What can your health visitor do to support you?

[ClareD1984]

I'm currently training to be a Health Visitor and have been looking into the role of a family's health visitor in supporting women with post-natal depression. Would love some feedback from ladies who've found their health visitor supportive (or not) and try to improve or reinforce the way in which we deal with this sensitive subject? Any comments will be welcomed and treated with respect and confidentiality, their is no need to mention names of the health visitors you have come into contact with, I'd just like some ideas to take back to the team to help us to deliver the care that women and families need.

One health visitor I had was lovely not judgemental at all and pointed out my son wouldn't be taken off me and it is an illness nit a weakness sound simple but meant the world to me at the time when I was in a state.

Hi. My health visitor tried hard but what i would have liked was longer term support. My DS was born at 11 weeks. So the first 8 weeks he was in hopsital, and I kept getting silly letters telling me to go to the HV and new parents group --- doh he's in hopsital, i don't think so.

Then when he did come home because everything was by date of birth I missed that normal parenting stuff.

The HV then stpped in and was good ish for a bit but DS was under the hospital. And the hospital were very good for him. The downside was I kind of got lost, family support got lost and as everything was sorted for DS no-one thought of me depsite the fact I was permanently on the edge of depression and PTSD and I know they were looking out for it. I would also like the HV team to have a greater understanding of PTSD rather than PND post partem for women like me.

DS has been back in hospital since (he has longer term health issues) and every time he goes into A+E HV gets informed. No-one ever follows up with me though. Given the stresses of DS it would be good is the onus for getting support wasn't always on my shoulders.

It would just be nice to know the system works for all kinds of MH issues arising post birth not just classic PND.

sorry 11 weeks early not 11 weeks

I have had a plethora of different Health Visitors, some good and some totally pointless. The latest ones basically are useless simply by the fact that I don't see them!
However I had a wonderful Health Visitor (DH didn't like it as he was a man and Dh felt it was strange..typical man!) He visitied just to check on how we were. Never made it feel like he was checking up on us just checking in if you see the difference. When I mentioned a concern it was addressed and dealt with as soon as possible. He was very non judgemental and the PND that I sufferend he was unhappy that the Dr didn't diagnose it before I managed to get over it myself. I had no support from the Dr even though he referred me several times but having him onside made me realise that the problem wasn't me it was the PND. He helped find me breast feeding/baby groups that would help with my baby and his 12 month old sister.

My HV with my first was great in the beginning, she noted areas of concern on the PND form and got me some help with Homestart. However she never called or visited again. The Homestart volunteer was awful and spent her whole time trying to get me to get DD christened but I had no idea how to stop her from coming, change her or get additional help (part of this was due to my PND).

Second time around she turned up with the numbers of breast feeding support groups and other helpful numbers when DS was a month old (by which point I had struggled and given up). Never saw her again (and I'm pretty sure I had PND again).

My health visitor is really nice. She's visited me every couple of weeks to see how I'm doing. She encouraged me to go back to see a more sympathetic doctor, who has BF herself and understands if you don't want to give it up! I'm now on some different medication which seems to be working a bit better than the sertraline I was given the first time, without any warning of the unbearable side effects I experienced.

She's a good listener and doesn't judge me. She made me understand that I'm not alone and that I will get better.

What I'd find useful is some way of meeting other people with PND/PNA. I feel quite isolated and this would help me feel that it's not just me. It does seem like it a lot of the time when I go to baby groups and everyone seems really happy and full of energy - or when I meet up with friends and feel that they are being better mums than I am. I'm not sure this in in a health visitor's remit though.

what a great response, thank you! It's really good to hear that, on the whole you have had a positive relationship with your health visitors.
I'm going to reply to you all individually, when I get a bit of time to do it properly. All of your feedback is really valuable, it helps to strengthen our service and allows us all to reflect on how we can make difficult times that little bit easier for mums!

One of the things that would have helped was having the same HV each time. I teetered then fell into PND or could have just been depression, which was triggered by two vary easy to unpick/discuss factors and lack of any outside support. The HV who turned up when I was a hair's breadth from asking for help was bright and breezy and obviously in a rush so I felt I didn't want to burden her. Later at check-up I did let it all out to HV in a clinic. I did get more visits then from a single HV but when my GP did the straight bf or Ads she accepted his point of view. I felt I was being pushed to "get on with it" and there was no support available so I hid it until everything fell apart. HVs need to know what support is available in their area, good practice and perhaps help mothers do be more assertive or support them when GPs don't/won't. What I eventually got was ok but not enough to stop things spiralling out of control. Also would have helped if they had a role in talking to both parents? Perhaps asking OHs to be around for an appointment and talk to a couple about supporting each other through the early days and what can be done?

I think this is an extremely good book. It explains what types of councelling works and what doesn't. The author believes that long term person centred councelling can deepen depression in some cases.

www.amazon.co.uk/depression-Fast-Human-Givens-Approach/dp/1899398414

A reflective listening approach can be good for short term support, but I think a seriously ill client is better off with a different councelling approach like CBT or learning relaxation techniques or anxiety management. I would like the health visiting service to work more closely with the local MIND network as Mind sometimes runs useful courses for women with depression.

I would like the health visiting service to make more use of questionaires to see if certain drugs/ interventions are helping or not. What works for one person might not work for another.

I think health professionals have to be ware of their own issues with transference and counter transference. I think the team approach to health visiting has been a massive improvement on the old system.

Again, thank you for the responses! I think a lot of what you've all said seems to run in a common thread. Things that come up, not just with you guys, but in practice and in research is the importance of trust within the client HV relationship and the feeling that the HV has the time to sit down and talk to you properly. Listening visits are something that are really important, I think even just a phone call can be beneficial. Hopefully now the numbers of HVs are being massively increased we can spend more time building relationships with mums. A big part of the HV job is empowering women and families around lots of different issues. I see the role as also being a source of knowledge and a referral point for other services, such as counseling. Unfortunately HVs aren't trained in counseling and therapy, but a lot of research has shown that more training should be given in these areas to help women suffering from PND.

I too would like to share my positive HV experience. She has been amazing! I had DD3 15 months ago. My HV recognised the symptoms of PND early on and got in touch with the Perinatal mental health team for me who i am still under the care of. She set up a PND support group in association with the local Children's Centre which helped me to realise that a lot of what I felt wasn't unusual. I still see her about once a month, (I'm still not in a good place mentally) and she's never made me feel guilty for taking up her time. I also have her mobile number and have text her on occasions when ive felt a bit wobbly. She is always willing to listen and give me a much needed hug occasionally! And she never cancels appointments unlike my CPN! She has been amazingly supportive and I have a little bit of hero worship for her!
I won't name her but it is a shame that she doesn't get the recognition she deserves!
Great to hear other positive HV stories, most people seem to moan about theirs