Thursday, 28 April 2016

So you think you might like to work in perinatal psychiatry?

I was asked to speak at an event at the RCPsych today, encouraging more doctors to enter the perinatal psychiatry field.  Obviously I couldn't attend (being on the other side of the Atlantic!) but I sent over some thoughts in writing.  Please share with anyone who might consider this career.  Worldwide, we need many more perinatal psychiatrists (not to mention mental health nurses!).

Why choose perinatal psychiatry?

You've already studied medicine, and taken an oath to Do No Harm.  You are scientific and yet artful.  Pursuing the noblest of professions.  The world will always need doctors.

You are thinking about a career in psychiatry.  Perhaps you'd rather work with thoughts, emotions and behaviours than with blood and guts.  Be warned though - we psychiatric patients can still provide plenty of the latter!  Your tools in psychiatry will be your OWN mind, rather than the scalpel or stethoscope - how you communicate with us, what you choose to hear, how you evaluate the complex human pictures before you.  Are you good at managing chaos?  If you aren't yet, you soon will be.

You've come across the term "perinatal" and are curious to learn more.  What is perinatal psychiatry?  Might it be the path for me?

I'm not going to paint you a picture of roses and unicorns.  You are too clever to fall for that.  Instead, as someone who spent some time in a Mother and Baby Unit, I will give you realism. 

MBUs: inspiring, rewarding, emotional, tense, suffocating places.

Scenes of utter joy one minute (imagine a new mum looking into her baby's eyes and smiling at him for the first time!).
Hilarity (explosive poo crisis in room 2!).
Friendship (between patients thrown together in the most inauspicious circumstances - and, yes, the staff caring for them).
Heart break (the decisions that you - yes, you - may have to make will be life's hardest: removing babies from families; treating mothers against their will; deciding their problems are not psychiatric after all but social - and you have no drug or therapy for that).

But if you are considerate, calm, good at balancing risks, seeing the bigger picture, communicating with both the psychotic and their equally frantic family members, then perhaps an MBU could be the place for you to make a real and positive difference.  

Because if you help fix one severely mentally ill new mother (and I was one) then not only do you send her home but you give her and her whole family their life back.  You give the baby back his mum and the dad back his partner. You give each family a new start.  And rather than remembering the hideous psychosis and the fear and the distress and the panic of their postpartum days they will remember the care they received throughout it all.  They will get on with their lives, not just recovered from that spell of illness, but hopefully stronger and more able to cope with whatever life throws at them next. 

So - consider it.  Do not enter into it lightly.  But consider it.

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