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.

@SwordToFlamethrower I'm sorry you had a bad experience but not all health visitors are bad and certainly not horrible at best. Like all professions there is good bad and in between. It's a really intense period for many people and they can be invaluable. It isn't helpful to suggest they are all rubbish

Statement from section A followed by a statement (or similar) from section B

A
I'm working with the GP under the advice of my psychiatrist but..

I'm confident in my treatment plan but...

my psychiatrist has advised I'm not to take the medication because of the reaction I had to it but...

B
I would like your advice on the trapped wind baby is having

I would like your advice on weaning

I would like your advice on managing babys reflux

Just examples of phrases you could use (depending what the issue is with your DC that you want the advice on)

I think the key though is to try not to ruminate on what she might say, just because she made comments you didn't like last time, if you go into it with that mindset any little thing that might be misconstrued is going to sour the contact and might end up being a barrier to the advice you've said you'd like about your baby.

Honestly OP, your responses are worrying me.They sound quite hostile and antagonistic. I don't know you (obviously) or your mental health status but I do have friends who are health visitors. They are not there to interfere or aggravate you. They are there to offer support and encouragement and what can be , for any new mother , a difficult time
Take the time to engage with them. Explain as best you can how you're feeling and why. That your GP has given you Meds and that you're taking them as prescribed.
They , in turn need to engage properly with you. A 5 minute flying visit is not long enough. If that's all they have scheduled for you then you can ask them to come back when there's more time.

Not all HV are amazing! Mine was absolutely awful, I took my kids to have vaccinations etc but stopped going to weekly weigh ins etc because she never listened and just kept spouting what she "has" to tell you. I moved to another country and my HV was brilliant so personally I would say trust your own judgement on it.

ok so that’s what you can tell her

I’ve had 3 babies. Health visitors ask about your mental health pretty much every time they visit, especially in the earlier months. She is just doing her job. Shes suggesting going to bed earlier because she knows sleep impacts your mental health, an earlier night might make you feel better, that’s good advice. You say your natural rhythm of sleep is 2am-9am, unfortunately this goes out the window when you have a baby you just sleep when you can because baby is not going to follow your rhythm. If you are still struggling with your mental health maybe contact your GP and see what service you have now been referred to and when you are likely to see them, if you tell your GP you are still struggling they may be able to rush the referral.

Many health visitors are qualified midwives and/or have other qualifications in mental health nursing or practice nursing. As pp have said, it is a post grad course.

Sounds like it's just irritating and unwelcome.

Health visitors are highly qualified so would probably be quite helpful to you.
I was a health visitor: degree, Registered General nurse, Registered mental health nurse, adult teaching cert. Enough for you?

Which one of those qualifications allows you to tell someone what medication they need to take and the reason why their medication is not working?

Granted, I'm just a nurse with a few post-grad certs in adult nursing, but none of those certs allows me to diagnose or prescribe psychiatric drugs to patients. I wasn't aware that HVs had that power.

Right so your getting a home visit from HV and haven't seen her for a few months, because your having trouble with baby sleeping and thus decreasing your sleep

When you last saw her you felt she made sweeping statements about mental health that contradicted the advice of your specialist team.

Hi Val,
Thanks for coming round, the reason for my call was Bobby isn't sleeping I've tried X,Y,Z I don't think it's teething, his appetite and output are the same etc etc can you advise anything.... now that you mention it I'm not getting much sleep as his sleep pattern is affecting me but I've never been able to nap when he does and as you know the chores never stop... how am I feeling in myself- ah thanks for checking I've been discharged from PNMH which I'm guessing you know and working with my GP on alternatives to anti depressants due to past medical responses. I'm getting there slowly and it was definitely the right decision for me not to be medicated but yeah more sleep would always help so thanks for coming round.

Sorry, what? I am not saying HVs are not highly qualified, but to suggest they have the specialist knowledge to diagnose and treat complex mental health conditions is quite frankly ridiculous.

The very fact you think you are in a position to do this shows a complete lack of understanding for the complexities of mental illness.

I'll never understand the hate that health visitors get on here. My health visitor was amazing when I had a PND and was a vital support for me and my child in my recovery. They helped me access support I wasn't aware of and really supported me on my journey to recovery. I can't understand why you wouldn't want to work with them.

I didn't find my health visitor very professional because she turned up in open toed sandals - not an issue at all and I was quite happy for her to keep them on indoors.

But she didn't keep them on indoors, she tucked her bare feet up under herself on my leather sofas and I just found it a bit grim.

How am I supposed to take professional advice from someone with such limited self-awareness/understanding of how to politely conduct themselves in someone else's home?

Either that or it was a a mad dominance display (I'll wipe my sweaty feet over your furniture because I'm in charge).

I don't think YBU, op, if you've got one that likes to belittle and dominate.

I do think it's worrying that you've been discharged and don't feel you should have been, but as you say that's between you and your GP.

Why did you start this thread? What do you want out of it?

Just have a polite phrase or two ready to shut it down. Thanks for your thoughts but I'm already under the care of my GP and feel comfortable raising any problems with her. Thank you for your concern but I would prefer to let my psychiatrist lead on this. I appreciate you asking but I am already well cared for by the psychiatry team and it isn't helpful to discuss it outside of that.

What advice were you hoping to get? You told her you don't go to sleep until 2am and she said you should go to bed earlier. Sounds like good advice to me. Can you go to bed when the baby goes to bed? Does the baby sleep in bed with you? That's the best way to get the most sleep in my opinion, rather than wondering why a baby doesn't do things that aren't natural for it, like sleeping in a cot and staying asleep all night. It's normal for them to want to be close to you, and normal not to sleep through the night. My partner was a night owl, he had some really hard times waking at 4.30 / 5am. But he got used to it. You can force your body to get used to it eventually.

@Sausagedog101 but depression itself is a spectrum illness. I don’t think anyone expects a HV to treat psychotic depression. But they should be well able to diagnose depression and then to understand/ decide when its treatment is outwith their own level of knowledge.
The issues being argued about in this thread are really too complex for it. We don’t know the whole picture
Personally I did think my HV was a waste of space, but I’ve also treated people with PND in my years as a Junior psychiatrist. I don’t think the OP should be taking advice off the internet.
I think she should go back to her GP, with whom I believe she does have a working relationship, and discuss everything there. I don’t think more advice should be offered, as I’m not sure she wants it (looking at OP’s posts)

Sorry op i haven’t had time to read the whole thread, but i have had similar care to you.

I was under perinatal (more due to fear of birth/hospital stay after first birth due to poor care). I eventually asked to be discharged also when my baby was 4 months old, as quite simply, they don’t help.

If sleep is the main problem, which it is also with me, they can’t help. We need the actual situation to change. And talking about it, having the same dull convo again ‘oh try and get some rest when you can’ is even more exhausting. So it will be no different from the HV. What you need is practical help.

I'm sorry to hear your experience with perinatal wasn't a good one. I wonder if there is a postcode lottery to it. Where I am, luckily, the service is outstanding. I'm sorry that wasn't the case for you!

They were excellent while i was pregnant and helped with the birth plan. But that is different than when the main issue is that you are being tortured with no sleep. Because realistically what can they do? Talking about being tired from no sleep isn’t helpful and is boring and tiring.

This thread is mostly useless, many people react to a random part of your messages. Maybe AIBU isn't the best section of MN for this, you can try some health/MH oriented sub forum.

If I understand it correctly, you have a bad experience with your HV and want to get ready for the next one. You want to discuss just the baby, not yourself.

It sounds to me that in the past meeting, she might have really overstepped, giving rather basic advice to someone with more complex case seeing a specialist.

Is your new referral under way? Is there any chance she could do something to speed it up?

Prepare one sentence - appreciate her concern, express that "you discussed your MH medication with specialists", and maybe something about your next referral.

Because your mental health affects your baby. You must understand why she wants to discuss this with you.

Ask to see a different HV, perfectly within your rights, they work in teams. They're all professionals, but perhaps another will have an approach that fits you better.

@PinkCritic I had a similar situation with my midwife and subsequently with my health visitor & I feel your pain. To this day I kick myself for talking quite so honestly with them because of the chain of events that then took place because they too thought they knew better than one of the leading maternal mental health psychiatrists in Scotland. The stress and upset caused by their inability to accept that they didn’t have the correct knowledge or training was significant and ruined my pregnancy and postpartum period. If I had my time again I would tell them as little as possible barring some stock phrases so they can tick their boxes and piss off. The best support I got was from my mum who came over every day and sat with the baby & helped with laundry and dishes so I could get 2 hours uninterrupted sleep every day…no pill, talking therapy, GP or bloody health visitor can provide that support. Do you have anyone around you who could help with that even a few times a week? Keep your chin up, put on your best face and tell them what she needs to hear; you’ve had an app with the GP who is under the direction of the perinatal health psychiatrist and you have been referred to another service & when you called you were just having a bad day after little sleep & you were looking for some tips for supporting baby’s sleep & try to let the useless & uninformed comments roll off you (not easy I know) & hopefully she will wind her neck in.