation or euphoria, rapid mood changes, visual and auditory hallucinations, extreme confusion or saying and doing things out of character. In some cases it can result in suicide - the leading cause of maternal death in the UK.

The lack of health support in terms of mother and baby units for new mothers suffering psychiatric illness is also a cause for concern.

According to the Maternal Mental Health Alliance, pregnant women and new mothers in almost half of the UK do not have access to specialist mental health services. Despite the fact more than one in ten women will develop some form of mental illness during pregnancy or within the first year after having a baby.

In North Yorkshire and the North-East, the nearest facility for mothers and babies is in Leeds. If those beds are full, the next nearest facilities are in Morpeth in Northumberland or Manchester. It means many women have to be treated many miles away from the support of their family, or from other children.

The lack of units can also result in women being treated on adult psychiatric wards and suffer the further trauma of being separated from their babies.

Dr Jessica Heron, director of Action on Postpartum Psychosis and senior research fellow at Birmingham University says: “Where mother and baby units (MBUs) are unavailable, mothers might only have the option of an adult psychiatric ward.

“It is traumatic even for a severely unwell mother to be separated from her baby at such a key time.

"General wards are not set up with appropriate facilities to care for newly delivered mums or visiting newborns, whereas specialist MBUs enable a mother to learn the practicalities of parenting while providing a safe environment for mothers to continue care for their baby.

“It is tragic that there are many parts of the country with no MBU. Our research shows that mothers with Postpartum Psychosis who are separated from their babies take longer to recover, report more trauma and feel less confident about looking after their babies upon discharge from hospital.”

Hannah is also calling for more specialist units.

“I had my second child in 2013 with a care plan in place but thankfully I didn’t get PP again. My message to others is, with the right support – from family, friends and professionals – you will get better.

“We desperately need more investment to raise awareness and more mother and baby units for women to access.”

For more information visit Action on Postpartum Psychosis' website: