Mental Health, Q&A
Q&A: Mandy Raywood
Posted on 16th September 2019
It seems like forever since we posted on the News page – that’s what the school summer holidays will do for you! Anyway, the children are now back in school and we can all get back to ‘normal’, with routines, and structures, and just feeling a bit more organised. That also means that, in addition to writing a few more blog posts to keep you updated on DadPad developments over the summer, we can get our social media more regularly updated. For starters today, though, here’s the latest in our Q&A interviews, with the wonderful Mandy Raywood, who we spoke to back at the start of the summer. Mandy is the Specialist Perinatal Team Leader with the Perinatal Mental Health Team here in Cornwall and has been one of our biggest champions, supporters and PMH ‘advisors’ since the very beginning of DadPad…
Hi Mandy. Could you start by giving us a quick overview of your current role? What does your work involve?
I manage Cornwall’s Specialist Perinatal Mental Health Team. We are a multi-disciplinary team comprising a perinatal consultant psychiatrist, psychologist, mental health nurses, an occupational therapist, a social worker, specialist perinatal nursery nurses and admin staff. We work with women who have or develop severe mental illness in the perinatal period (which is up to the baby’s first birthday). We offer interventions to treat the mental illness; we are always mindful of how this may impact on mum’s relationship with her baby, and can also offer interventions to help enhance this, too. Wherever possible and when appropriate, we include fathers, partners and extended family in the care package we deliver.
So, how did you end up in this job? What’s your background?
I have always had an interest in parental mental health, its impact on parenting and outcomes for children. Very early in my career I realised that most of the adults in mental health services I was working with were people who had experienced adverse childhood experiences (ACEs) and poor parenting, and it made complete sense to me to support families around the time of having a baby, to enable the baby to get the best start in life.
I trained as a mental health nurse in St Lawrence’s Hospital Bodmin in 1986, where I worked as a staff nurse on a general adult psychiatric unit for four years. I then worked in the community in the Falmouth area for about nine years, during which time I was involved in The Beacon Project. This was a multi-agency initiative, targeting families who lived on the Beacon and Old Hill estates in Falmouth, with the aim of improving outcomes for families and children. I applied for a mental health nurse post in the Falmouth Sure Start ‘Pebbles’ project in 2002. During the four-and-a-half years I worked there I worked with families with children under five, trained in parent education and attachment, delivered services aimed at improving mental wellbeing in the family (such as cognitive behavioural therapy (CBT)), and also delivered parenting groups and workshops for mums and dads who were struggling with aspects of parenting.
After Sure Start had finished, I knew that the development of the perinatal service was on the horizon. I wanted to keep using the skills I had developed, so got a job working in the Child and Adolescent Mental Health Service (CAMHS) which involved working closely with schools in the Falmouth/Helston/Mullion area, helping them to identify children who were experiencing mental health difficulties, training teachers and delivering interventions in schools to help improve the children’s emotional wellbeing.
I have been in my current role for just over six years and have developed the service from being a very small team of 2.5 clinicians to a much larger multi-disciplinary team that is able to offer a range of therapeutic interventions. We’ve been very fortunate to receive additional funding from NHS England to expand, and have got some wonderful staff in the process.
We are delighted that you’ve been a supporter of – and valued contributor to – the DadPad since Day 1. Why do you think the DadPad is such a valuable resource?
DadPad is a fantastic resource. In my experience, many dads research to find out the information they need, and the DadPad makes this process so much easier as everything is accessible in one place. Dads are often working and/or not able to attend professional appointments, so may miss out on having the opportunity to talk to professionals about any concerns they may have or to get relevant information. The DadPad app is jam-packed with advice and information, and easy to access at any time of day or night.
What tips would you give the partner of a mum who’s just given birth, in terms of helping to support, and watch out for, her mental health?
I think the most important thing is to look out for each other. Although having a baby can be a really exciting time, it can also be stressful, particularly if neither of you are getting much sleep. Mum may still be recovering from the birth, trying to cope with breastfeeding and will be extremely tired. Offer to look after the baby so that mum can catch up on some sleep. Offer her a drink whilst she’s breastfeeding or make her something to eat. Encourage mum to rest and not to worry about housework (as only more dust will settle tomorrow!). Although everyone will be excited to meet your baby, it might be helpful to limit the number of visitors to your home in the first couple of weeks, to allow you both to have time to get to know your baby and recover from the delivery.
What are your thoughts on the concept of post-natal depression (PND) in men, as there are lots of people out there who think that it doesn’t exist?
Post-natal depression in men definitely exists, and possibly in higher numbers than we realise. It might manifest itself differently to that in women, however: although men don’t have to contend with the physical ordeal of delivering a baby and breastfeeding, as women do, they may still feel low in mood, anxious or sometimes traumatised by the delivery. Often the dad only has a two-week period of paternity leave before returning to work and he may be the only source of finance; all this will place him under more strain if the mum is also mentally unwell. Because there isn’t much information available about post-natal depression in men, it may not be considered by professionals (or the dad himself).
We’ve all heard of PND, but post-partum psychosis is probably less well-known. Can you tell us a bit more about this condition, please?
Post-partum, or puerperal, psychosis is a very rare but serious condition that can occur suddenly within the first few weeks after the birth of a baby. It can affect 2:1,000 women with no previous history of mental illness, and there is also a high risk of reoccurrence after subsequent births. It is a treatable condition which most women make a complete recovery from with no trace left behind. If you have a mum or sister who has experienced it, then this increases the chance of developing the condition yourself.
Symptoms vary and can change very rapidly, but it often presents with key features of not sleeping, being over-active and/or significantly anxious, her mood may change from being quite happy to being tearful quite quickly, talking fast, seeming confused and finding it hard to make sense of what’s going on around her. She may also experience hallucinations, such as hearing voices or delusions – e.g. thinking her baby has been replaced with someone else’s. These symptoms can seem very scary and the mum should never be left on her own with the baby whilst unwell. The mum should be referred to perinatal mental health services immediately or, outside of office hours, you may need to call for an urgent assessment by a GP, out-of-hours mental health services (in Cornwall, you can do this via Bodmin Hospital Switchboard on 01208 251300) or present at an accident and emergency department.
Have you been to the new Mother and Baby Unit (MBU) in Devon yet? What do you think about it?
I have; it’s fabulous. There are eight bedrooms with en-suite wet rooms, a family room, laundry facilities, a large open plan kitchen/dining/living room area, a nursery area, rooms for activities and groups, and a lovely enclosed garden which is overlooked by the family room and all the bedrooms. Upstairs there are two self-contained flats which can be booked for dads and partners to stay in, whilst mum is in the Unit. One of the flats and one of the rooms on the MBU can accommodate a wheelchair user. There is some wonderful artwork on the walls which adds colour to the building and makes it look more homely, rather than hospital-like.
[Click on this link for more information on the Jasmine Lodge MBU in Devon.]
Finally, then, let’s imagine that you’ve been made Health Secretary for the day. What would you do if you could make any changes you wanted to, within your sector?
Wow – what a question! I would allocate more money to perinatal services, and other services supporting families to provide parenting support and interventions from a much earlier stage, to enable early identification of those parents in need of support, to prevent things from worsening, and to offer a range of services aimed at enhancing the start of a child’s life. I would invest in family hubs, have services available to support families, and re-start Sure Start projects, such as the one I worked at in Falmouth, which was very successful.
A big thank you to Mandy, for such an interesting and informative chat. If you’d like more information on the work of the Cornwall Perinatal Mental Health Team, we recommend that you pop to their webpage, where there is also a really useful list of links to a whole range of useful resources, information and sources of support.