Supporting Parents with their Mental Health

Nearly all new mothers experience a few days of low mood, anxiety and tearfulness with symptoms being strongest around the fifth day after birth. This is a normal reaction to the hormonal and other changes after having a baby.  However, if the symptoms are still there at 10-14 days after birth, it’s important for the woman to see her GP, midwife or health visitor for an assessment.

The symptoms of depression during or after pregnancy are tearfulness, irritability, feelings of loneliness, loss of confidence, and a lack of satisfaction with motherhood (MIND 2006).

Mild anxiety is when someone feels overwhelmed by responsibilities and unable to cope (MIND 2006).

10 -15% of the general population get some form of postnatal depression, and the risk factors which make depression more likely are factors which often affect parents in foster care, such as being very young, having a partner who is abusive or unsupportive, or losing your own mother in childhood.
This makes it all the more important, as foster carers, to be aware of symptoms and know how support a parent who is affected.  Remember you can always speak to the midwife or health visitor yourself if you are worried.

What to look out for or ask about

• Loss of interest in things that she used to be interested in
• Feeling sad or tearful a lot of the time
• Being unusually irritable
• Finding it hard to sleep even when the baby is asleep, or sleeping more than normal
• Lack of motivation to do normal things like getting washed and dressed, washing her hair or clothes
• Finding it difficult to connect with the baby, either before or after birth

What you can do to help

• Encourage her to talk
• Help her to take time out for herself, away from the baby. Even just having a shower can be difficult if the baby cries a lot
• Encourage her to talk to the GP, midwife or Health visitor
• Support her to go to her appointments with her psychiatrist, psychotherapist or counselor

Sometimes placement plans put a lot of emphasis on assessing a mother’s ability to care for her baby without help. All other new mothers are encouraged to have a support network to enable her to rest, have meals cooked, and have family members help with some baby care.

Despite this, the system we are part of often asks us to withhold this support to new mothers who are already vulnerable. Part of your role with a new mother or a parent who is depressed may be to advocate for her right to the support that all other women are encouraged to get.

You may find it useful to show official online information like the Royal College of Psychiatrists which specifically encourages women to get support with practical tasks and to try to catch up on sleep and get time away from the baby.
You will find some useful films on the Best Beginnings website section on perinatal mental health.

Supporting a parent to find help

The first port of call is the GP, midwife or Health visitor. This useful list of questions to ask at an appointment with a health professional may be helpful. The health professional may make a referral for specialist help from the Perinatal Parent-Infant Mental Health Service who offer psychiatry and psychotherapy services.

In some areas, any professional working with a woman can make a referral, and women can often self-refer, so it’s worth finding out the policy in your area.

The symptoms of a serious perinatal mental illness include those listed above, but are more severe, where a woman may feel completely hopeless and incompetent, extremely tired but often not able to sleep, has difficulty concentrating or making decisions, and can also include morbid thoughts about herself or the baby, often with thoughts of suicide or harming her baby.  Feelings of severe anxiety can make her feel as if she is going mad, with panic attacks, palpitations and difficulty breathing.

Two women in every thousand develop psychosis, where they believe things that aren’t true, see and hear things that aren’t there, and behave in uncharacteristic and uninhibited ways.  This can happen to any woman but is more common for women who stop or change medication for an existing psychotic illness.  Postnatal Post Traumatic Stress Disorder (PSTD) is experienced as nightmares, flashbacks, anger, and difficulty concentrating and sleeping and can be triggered by a traumatic labour.

Experiencing the symptoms of these conditions is very painful and distressing for women, and as foster carers, we need to be aware of the signs of severe mental illness and recognize the seriousness of the situation so that the woman in our care can get the help she needs quickly.  Although women with no previous history of mental illness can develop serious perinatal illness, women who have had a previous serious mental illness are much more at risk, even if that was many years ago.

It’s really important to tell a health professional urgently if you think the mother you are caring for has any of these symptoms.  You may even need to make the baby safe and call an ambulance.  It is also important to remember that with the right treatment, most women completely recover and go on to look after their children safely.

Eating disorders are a group of serious mental illnesses, and pregnancy can be a very difficult time for some women as their body changes. You can find out more about eating disorders in pregnancy at Eating disorders and pregnancy website and about eating disorders generally at BEAT: Eating disorders support charity with helpline

If you are caring for a father, a couple, or the father has regular contact, it is also important to remember that new dads can also get depressed, and feel overwhelmed, frustrated and isolated if their partner is depressed. See the ‘Supporting couples and fathers’ section for more information.