Thursday 30 July 2015

The "portfolio" career

I grew up in a pre-internet, certainly pre-social media, age when middle class children like me had a certain path to follow.  Exam results such as mine pointed resolutely towards a career in medicine, the law, or perhaps accountancy.  Upon graduation, we were expected to secure a graduate trainee post and ascend the relentless upwards path towards partnership, consultant post or academic tenure.  Our job was to follow instructions, shine in our annual appraisals, and always ensure our consumption and debts grew in line with our salary.

I fell off this well-trodden path towards the end of 2010, when I was thirty years old.

I was finding it harder and harder to conceal and manage my chronic mental illness. I had paid off my student loans and bought my first shoebox of a flat, but I had no sense of professional fulfilment, ambition or vocation.  I looked at my seniors and wondered "did I really want to be them in five or ten years' time?"  Worst still, as a management consultant by this point, I wondered what on earth it was I was selling - and whether there was any value in it anyway?

The exact circumstances of my departure from this professional life are clouded by time and judgement.  But I got married soon after and from that point on (bar a brief excursion into postgraduate education) was focused on my family.  I took up some voluntary work, and helped out a friend with her bakery and coffee shop business, but other than that gave my "career" very little thought.

It has been the roller coaster of life following childbirth that has given me the career which I now hold dear, and which bears no resemblance to any plan set out by parents or school career advisors.  My working hours are spent on social media.  Being an expert service user.  Peer supporter.  Charity trustee.  Blogger, writer and spokesperson.  I think the modern term for this is "portfolio career".  Here is what the term means for me in practice:

Social media
Few people get paid for engaging in social media.  But it is such a big part of my daily routine, that I feel it has almost become part of my job.  Certainly it has allowed me to meet my colleagues and co-
workers in maternal mental health.  I have found my Tribe, my soul mates, and we gaggle around our online water cooler and gossip and moan and pick each other up like in any other workplace.  I communicate with them through twitter and Facebook groups and we occasionally share google documents and Dropbox folders but more often than not ideas are thrashed out and actions agreed via Messenger and gmail.

Expert service user
I knew early on in my recovery from severe mental illness that I wanted to use my experience to help others.  I was incredibly grateful for the care I received, but I knew that not everyone was so lucky - and that even good care can be improved.  I am now a service user representative for my local "strategic clinical network" for perinatal mental health.  I sit alongside GPs, psychiatrists, health visitors and midwifes and we discuss our local services and how they can be improved.  I'm also a patient representative for the Royal College of Psychiatrists "Perinatal Quality Network" which assesses and accredits every Mother and Baby Unit (and an increasing number of community perinatal services) in the country.

Peer supporter
Related to this, I set up a local peer support group targeting other mums recovering from perinatal mental illness.  Or who just needed a break from the usual competitive mummying mother and toddler groups!  I now have a dear friend who runs the group with me and who has helped ensure its future, agreeing a collaboration with an incredible Children's Centre and joining forces with the amazing charity Cocoon Family Support.  I am so thrilled and proud to be part of this, and cannot wait to see what we can achieve together.  I know first-hand what value good (trained and overseen) peer support can be.

Charity trustee
Doing the peer support work has led to me agreeing to become a trustee of the charity.  The plan is hopefully for me to become Chair of Trustees, allowing the founder to take on a more Chief Executive role (and be paid for her tireless work!).  I am excited to be a spokesperson for the charity, and to ensure that if and when we receive Grant funding or other donations that the money is spent wisely and effectively towards our aims.

Well, here you are reading the blog, so you know by now that I like to write!  I've always been an opinionated so-and-so, and now I have the perfect platform.  Blogging has led to all sorts of wonderful experiences, and I've met some amazing fellow bloggers who inspire me daily.  I love getting feedback on what I write.  Sometimes even my family members will read a particular post and comment on it, and that means a lot.  But mainly I write for myself.  And for my son, who I hope reads all this one day and understands better where his mum is coming from!

Leading from the above, I've been given some amazing opportunities to speak out about my experiences.  I've spoken on Channel 4 news, on Good Morning Britain, ITV evening news and I've just given my story to the Saturday supplement of the UK's highest-circulation newspaper.  I took part in the recent Victoria Derbyshire special programme on mental health, which was a life two-hour debate on BBC2.  I am a media volunteer for the Maternal Mental Health Alliance and Action on Postpartum Psychosis, but it is quite common now for me to be contacted by journalists over twitter.  Even more exciting, I was invited last year by the RCPsych to speak at an event in Parliament.  It was the All-Party Parliamentary Groups on mental health, and on "1001 critical days", and I spoke to a packed (and rather grand!) room on what happened to me, all the while looking out over the Thames to the hospital where it all began.  I thought how funny it all was, how far we had come.

So - that's my explanation of my "portfolio career".  I hope my old careers advisor never reads this!

Thursday 23 July 2015

You don't buy me flowers

A large part of the Victoria Derbyshire mental health debate ( ) centred on the issue of "stigma".  It's an often-used term.  We must reduce it!  But what does mental illness stigma mean in practice?

For me, the stigma of mental illness (and particularly the stigma of being admitted to a psychiatric hospital) meant that I spent the best part of three months in said hospital, with only one single visit from a friend, no get well soon cards, no grapes, no flowers.

My friends would not have been unkind or unthinking.  Far from it.  No, they were frightened and embarrassed.  Fearful of how I would react to them knowing I was so ill, and too uncomfortable to acknowledge my madness.  There is a hush around mental illness: Kathryn is finding motherhood difficult.  Kathryn needs a rest.  Kathryn is still recovering from a traumatic birth.  Kathryn is getting some help.

The contrast to a physical illness is clear.  If I had been in hospital with a broken leg or appendicitis then my friends would have been told clearly what I was suffering from, how I was being treated, and my prognosis.

I don't blame my friends at all.  I realise now that they were waiting for my permission to talk about it.  Six months to the day since my admission to hospital I posted the following public message on Facebook:
"This is a long one... Six months ago today I was committed to a psychiatric hospital. I had lost my mind to an illness I had never heard of called postpartum psychosis. The symptoms were the scariest thing I have ever experienced, and even scarier for my family to witness. What should have been the happiest time of our lives, as a new family, turned into a waking nightmare. At various points over the subsequent days and weeks I thought I was going to be burned alive, locked in a room and never let out, in constant pain. I didn't believe I had a family or even that my son had been born.  At one point I even questioned whether the universe itself existed or whether it was just me, in a locked room, alone and in pain for all eternity.

Anyway, with the dedicated care of some amazing doctors and nurses, and with an incredible family who stood by me, I beat the psychosis and reemerged my old self again. But with the best gift I could ever have, my wonderful son.  I was lucky, many others who experience PP are not. Look out for some fundraising activities from me in the future and and thanks for reading. If you are wondering what makes me share such personal info on Facebook, it is to stick two fingers up to mental health stigma and discrimination. It can happen to us all. "

My iPhone came alive as soon as I posted that, pinging with messages of support from family and friends.  They thought I was brave, strong, inspirational even.  Many hadn't known why exactly I had been AWOL after The Boy's birth, so they learnt something new about postpartum psychosis.  I was so touched by everyone's support, but at the same time a little sad that that support had to wait until I had spoken up.  Because many psychiatric patients never speak up, and live out their illnesses alone and in shame.

There is very little you can do or say to make matters worse for a severely mentally ill friend or family member.  But there are a hell of a lot of things you can do and say to make things better.  Start with "Hello".  "When can I visit?" "Do you need some clean socks?" "Shall I bring you an M&S sandwich?"  You get the idea!

I've had some feedback on the above.  There are a few things I should mention here, which I did not realise at the time (being psychotic):
- for the first month or more of my admission, the senior doctors advised against any visitors other than The Husband and occasional visits from close family (my parents).  Other visits were thought to trigger more stress and anxiety.
- a really close pair of friends did attempt to visit earlier on in my stay, but were put off (I didn't realise this at the time).  They did successfully visit later on, when I'd already had some home leave.
- the physical lay out and facilities of the ward were not conducive to successful visits.  My room was too small for visitors, and the communal areas were often noisy and, as you'd expect, full of other patients with their own needs and issues.

One friend (a former mental health nurse herself) made the great point that hospitals (and families) should consider diarising events for patients who are too ill to receive visitors or have much knowledge of what is going on at the time.  This could include photos, notes from friends, and so on.  I think this is a brilliant idea!

Monday 20 July 2015

Mental health in the media

It was with great excitement (tainted only somewhat by the tiredness of a 6am start) that I entered the iconic W1A headquarters of the BBC.  Around 80 mental health survivors, carers and professionals were gathering for a two hour live debate hosted by the Victoria Derbyshire show.

On the guest panel were former government minister Dr Liam Fox MP, comedienne and campaigner Ruby Wax, Dr Adrian James from RCPsych, Dr Liz England from RCGP and Clare Murdoch, head of a large NHS mental health trust.  But this wasn't a Question Time style panel show.  No, here the studio audience had the floor, and the debate took the form of a real discussion: soaring, emotional, raw, shocking at times.  The show was roughly divided into four segments: service user stories, the impact of cuts to mental health care, sectioning and detention, and finally more hopeful stories of recovery.  

There was an impressive range of voices heard: from a beautiful young anorexia survivor who had been turned away from hospital weighing just 4 stone as she wasn't yet ill enough, to a middle aged couple who had battled through the husband's severe clinical depression.  We heard from PTSD sufferers, those with bipolar disorder, borderline personality disorder, severe anxiety - and everything in between. We heard how many acutely unwell people had had to wait months or even years for treatment.  How families and friends had had to step in and provide life saving care.  How people had been discrimated at work or felt stigmatised by their communities.  It was an incredible, wide-ranging, discussion and we could have continued for hours.  Victoria handled the whole thing with ease and sensitivity.

I was initially contacted by the show's producer via twitter.  But I was soon in touch with my friends and colleagues at Action on Postpartum Psychosis: we were all keen that maternal mental health was included in the debate, and my brief was to get in a mention for APP on air.  APP are currently short listed for an important National Lottery award, so every bit of publicity counts!

I was pleased to be picked in advance to tell my story on air, early on in the debate.  I was after another lady, Sarah, who had just given her distressing account of postnatal illness.  Clearly Sarah had struggled to access the right treatment and support, and is still deeply traumatised by her illness and the fact she could not look after her children for a time.  Victoria introduced me at that point, to give an example of what can happen with the right treatment and support.  I always say (despite the trauma of the illness itself) that my story is a fortunate one, full of hope and encouragement.  I visited the very depths of psychotic hell - and survived.  Recovered.  With my baby and my family and my life fully intact.

I am so eager to tell my story because I believe people need to hear it.  Women need to know what can happen following childbirth, but also that it is not the end of the world if you seek help and access the right treatment.  The horrendous stories, like Sarah's, are the result of too few families knowing that this help is out there and that you can recover well from illnesses such as postpartum psychosis.  My job, and the job of charities such as APP, is raise awareness of the illness, while at the same time continuing to lobby government for the resources needed to provide the life-saving treatment necessary for it.

Sadly our efforts were somewhat undermined shortly after the show aired, when the main BBC News item on the debate was headlined "I wanted to kill my children".  Clickbait headlines such as this are the reason I am so wary of tabloid interviews - but I expected better from the BBC, particularly after such a productive morning.  APP were also furious, and several formal complaints have been made.  I really hope the BBC listens to us and understands why this sort of reporting is so damaging.

You can watch the whole 20 July 2015 Victoria Derbyshire show here:

Coincidentally, The Boy and I also featured again on Channel 4 evening news.  Some archive interview footage is included in Victoria MacDonald's report on unsafe discharge from hospital (around 4.40 minutes in):

Here are a few photos from the day:

Monday 6 July 2015

An Ode to London

(Apologies for the dubious rhyming)

Busy, busy, in a hurry
Pounding the pavement,
Checking for messages
Sipping our coffee.

The tube train shudders
We're herded off
Annoyed, late for work,
Electrical fault.

Across London Bridge
Into the City
To our meetings and emails:
Work's nitty gritty.

But something is wrong
Today no one's hustling:
People are pale 
And nervously talking 

Of bombs and terrorists
One, two - maybe more
Screens fill with carnage 
Twisted metal, pain and gore.

The news brings us stories
Of heroes and villains
Those who have saved
And those who have slain us

And through it all
London's united 
In grief, shock and awe
But together determined

"Don't let them win"
The opinion pieces pleaded
So we reclaimed our streets
Our tube, and our buses.

Because London is nothing
If we don't keep it moving
Working, meeting, dancing, dining,
Keeping our lifeblood going.

So remember the dead,
Fight ignorance and hatred
With love, laughter, tolerance:
London's calling, London's sacred.