NHS mental health worker.. 17 weeks preg, help/advice pls

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Hello all, I hope this is the right board!
im really struggling with my options and feeling guilty.
I’m a band 6 practitioner in a community mental health team. I only started this sept, and I’m already struggling with my own mental health/ pregnancy symptoms. I was previously off sick for 3 months before this role, I worked in a perinatal mental health role for a year, all whilst I was struggling/trying to conceive and had suspected fertility stuff investigated. I fell pregnant on my sick leave! It was a big surprise and I am over the moon, so I left perinatal and joined the CMHT as there too much similarities in the perinatal work and what I was still going through, if that makes sense.. the CMHT is worse, I can’t cope with the new founded perinatal anxiety and managing people who want to end their lives at the same time. I can’t stop crying usually.
I feel like I’m only holding on for the nhs maternity pay, I know full well I won’t go back, I can’t deal with all the crisis and risks. I need to admit that I can’t cope with it.
Manager did a preg risk ax but I still feel so alone, unsupported, guilt that I’m off again today, and I don’t want any more stress on myself and my baby. This is such a precious time. I already had to have a check up at hosp due to severe abdo pains and would hate myself if anything happened to my baby.

Not sure what my options are and what to do tbh!

thanks for reading

I'd definitely consider moving jobs - this is not just about maternity/pregnancy - overall it sounds like the cmht is not for you! You also know you need to be in a good mental state to help others the best you can, especially as that often will be offering them containment for all these big scary feelings - hard when you are feeling v scared about it too!

Given you are a B6 you are likely nursing,OT, SLT or a psychological practitioner of some kind? What about PCMHT? Which tends to have less risk. LD, physical health and older adults do still come with risk but often less mental health/risk to self based. I also wonder if your healthboard hires mental health staff for the staff wellbeing / occ health depts?

I completely understand why you couldn't work in perinatal - I am also a mental health clinician who also struggled with fertility and miscarriage and there is no way I could work in that, too much resonance!

If it helps - people give birth to healthy babies in war zones, when they've experienced serious loss etc so I would focus more on the impact of your work on you than on the fetus at present.

Do you feel you can express any of this to your manager/supervisor or another team lead clinician? Eg that I am really struggling managing the level of risk to self. Previous supervisors I have worked with would offer check ins to "share" risk and ensure we were all doing what we could/should for people at risk to themselves

Hello @IWillBeWaxingAnOwl thank you so much for your understanding reply. Much appreciated 🌸

yeah, you’re right I don’t think this has too much to do with pregnancy/maternity, apart from sticking it out for mat pay! I knew once I’d finished my last sick note up that I wasn’t 100% ready to go back into this work, i could feel myself cracking easily on my first week.. I haven’t even finished off my own therapy yet! But all I put first was money first and foremost for baby.

I am an care co/ practitioner but my background is OT, I do feel also I should’ve stayed as band 5 longer! I only qualifed in June 2021… but they seemed happy with my interview and experience so far.

I have actually applied for band 5 IAPT screening/ clinical admin type role. I enquired with them and told them outright I am pregnant and interested in applying for a therapy type role with less risk management and patient facing. Which they confirmed it was more WFH and less risk. they were lovey and said being pregnant isn’t a reason to decline someone at all.It’s fixed term which I know can be extended for mat leave in nhs?! Here’s hoping I hear back, the band 6 back to band 5 really isn’t too much of a drop after tax!

thank you, babies are so resilient in there aren’t they! They are so amazing, I just don’t want my emotions and stress to affect that bonding and love hormones. It is really more my mind.

those shared risk check ins sound great, my line management seem pretty quiet. No supervision booked in yet. I feel like they are under so much too.

you really understood me, thank you 🙏 you sound like you must a fellow mental health worker too x

@IWillBeWaxingAnOwl sorry, just seen you mentioned you are a MH clinician. Big hugs to you, this line of work is hard!!

I seriously have been thinking all the day so much about this, I think the drop back to B5 in a new less risky role is the way forward…

That sounds really tough. I'm a MH practitioner and community care coordinator is a role I would not touch! All the admin stress, all the risk and not much team support.

For now, can you ask for your caseload to be adjusted a bit? If you have any pregnancy related health issues you might need to take time off. Can you use that as an argument to have some of the riskier patients taken off your plate - because you can't commit to being there if there is a crisis?

Also, pregnancy risk assessment should be redone at each trimester, so there will be another opportunity to make changes if things aren't working. The expectation would be that you are exposed to less stress and risk as your pregnancy progresses. If there is a risk of violence from any of your patients there should be mitigation for that too - like not seeing them in person, seeing them with someone else or not doing home visits.

In the long term, don't stress about finding cmht really hard. It is really hard! As an OT, would an older adult or LD MH role suit you better? Or if you are interested in psychology, you can train as a CBT practitioner I think - that's B6 for training and B7 once qualified. You can use the time you are on leave to think about what kind of role would be a better fit for you.

Can you speak with your line manager again and explain the impact its having on you? I'm assuming you get supervisions? Alternatively you could go through your gp and ask to be signed off for a while but your line manager may be able to look at redeployment to something else more suitable for you? Its definitely difficult, I also work in a very emotionally challenging job with lots of safeguarding around mental health and I would say that the early stages were the hardest part for me. You need a good mechanism for debriefing and really robust self care practices to promote your own resilience here and there's a duty of care from your employer to help you develop that. Can you link in with oh or is there an employee counselling service you could avail of?