So, what happens when you pen a lengthy and (hopefully) well thought out letter to the big boss man of the local NHS trust? When you try to articulate through your anger and explain how and why you feel that the wrong choices have been made and the wrong (ie: zero) care provided.

On the final day of the twenty five that, legally, a response has to be received a white envelope did indeed drop through my letterbox. Four sides of A4 that would make interesting reading to no one but me as they detailed every single doctors appointment that I attended from January 2011 to the present day. Words and dates and facts and excuses.

Why was a detailed care plan not set up before I had even given birth? Quite simply because it falls to the health visitor assigned to me to make said plans and unfortunately we had to cancel that appointment as I was in labour on the morning that she was due to visit. Although not something that’s particularly ideal (to say the least) to discuss between contractions or while crowning, it is being implied that the fault lies with me for not being available at that time.

Perhaps I should have crossed my legs.

Perhaps they should have written up a plan with me at the next earliest available opportunity?

Until the final paragraphs the letter continues in the same vain; documenting every single contact with GPs and services and insisting that I reported to be ‘feeling better’ and omitting at least another three pages worth of information about side effects and tears and begging and pleading and…

Finally, inches before the end of the last page the questions that I asked about my care are answered. No they say, my condition was not worsened or prolonged, yes they followed the guidelines set out by NICE. All this written not very clearly or transparently, making the hypercritical sentences that follow even harder to decipher. No, they haven’t caused me any harm or inconvenience by the treatment that I was given, but yes they are sorry for any harm or inconvenience that has been caused. No, I do not have a valid complaint, but yes my complaint has been partially upheld as it has highlighted the need for further training.

Eh?

Without going into the NICE guidelines, which I now know very well after pouring over them to check I wasn’t completely wrong, I can tell you that without a doubt they were not followed (antidepressants as second line of care following CBT/IPT or alongside, referral within one month and therapy/support no longer than three months following, communication to rule out the need for repeated assessments, support and understanding of the stigmas and emotional impact, support for family…).

I spoke to my community mental health worker (yes, I finally have one of those after refering myself) after I had received the letter and she immediately said that she would write a letter stating that the delay in my treatment and the lack of specialist advice I was given regarding my medication did indeed cause my condition to worsen and become more prolonged. She then went on to tell me that I will need to remain on my current dose of medication for at least one year before deciding whether or not I am ready to start the weaning process to come off it.

This means that at the earliest I will not be free of medication until the end of 2013. That’s nearly three years since I had Beans.

PND is a treatable and curable illness. It can be wiped out in a matter of months if it is caught early enough and treated correctly and with the right support. I saw the doctor to ask for help in February 2011 (according to that letter he ‘wasn’t worried, all feelings are normal but patient to report back in one week if still feeling the same’ and the notes from the appointment I made the following week ‘patient suffering from severe postnatal depression. Immediate treatment advised’. What had changed in a week?) I put myself in the right place to be given the right help to have not need to go through all of this.

I feel so much better than I did, I am coping with more, having less bad days and finally finding more self confidence with Beans. But I’m still not free. I wont be free until Beans is nearly three.

PND hasn’t just affected me, it has hugely impacted the husband, Beans, our families…Our lives are still not our own. The choice over when we can try for another baby doesn’t even belong to us any more, it’s down to how soon I can come off my medication.

It is no ones fault that I became ill, I don’t think that anyone deserves to be struck off or fired from their jobs. But. But it is clear that I have suffered in ways and for an amount of time that simply wasn’t necessary. It is clear that training is needed for all staff dealing with mental illness. PND is the number one reason of death for postnatal women in the UK. I have a daughter, she might need that care one day.

And for all of that I want a proper apology.