The world of commissioning takes you to a variety of places, and gets to speaking to a host of people about things you would never imagine. That is certainly my thought for the day. Today has been one of those days where I have travelled about a bit and done a variety of things and today is one of those days when I can definitely say I liked being at work and things were good. I started by facilitating a team to look at the way in which people interact with each other, and got them to look at their rights and their responsibilities. Their rights to be treated well, to be respected and to be well managed all came up. However these rights don’t come without responsibilities to patients, to carers and of course to each other. Hopefully I left them with something to reflect on. Then it was back to the office to pick up on some work; emails, phone calls and the like. Then off again to facilitate an action learning group; getting a group of leaders of others to examine issues about their work. Finally I went off for a meeting at a mother and baby mental health unit.

When I had my son I took the whole thing in my stride emotionally. I had been unwell before the birth with pre-eclampsia and it was something of a relief to have actually had the baby and be free to get out and about and do what I wanted. That is not to say every day was a joy, because life with a young baby is tiring, stressful and at times frustrating. However I have thankfully never  known what it is like to suffer from a post natal (or any other) mental illness. But I do know a couple of people who have become seriously unwell following the birth of their babies and know that identifying the illness, treating it and being able to provide care and support to the whole family are vital. We are lucky enough to have a mother and baby unit not so far from here and through a chance encounter we have probably opened a can of worms.

I can’t go into detail about what led me there, but by the time I left I was convinced that we need to do more overall to ensure diagnosis and treatment of post natal mental illness. The links between our maternity units and the mental health team are not what they should be (the healthcare commission identified that too), and with only 100 mother and baby beds in the whole country we do not have sufficient facilities to manage this problem. Apparently 1 in 500 births results in a significant episode of puerperal mental illness, with 1 in 10 suffering what will feel significant enough but which be considered less serious. Our health visitors and midwives are skilled in identifying problems, but without the infrastructure of services, with many women having to be separated from their children and being admitted to ordinary wards and some children even ending up in foster care because families cannot cope then more needs to be done.

As managers in the health service we often get labelled as not caring, not being able to identify the needs of the people out there. I am a novice here, I am just learning about this issue but I am pretty sure that there is some work to be done here to make this situation in our area better. But only if I can find enough people who also care enough.