Aibu for not wanting to discuss my mental health with health visitor?

[PinkCritic]

Name change as outing.

I have my Health Visitor coming as I'm struggling with getting the baby sleeping/I'm struggling with lack of sleep.

I was under the care of Perinatal mental health but discharged when baby was 4 months old.

The Health Visitor starts to say stuff about my mental health and sleep etc and I just think she's not qualified to. For example she says I should be on anti depressants, various reasons why they've not worked and I don't see how she's qualified to say anything other than say speak to your GP.

To be clear I've had long term support from Perinatal, not sure why they've discharged as I don't think my mental health is really stable but they have discharged back to GP to refer to another service.

Health visitor is a bit judgmental as she always thinks she knows best. For example I'm such a night owl and my night sleep at 2am and up at 9am is ny natural rhythm. I'm in bed at 10pm and still not sleeping etc. my natural rhythm is that time. She just thinks I need to go to bed earlier lol.

Anyway how do I handle her as I have to see her and no doubt it will be - take your fucking medication talk. You have post natal depression.

It’s your health visitors duty to ask about your mental health, particularly as you’ve had previous input from secondary care services. She wouldn’t be doing her job correctly if she didn’t. However, it’s but her role to advise on meds, that’s for a medic.

Perhaps you need to be referred back if you’re struggling to mind mental health stability, as you said. As you’ve also said you had difficulties prior to baby, perhaps it’s not PND or even depression/depression alone. Maybe the anti depressants haven’t worked because it’s not just depression and you need to explore your diagnosis again with the correct professional.

your health visitor can make them referrals for you or speak with the right service and advocate on your behalf, if you let her

She could well have actually been asked to check up on you by GP you know?
Also she can probably see your GP and Perinatal mental health notes so knows exactly what they have advised. The concern may be about non engagement with adviced treatment.
The HV Is responsible for maternal mental health and is trained to assess this because it can impact the child.
She may have other options for you if you don't have meds or a maternal mental health support group or additional help at home.
Probably worth a chat!

I think for the sake of getting the help you say you need with your baby, just put up with/ nod along/ ignore the supposedly unhelpful comments about you and say thanks, but you’re already dealing with your mental health with GP.

Your baby's health is reliant on your health, it's that simple

Your posts on here come across as confused and aggressive and you have a history of suicidal ideation and violent assault when being treated for depression, so I’d say your HV’s concern isn’t groundless .

She shouldn't be telling you to take meds nor should she be telling you the reasons they don't work is because X, Y and Z. She is not qualified to give that advice and she shouldn't be giving her opinion. But, just smile, nod then continue to follow your doctors' advice.

You’re stressing a lot over something that hasn’t happened yet. She may actually be helpful to you and you’ve had some good advice about getting her to back off by saying you are under the care of the GP. As you say, HVs can’t prescribe medication so they should not be pushing it if you tell them you are already being dealt with by a medical professional.

Above all, stay calm. It’s understandable that they are concerned about your MH if you phone up and cry down the phone. No, they won’t be experts like a psychiatrist but they might make suggestions but you don’t have to follow these if you don’t want to. However if you become overly antagonistic with them, there is a risk that they refer you to other agencies so just be calm and polite.

Checking in on your mental health is a really important role for a health visitor . So many women do not get the support they need for PND. And for some women and babies this has resulted in tragedy that could have been avoided. You said you don’t think you should have been discharged from perinatal mental health as you don’t think your mental health is stable. She may not be asking in the right way, and she’s not qualified to advise re medication but I think she’s probably doing the right thing
Go to your GP - they will be able to advise and can rerefer to perinatal mental health. Good luck with it all. There is help out there

She had to comment on your mental health though to make sure you and the baby are safe and well, it's literally her job.

I haven't read the full thread but your ignorance of the role of HV and the importance of your mental health in bonding with and raising your child is shocking and suggests to me that you need her input more than you think. There are studies that show the impact on school attainment in children up to the end of primary school from poor maternal mental health, so it's very much her job and her business. YABVU

If you're not comfortable speaking to her, don't.

Just tell her you'll take any concerns to your GP.

Not everyone gets on with their HV and not every HV is good at their job.

Because she won't have already thought of any of these basic ideas I'm sure...

Not my experience of Health Visitors. Over confident and under informed.

OP, what team have you been referred to? I say this because usually, the Perinatal Mental Health Team works in conjunction with other services, ie CMHT and the Early Intervention in Psychosis Team.

You’ve misunderstood the role of a health visitor. Their role is to support families not just the child under 5.

the advice from someone who’s never actually experienced sleep issues.

Just ask to change health visitor.

I'm with you OP. I don't say a word to them. I am terrified they basically have social services on speed dial.

When they ask me about my mood, I say I am under the care of perinatal and discuss everything with them (which I do). I don't discuss with the HV though.

I have lifelong depression, and this is what I thought before having kids. For me, postpartum depression was its own special brand of hell.

You keep saying 'no education' or 'zero knowledge and training', but that just isn't true. You're very angry.

For all you know she could be a mental health nurse and therapist. She could even be a prescriber. She may have worked in a perinatal mental health team. She could have retrained after becoming a clinical social worker. She may be studying counselling on the side. She could be a PhD student for maternal mental health.

Either way she would have as a degree of mental health training- and she my have significantly more- you wouldn't know unless you asked her.

It doesn't really matter- you are not obliged to even see your health visitor. It is not a legal requirement.

Your defensiveness may be triggering a red flag for her- she could be completely wrong and you have every right to tell her that.

My health visitor the other day was a trained mental health nurse and she was lovely.
I have had an awful one in the past though. Just say you are being supported by your gp and change the conversation

How about saying “fabulous idea, please write me a prescription that I will get filled right away”. Of course, she won’t be able to because she is not qualified to prescribe or instruct you as she previously did. You may or may not wish to drive this point home with a snarky comment. Up to you. She sounds like a right PITA.

You don't have to see the HV. You can decline their service if they are overstepping, which in this case, it sounds like she very much is. Some HCP have a tendency to think that their role is general advice about everything and forget their remit. HVs may be qualified to give some advice re mental health and to spot signs of PND, but their role if they notice this would be to signpost to GP and psychiatric support. They are not qualified to tell you how to parent, or how to run your life.

Not all health visitors are judgemental. They are also trained in perinatal mental health and part of their role is to check on your mental health, provide emotional support, advice and refer to other services. If I were you I would request another health visitor, I've had really good experiences with mine and I was also under perinatal MH team.