Tonight's "#PNDhour" is all about Mother and Baby Units (MBUs). So I thought I would jot down some reflections on my time in one. MBUs are acute psychiatric inpatient wards for women who are either pregnant or up to 12 months post partum. The majority of patients have acute and severe depression and/or anxiety, or postpartum psychosis. But there are also (in my experience) some who are there on dreaded "parenting assessments", or those who may have learning difficulties or social problems. There are around two dozen MBUs dotted around the country (this is not quite enough, but we are lucky in comparison with the USA, which has only one or two!). They tend to be located within large psychiatric hospitals, and are led by a specialist consultant psychiatrist, a ward manager, mental health nurses, healthcare assistants and nursery nurses.
I was an inpatient, along with my newborn son, from the 19th November 2012 to the 31st January 2013, at the Channi Kumar MBU at the Bethlem Royal Hospital. The hospital is run by the South London and Maudsley NHS mental health trust. I was a "voluntary" patient, technically - but it was made very clear to my family, who had brought me to A&E just two days after arriving home from the maternity ward, that I would be sectioned otherwise. I would also have been sectioned if at any point I had tried to leave.
So, yes, it was a "secure" place. There were no door handles or hooks. The duvets were rubber and the bedroom doors had windows. On arrival, these were all the first things I noticed, and it only made me feel more paranoid and scared.
Looking back, of course, I see the reason behind all the design features. And I know the staff there made it as homely and as cheerful as possible. There were 16 bedrooms, three shower rooms, a dining area (we had no access to the kitchen) and a nursery, which also had a (locked) milk room and a baby sleeping area. I was given a tour on the night I arrived, but I was so exhausted and out of my mind I didn't take it in. My husband left the pair of us that night completely distraught. This wasn't where we were supposed to be. The Boy had a beautiful nursery all ready and waiting for him back home: expensive mobile, hand knitted blankets, rows and rows of babygros and sleep suits all washed and ironed and neatly folded. Now he was whisked off to the MBU nursery, to be cared for that night (and, it turned out, many many nights subsequently) by strangers.
The other ladies I met gradually over the course of my stay (keep in mind for at least the first 3 weeks I was "The Crazy One"). We came from all walks of life (a cliche but true!) but shared a very personal and intimate experience. We bonded over Occupational Therapy, feeding tips, explosive poo's and all the other new mum topics of conversation. The staff too came to be important figures in my restricted life as an inpatient. They were, for the most part, incredibly kind and patient. They all shared duties, so you were as likely to be under one-to-one nursing from a nursery nurse than a RMN. And similarly the mental health nurses were all dab hands at feeding and changing newborns.
And what of my illness? I was admitted with suspected postpartum psychosis. Very quickly it became clear the psychosis was getting much worse. But I was in a safe place. My hallucinations raged and raged, as I fought my sleep deprived mind, not to mention a lethal urinary sepsis. The staff had seen it all before, which was some comfort to my frightened family who thought they were losing me forever.
My psychosis loved the MBU. Paranoid? That strange man (a student on work experience) is following you and monitoring your every move. Confused over names and faces? We will introduce you to dozens of new people all with strange names and confusing job titles. Think someone has taken your baby? We will have a constant stream of crying infants being carried up and down the corridor. Hallucinations about suffocating? We will keep you in a small bedroom. It was an easy place for the psychotic mind to wander.
But I was safe. For the first few weeks, when my illness was at its worst, I was under one-to-one care. That meant I had a member of staff with me at all times, 24 hours a day. The Boy was, at this point, primarily cared for in the nursery. But I was always encouraged to spend time with him and to do as much of the practical care as possible. I was so unsure of myself, I assumed everyone there could look after him much better than I could. It was a sign of my recovery when I started to prefer doing everything myself and taking proper charge of him.
Soon enough, the time came for our gradual discharge. What started as a precious few hours home leave on Christmas Day turned into days and weeks of leave until I was happily discharged into the care of my GP and a perinatal Community Psychiatric Nurse. We also had fantastic follow-up care from a specialist Health Visitor, who made a lot of time for us and made sure my anxieties were allayed.
I look back on our MBU time with a mixture of emotions. Certainly some of the most horrific, frightening, catastrophic memories were from that place. But it also gave me the strength to heal and allow me to become the mum I am now. I am truly grateful to every single member of staff there (and all the fellow patients) who helped me and my son on our way. I campaign now for more access to MBUs. I am also a patient representative for the Royal College of Psychiatrists' inspection and accreditation programme
