Caithness campaigners welcome UN report on maternity services
The Geneva-based UN committee has been examining a number of issues related to human rights across the United Kingdom.In a section on sexual and reproductive health rights, the committee said women and girls in "peripheral and remote areas" were adversely affected by maternal mortality and disparities in access to sexual and reproductive services and information.It recommended that the governments of the UK "increase efforts to ensure equal access to maternal health services" for migrant women and women from ethnic minority groups. It also recommended that facilities be properly equipped for antenatal, perinatal and postnatal care, "particularly in rural areas". The report went on to say that the availability of sexual and reproductive services should be strengthened, particularly for women and girls in rural and remote areas.
'Extra support'
Chat has been campaigning for consultant-led maternity support to return to Wick.The service was replaced by a midwife-led unit in 2016 because of safety concerns. People in the north Highlands can face round trips of 210 miles (338km) or more to give birth in Inverness.Chat campaigner Iain Gregory said the UN report provided "a huge amount of extra support" and he hoped the intervention would bring changes to the current arrangement.He said the UN committee considered written submissions by Chat in the process of writing the report.A spokesperson for NHS Highland said it provided as many gynaecology and maternity procedures as it could in Caithness General Hospital.The health board added that it had increased the midwifery team in Wick, with high risk or complex cases continuing to be referred to Inverness.The Scottish government said it was considering the recommendations of the report carefully.
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The 15 signs a loved one is struggling with their mental health - and how to help 'It was clear to close family that beneath the smiling and friendly face that Roisin presented to the world there were very difficult struggles going on. 'There was still a deep and enduring depression and so many anxieties.' 'Roisin felt her brain was in some way irreparably damaged' The court heard Ms Harron had suffered bouts of depression from her teenage years which may have left her susceptible to postpartum psychosis. After the birth in October 2017 she suffered a week of "hypermania" - a severe form of mania - and was admitted to the mother and baby unit at Bethlem Royal Hospital in Bromley, which specialises in the treatment of antenatal and postnatal illnesses, remaining there until March 2018. As part of her treatment she was given the ECT sessions, with her family saying Ms Harron felt 'her brain was irreversibly damaged', leaving her unable to remember things. 'Roisin prior to her illness had an incredibly good memory. During her hospitalisation her memory became quite impaired,' the statement went on. 'This was partly down to the effect of her medication but also part of her treatment in Bethlem Hospital was an on-going course of 12 ECT sessions. 'Margaret and Henry were both shocked at the obvious damage to her memory and cognitive abilities at the time. 'The recovery from this appeared to be very slow and although her memory did improve greatly Roisin felt her brain was in some way irreparably damaged. 'She talked about having brain fog and became very upset at forgetting things.' Changes to medication When Roisin was given the diagnosis of bipolar disorder - a mental health condition characterised by episodes of extreme highs and lows, which can last for weeks - her parents contested this as there were no further manic or psychotic episodes following the one straight after the birth. She was given many drugs to try and stabilise her mood, but the trial and error nature of trying to medicate someone in her position left her feeling terribly anxious, the court heard. 'Over the next few years there appeared to be a lot of uncertainty from mental health services over Roisin's treatment,' her family said. 'Different medications were tried and doses often changed. Roisin was highly sensitive to even minor changes. 'Each time Roisin experienced anxiety planning the changeover and sometimes severe withdrawal symptoms. 'Robin believes that continual worry about medication and changes had a significant detrimental impact on Roisin's mental health.' 'Roisin put a brave face on' After a year of mood stability, Ms Harron was discharged from experts at the South London and Maudsley NHS Foundation Trust (SLAM) back into the care of her GP at the Paxton Green Group Practice in Gipsy Hill, south London. But her family said this often meant her having to traipse from pharmacy to pharmacy to get her drug prescriptions if they were unavailable, something which added greatly to her upset. 'Roisin put a brave face on (her discharge) but she clearly missed having some regular contacts that she had built up a good relationship with,' her family said. 'She had people to confide thoughts and feelings to that she was not able to do with her family and friends. She clearly felt she still needed mental health support. 'Instead of picking up her prescriptions from Lambeth Hospital she had to use local pharmacies. 'A new anxiety for her was not being able to access her medication. There were difficulties in the distribution and availability of many drugs. 'Roisin would have to track around various pharmacies hoping to find her prescribed medication. 'The negative impact of these changes in routines around her medication was significant.' Sarah Bourne, an occupational therapist at South London and Maudsley, said Ms Harron was referred to the OPTIMA mood disorders service, an outpatient programme for adults with bipolar disorder who have recently had hospital admissions, in August 2019. She 'engaged proactively' with sessions and was on five drugs as well as folic acid and B12, Ms Bourne said. 'She had a history of depression from 15 years and an episode at 21 at university when she took an overdose,' she added. 'She demonstrated resilience, courage and determination,' Ms Bourne said of her treatment, adding that Ms Harron didn't always recognise her own strengths. 'She had great family support and continued to work four days a week. I was very shocked to hear of her death,' she said. What is postpartum psychosis? Postpartum psychosis is a serious mental health illness that can affect someone after having a baby. It affects around one in 1,000 mothers after giving birth. Many people who give birth will experience mild mood changes after having a baby, known as the 'baby blues', which usually only lasts a few days. But postpartum psychosis is different and should be treated as a medical emergency. Symptoms usually start suddenly within the first two weeks after giving birth and include: hallucinations - hearing, seeing, smelling or feeling things that are not there delusions - suspicions, fears, thoughts or beliefs that are unlikely to be true mania - feeling very 'high' or overactive, for example, talking and thinking too much or too quickly, restlessness or losing normal inhibitions a low mood - showing signs of depression, being withdrawn or tearful, lacking energy, having loss of appetite, anxiety, agitation or trouble sleeping sometimes a mixture of both a manic mood and a low mood - or rapidly changing moods feeling very confused If you think you, or someone you know, may have developed postpartum psychosis, see a GP immediately. You can all 111 if you cannot speak to a GP or don't know what to do next. Go to A&E or call 999 if you think you, or someone you know, may be in danger of imminent harm. Source: NHS Dr Aneesa Peer, consultant psychiatrist based at SLAM, said Ms Harron was discharged in April 2023 with her Bipolar Disorder in remission. 'When patients are dealing well and are stable for a year at least and they are on a good treatment regime they are considered for discharge,' she said. She added there was a one-year rule for discharged mental health patients that means they can be seen by an expert within four weeks rather than being added to a potentially longer waiting list. 'She herself didn't refer back after her discharge,' Dr Peer added. 'She was in communication with her GP, there was dialogue with her GP around her treatment and her treatment options.' Ms Harron's father Henry, a retired social worker, told the inquest he found the attitude towards his daughter's medication too 'blase.' 'It was one of the most anxiety-promoting things for Roisin,' he said to the court. 'Every time there was a medication change for Roisin since her son was born it caused a lot of anxiety and these were the trigger points. 'In the past she would have had support with these changes in medication and she didn't have that support.' Dr Peer replied, saying: 'Roisin was very astute around her medication. She would advocate for herself very clearly and concisely. 'This is not someone who is waiting on support, but I do appreciate that support is helpful when people have it and I do hear what you are saying. 'Patients come back to us all the time. The door is open. 'I'm not sure how we could have intervened.' Ms Harron's stepmother Siobhan Hier queried the number of deaths due to postpartum psychosis more than 12 months after birth and said she felt her stepdaughter's death was directly attributable to the condition, even though it occurred years later. 'The trigger was the birth,' she stressed. Ms Harron's GP, Dr Saif-Ur-Rehman Najeeb, said Ms Harron had not requested a referral back to mental health services, but said she had good insight into her condition. 'She didn't have any risk indicators,' he said. Cardiac arrest and overdose Ms Harron was reported missing and was found fully clothed in a bed at the London Crystal Palace Travelodge on June 17, 2024. She had taken a huge overdose of at least nine prescription drugs alongside ibuprofen. Dr Mihir Khan conducted a post mortem and found Ms Harron to have died of cardiac arrest and an overdose. The Royal College of Psychiatrists estimates that between 600 and 1,200 mothers experience psychosis each year in England and Wales. It is a medical emergency that causes high mood, depression, confusion, hallucinations and delusions and usually occurs within two weeks of birth. If left untreated, it can increase the risk of suicide and in rare cases put the baby's life at risk too. Suicide continues to be the leading cause of direct maternal death between six weeks and 12 months after birth, accounting for 39 per cent of deaths in this period. Assistant coroner Victoria Webb recorded a verdict of suicide and noted her having suffered postpartum psychosis.
