Men and mental illness and young children – Argyll Perinatal Network
Graham Morgan
Mental Welfare Commission
June 25 2021
Hello everyone
Thank you so much for letting me speak to you today. First of all I have to start off with a relevance warning, the story I am telling starts off thirty one years ago so much of what I talk about will not be current practice but there may be some themes that linger despite the passing of time.
Secondly my sister is Juliet Morgan who organised this and who you work with – I have never done a work thing with her so I am a bit apprehensive.
And thirdly I had better introduce myself. My name is Graham Morgan, I am an engagement and participation officer (lived experience) for the Mental Welfare Commission.
I am pretty certain that many of you will never have heard of us. In short we are a non-governmental public body that supports, upholds and promotes the rights of people with a mental illness, learning disability, autism, dementia and related conditions. We are especially concerned with times when the law comes into our treatment but also in anything concerning the care and treatment of people with these experiences.
We could be ideal sources of information when you come across people with these conditions in your everyday work. I will talk about that a little bit more at the end of this talk.
My fourth introduction is that when I said ‘lived experience’ I should have said that I have a diagnosis of paranoid schizophrenia and depression and that the subject of the mental health of fathers and their children was once and still is very close to my heart.
I was thinking of this talk as I walked around Ardmore Point earlier with Dash the dog and when I went back home, wandered into the coop to buy bread. I saw lots of cards for Father’s day and as usual, had a momentary pang because I know I will not get a Father’s day card and doubt I will ever see my son again, who is now nearly thirty years old and, as far as I know, living on another continent.
I don’t know when I first developed mental health problems but I first started getting treated for them when I was at university and was lonely, suicidal and self harming.
I deliberately failed my university finals for reasons I no longer understand and some time later found myself helping deliver a charter yacht across the Atlantic for my Dad. It was there that I met the woman who became my wife.
I had become used to sleeping through most of the day and walking around town looking at the ground. I felt unloved and unloveable and somehow, into my life walked someone who was beautiful, who desired me and wanted me in her life. I found I began to greet the day with a smile and found that the sadness of my life fell away from me. I found love and companionship and joy.
After a few years we found ourselves in Scotland where her family lived, we got married and very shortly afterwards my wife became pregnant.
We were delighted but it signalled a time of great change, despite being about 28, I was still very young and immature. I had worked for a brief time as a yacht skipper but had spent a life that was more about voluntary work, the dole and travelling. I relied a great deal on my wife for my wellbeing and was and continue to be very socially inept.
I also had, again for reasons I no longer understand, a determination to give my future child an upbringing unlike the one I felt I had had. I wanted my child to feel loved and to flourish and find joy in its life.
Life changed very, very, quickly during my wife’s pregnancy. I got my first proper job about three months before my son was born. We moved into a house of our own only a few weeks before she went into labour.
I doubted my ability to be a Dad, had only a very sketchy idea of babies and hadn’t found the ante natal classes at all helpful. I was also doing a new type of work in Scotland that had never been done before and which had a lot of my dreams and passion invested in it.
I don’t know whether we would have been your ideal couple or your heart sink couple; we loved each other very, very, much and wanted our baby to have a wonderful life. We had decided on real nappies; that my wife would express her milk so that I could participate in the feeds. We had a whole range of vaguely macrobiotic foods in mind for when he could eat properly; things like mashed up Hunza apricots and mushed up short grain brown rice.
My wife’s waters broke in the middle of the night and I took her to the hospital but nothing was happening so I was sent away and spent the next day at a major conference I had organised, dashing out every half an hour for news. I am sorry, they were different times and I hope I am a different man now.
I re-joined her at the end of the day when they decided to induce her.
All I really remember is that I was in a very bright room, that my son to be, had electrodes stuck to his head to monitor him and that the midwifes were lovely. One was very good at shouting
‘Give it laldy’
when my wife was pushing and another horrified me when she cut her with some huge scissors. My other guilty secret was that the umbilical chord was much harder to cut than I imagined it would be and that when I held my son, I walked him under the bright, bright, operating lights and was sure I had permanently damaged his eyesight with the force of the light.
I was tired and excited and as you can see a very anxious person.
The next wee while is a blur in my memory but mainly it was learning; learning how to fit a car seat, how to fit a baby in a car seat, how to put a nappy on without the pins piercing his skin, how to feed him his milk and sooth him when he cried, how to burp him and mop up his sick, how to bath him and how to sleep with him in the same bed without worrying we would suffocate him.
We had originally decided that we would both work part time so we could spend an equal amount of time looking after our baby but rapidly decided I would do my full time work while my wife would give up her job.
Parental leave was very different in those days so I was quickly back at work and back in a work place I had little understanding of. No one told me I could take time back when I worked over my hours so I just worked and worked and came home and tried to care for my wife and son.
Some of that time was wonderful; even the realisation that cobbled streets were good at getting him back to sleep at 3 in the morning and a car journey even better.
But creeping in were some new realities. I had never been so tired or had so little sleep. From being a carefree wanderer of the world I was a responsible worker and father and, from being a couple who had been wrapped up in each others world, we now had a tiny baby who my wife doted over, doted over so much that it seemed she had no time for me, which seemed a selfish and petty concern of mine at the time.
Everything went well for a few months but I found my tiredness, anxiety and uncertainty brought a dark shadow into my life.
The self harm I had engaged in a few years ago unexpectedly felt appealing again which confused and alarmed me. We were still close enough for me to tell this to my wife. She encouraged me to see the doctor who arranged for me to see a psychologist.
That felt good; we both thought it would be done, dusted, solved and soon I would be back on track with our life.
But in the weeks waiting to see the psychologist everything collapsed as though a switch had turned in my mind to a new reality.
I realised that my blood was toxic and full of evil spirits. I realised that in the bright reflections of the sea and the electric lights there were devils beaming evil into my mind and altering my thoughts.
One night, when we were relaxing after our son was asleep I did one of the most terrible things I have ever done. I realised the woods across the ground were a sacred ground which could neutralise my evil blood.
I told my wife that I would go to the woods and cut my wrists to get rid of the evil. I still don’t know how she felt. I imagine she was bewildered and very, very, frightened.
I spent some hours there but did not manage to harm myself very severely. The next day I was almost inarticulate with distress. My wife drove me to the doctors while I hid from the devils in the sun in the well between the seats. I could no longer touch my wife or my son for fear that they would be infected with my evil and at the doctors I jerked and twitched and tried to explain I needed to die and get rid of my evil.
I was soon in hospital on a section unable to touch my family who visited every day. Initially my wife welcomed the hospitals support but when she found them ignoring her knowledge of me or my beliefs, disillusion set in.
Juliet was asking me to mention the help we got from Midwives or health visitors at this time and it is hardly relevant as it was so long ago, but I don’t remember anything at all; maybe someone who came and weighed our son and took some measurements but I remember little else and the psychiatric staff? I suppose there is a fond imagination that we would talk about life, the past, the troubles in my mind. But as far as I remember there was no mention of anything like that, just the medication, the constant obs and the waiting for those small moments of freedom off the ward.
My family? I don’t remember much of that either, For whatever reason some of us can come to parenthood distant from our family. I don’t remember much at all to do with my parents; they didn’t visit when I was in hospital and I wouldn’t have wanted them to visit but they would have visited when my son was born. My sister, Juliet, who is talking to you now, I have no memory and do not even know if she was living at home or at university or if I saw her. My brother was coincidently studying to become a psychiatrist, and got married while I was still an inpatient. He got permission to take me out the hospital and was in charge of my medication. I was a token best man and sat at the best man’s table but a friend of my brother gave the best man’s speech.
As I was on 1000 mg of largactil with haloperidol top ups pretty much everything is a blur. I remember I ate and then went upstairs to lie on a bed and that my son may have been in a carry cot nearby. I remember I was incredibly touched at the kindness of everyone but my thoughts were so slow and my ability to speak so compromised and vague that there is not that much to say about the help I was given by those I care for and who care for me.
As an aside, after I left my wife, I regained the love and trust I had once had for my family. The last twelve years have been a wonderful healing and a getting to know of my parents, brother and sister, their partners and the nephews and nieces.
What I didn’t know until many years later, was that when I went into hospital my brother and his wife to be, cut short a tour of New Zealand to see if they could help and that once I left hospital, although they had just been offered good jobs in the NHS in London chose to take different jobs in Edinburgh, just in case they could help in any way. I hadn’t a clue this was the reason and didn’t see them much even though they had come up north to provide any support I might need. This has been a constant feature of my life with mental illness; throughout these years my family and my friends have been there for me, ready to help when they can; with me oblivious and often cruel in my disregard for the pain my experience caused them time and time again.
That was the beginning of two years or so of something I can no longer describe or remember properly.
I was in hospital for four months that time, spending some weeks on constant observations, I missed a lot of my son’s upbringing; spending ages and ages in a day hospital and sometimes losing myself again. One of my most painful memories was of a time when I had retreated to the rubble and darkness under the floor boards of the house because I thought it was a sacred place free from evil and how my son, by then a toddler, would walk to the trap door that lead to where I was and point at it and say;
“Daddy”
or during that time, when I came up from the floorboards and the dark, dressed up in oilskins to protect me and my family from evil; that I was determined to stub out cigarettes again on my hands and how it was only the sobs and tears of my wife that stopped me from doing it.
Remember, it was many years ago so my request for some sort of talking treatment is probably not what would happen now. I continually told my psychiatrist that I would like to see a psychologist and he continually said the talking treatments were completely ineffective for the schizophrenia he had by then diagnosed me with and that we would not refer me.
I wandered in and out of dark places for a long time, was put on depot medication and struggled to work but kept my job. I would see a psychiatrist but no one else except for the time I was at the day hospital, where cutting pictures out of glossy magazines and being encouraged to talk about them felt humiliating, especially as the OT talked exclusively and extensively about me in my presence and in public, to my wife when she visited.
It only now occurs to me how little support we got or that my wife got with our life in the community. I know she was absolutely exhausted from looking after a small baby on her own; visiting me when I was in hospital and looking after me. As far as I know it never occurred to anyone that we might need some practical or emotional help with managing. I have a dim memory that if we had been asked if we wanted help that we would have refused it, but it is only that; a dim and clouded memory.
The only response seemed to be to try to get me to take whatever anti psychotics were around at those times that I stopped taking them and went yet again, into a strange place.
My wife had a very close family at the time, but her sisters have now told me that she was very reluctant to let them know how ill I was and that it was only years later that they had found out that I had a diagnosis of schizophrenia which is, I suppose, one of the bitter legacies of stigma.
My brother, in a beautiful gesture said he would continue to pay our mortgage if I lost my job and income.
Not surprisingly relationships suffer at these times.
My wife said now I was on medication that I smelt different and that although she still loved me I had become a stranger to her.
I so wish that we had had the courage at the time to admit that what had happened had irreparably damaged us.
We moved to the Highlands to be away from the memories and politics of Edinburgh when my son was four, and although we said we loved each other our relationship really had the seeds of despair in it.
After many many years where our marriage only caused me to wince with pain at what once was so beautiful I found my love declining. My wife said she kept on loving me.
It is hard to describe the break up of a marriage or to truly know the effect it had on my son.
I say this to help you understand that even with labels that stereotype us as awful people and maybe even with some awful behaviour on our part that we can also be victims – there is very rarely any certainty about goodies and baddies in relationships gone wrong even when one of them has a mental illness. When a marriage goes wrong, having a mental illness is not necessarily the key reason for its failure and maybe should not be a conclusion we leap to in the labelling we inevitably do of people.
When I finally left my wife, my son who I had promised myself would never remotely feel the pain I felt I had had in my childhood, said he no longer wanted to see me. I have seen him twice in the last 12 years. It makes me sad trying to think of the youthful dreams and wonder that I had when he was born and even more sad to realise that my very worst fears for his and my life together became a reality.
What lessons would I share? – I have no idea really.
The basic one: Dads get ill too, feel the pressure of new babies, even get psychotic partly because they cannot sleep when caring for their family.
Dads are as full of uncertainty and worry about a new family as mothers are but rarely have anyone they can talk to about it. We try to work out how to combine the modern hands on role of father with the conventional role of work and this is often not compatible.
We can feel lonely and deserted and alone and ache for the love we once had. We are usually the ones who lose contact with our children when it all goes wrong. Maybe this bit is not about young children but the loss of my son nearly killed me and kills me a little every time I realise I let him down so profoundly that he will not speak to me or tell me where he lives and that I may never see him again.
On a positive note, I now live with Wendy and her young children. They are ten now. I first met her children when they were two; wee Charlotte says over and over that she loves me; James is more cautious. We have navigated explaining the scars on my wrists to them and their ‘cousins’. I have been treated against my will since leaving my wife but have a degree of joy now that I never thought possible. That is another story that you can ask Juliet about in your coffee breaks or if you are especially keen; read about in my memoir START.
I will finish by talking about some of the work one of our psychiatrist practitioners has been doing in connection with mental health care for mothers and babies. Hopefully that will help you know more about the work we do.
Before joining the Commission she worked as a psychiatrist in a mental health Mother and baby unit.
She has been closely involved in work that the Commission has carried out in this area.
In 2015 the Commission carried out its first national themed visit to look at perinatal mental health care in Scotland. We made a number of recommendations to the Scottish Government (and to health boards) and welcomed the establishment of a national Perinatal Mental Health Network the following year. The network has gone on since to drive national improvements in care.
One of the things The Commission found from our visit to mothers across Scotland was that they did not always receive care with their baby in a specialist MBU. We found that some women were treated on general psychiatric wards, and were often separated from their baby for long periods. This was a concern. We found wide variations in admission rates to the mother and baby units between health boards, so women in different parts of the country were not always receiving the same opportunity for specialist care.
In Scotland we are fortunate that there is a duty under Mental Health law for mothers who need admission for their mental health, to be offered admission with their baby (providing the mother is normally the main carer for baby and admission would benefit them both).
Because we found that not all women were being given this right (and because the new perinatal network shared concerns about this) the Commission began some work to monitor the situation across health boards.
We began this perinatal monitoring project 2 years ago and are now writing a report about our findings.
The important messages we would want to share from the work we have done in this area would be:
· If you have concerns about a woman’s mental health during pregnancy - or after childbirth – discuss this with her GP or a mental health professional
· Perinatal mental illnesses are treatable and women and their families should receive support, wherever they live in Scotland. There will be a perinatal lead for mental health in your health board, working with the network on improving services.
· Severe perinatal mental illness is rare, but it is important to act early and for women to receive specialist care. Women in Scotland have a right (in law) to receive care with their baby if they need hospital treatment. The Mother and Baby Units welcome referrals when there are concerns about women. You can watch a video tour of the Glasgow Unit and find out more (link below).
· NES have a great range of online (free!) teaching modules on maternal mental health for all levels of health and social care professionals. These are open access and we share the links below too.
· It is increasingly being recognized that fathers can experience mental health difficulties around the time of becoming a parent, with paternal postnatal depression becoming a focus of research in recent years. One study suggested10% of dads suffer from postnatal depression. Some studies suggest that 10% of dads suffer from postnatal depression. A study by the National Childbirth Trust (NC) in 2015 found many 1 in 3 dads (38%) are worried about their own health and 3 in 4 dads (73%) are worried about the health of their partner. Many organisations now offer information and support for dads/partners. We have some links we can also share.
Those messages; I know you already know through and through, but there is no harm in repeating them again I hope.
Any questions on this subject, do get in touch with the Commission by email or via our advice line.
I will now return to some final, hopefully not too patronising messages; remember that statistic about men and mental illness and childbirth? If we already are vulnerable and have a mental illness do look out for our wellbeing – we are at risk and may struggle.
But more importantly look out for all men at the time of the birth of their children. I come from a very heteronormative background but am acutely aware of my perception of the very limited support networks us men can end up with when we become a part of a couple.
We often have no one to confide in even if we are wanting to and often won’t confide in our partners as we are often wanting them to feel supported and looked after, rather than making them feel they also need to look after us and yes, I know it should be a mutual thing but some of us are still traditional in how we view relationships. We can be confused and alone; we might not have a clue about what we are doing or what we should be doing or what we want to be doing.
We may be delighted that we are about to have a child or have just had one, but we can also be bewildered and frightened and very alone and very uncertain and not totally sure how wonderful this really is so, just as a Mothers’ emotion needs looked out for, spare a thought for the Dads who we so readily tease for being incompetent and unaware of the basic things they need to do.
We would not dream or going to a new Mum and patronising them or making fun of their mothering ability and though it is a fond way of looking at men, maybe we shouldn’t do this to the Dads when they are also embarking on one of, if not the biggest, events of their lives and already doubt their ability and may also be full of worry and stress and anxiety.
Thank you.
By the way I went for a walk with Juliet earlier in the week and although I am happy to answer any questions you might have on me or the Commission do feel free to give me any feedback or views on mental health, babies, mothers, fathers that you might like me to feedback to the Commission.
Thanks again
Links:
· West of Scotland Mother and Baby Unit: https://www.nhsggc.org.uk/your-health/health-services/mental-health-services/other-services/west-of-scotland-mother-and-baby-unit/west-of-scotland-mother-and-baby-unit/#:~:text=West%20of%20Scotland%20Mother%20and%20Baby%20Unit%20Scotland%E2%80%99s,if%20their%20baby%20is%20under%2012%20months%20old.
· Perinatal Mental Health Network Scotland https://www.pmhn.scot.nhs.uk/
· NHS Education for Scotland:
o Maternal Mental Health online modules Maternal mental health | Turas | Learn (nhs.scot)
o Curricular Framework for Perinatal Mental Health(2019)
For women and Families:
· Maternal Mental Health Scotland: https://maternalmentalhealthscotland.org.uk
Website provides information to women affected by perinatal mental health issues, their partners, families and the general public. Their interactive map provides links to support groups across Scotland.
You can find out more about the Mental Welfare Commission for Scotland at
(Photo: grasses growing by the planter at Jeans Bothy. June 2021)
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