Finding passion and purpose in Northern Ireland
03 October, 2019
Dr Julie Anderson talks us through the best bits of her job, working with women who develop mental illness during or after pregnancy.
So, here’s the thing – I love my job. I just love being a psychiatrist. I truly believe I have one of the most interesting, varied and rewarding jobs imaginable.
I’m a general adult psychiatrist working with a community team in Northern Ireland. I have a special interest in perinatal mental health, ensuring those affected by mental health issues in pregnancy are given the best care, so that they can recover and get on with being a parent.
A very varied role
There’s no typical day or week in this job. There have been occasions where my day has started at 4:00am, coffee and wheelie-bag in hand bound Belfast City Airport for a vital meeting about perinatal services across the UK. Whilst politics and influencing were not at the forefront of my mind when I became a doctor, I am hugely passionate that perinatal services are evenly spread and I have been proud of our work in NI to advocate for this.
Evidence shows us that the perinatal period, while often wonderful and fulfilling, is actually the period in a woman’s life when she is most at risk of developing a new mental illness – or experiencing a relapse of a pre-existing mental illness. Evidence is also very clear that a mother with good mental health throughout the perinatal period will lead to better short and long-term health outcomes for her and her baby. As a general adult psychiatrist, I have witnessed the negative impact mental illness can have for a mother and her baby, as well as for the rest of her family.
I work closely with our services users to help us shape our work. In a Belfast coffee shop, I meet up with Lindsay, a mother with a history of perinatal mental illness who has been working closely with RCPsych NI in our lobbying and training efforts.
She struggled with significant anxiety and depression both antenatal and postnatally. This was not diagnosed until her son was two years old. She has campaigned for greater understanding of issues at this time in a woman’s life. She has also been an integral part of the training that the RCPsych NI have been delivering to healthcare staff in order to skill up the workforce.
As a consultant psychiatrist, I work alongside a fantastic community mental health team. My role is to take a clinical lead in the assessment and management of patients experiencing mental illness and to ensure that the best possible care is provided to patients. This requires teamwork.
Seeing patients must be the most rewarding part of my job. It's why, essentially, I became a doctor, and then a psychiatrist. Many mothers come to us frightened and vulnerable – it's a joy to see them improve their understanding of their mental illness, and to see the illness itself improve, so they are able to get on with life as a parent.
Providing clarity and reassurance
Recently, I came into contact with a lady with no history of mental health difficulties, who became acutely unwell a few days after giving birth. She was developing a postpartum psychosis, but this was not immediately clear to the maternity staff that were caring for her.
She was transferred several times between the acute psychiatric unit and the medical ward in the days after her daughter was born. This was a frightening experience for her and her family, not helped by the fact that the staff looking after her were unclear what her diagnosis was.
During this time, she was separated from her new born baby. She improved quite quickly with antipsychotic medication and was discharged to the home treatment team. This meant she was reunited with her daughter, but she had some psychosis, and so there could have been risks to her daughter because of her mental state.
Despite a period of time under the care of home treatment, she was not given a clear diagnosis. She did however continue to improve and was discharged to the community mental health team. I saw her at as an outpatient sex weeks after the birth,. and was able to take a history from her and her husband, reviewing all her notes and then giving her clarity on her diagnosis. Together, we made a care plan and at last she was able to move forward.
This is the part of the job and time spent with patients gives me great satisfaction. It is a joy to see how I, personally, and the team can make a real difference to people living with mental illness.
Currently, I have a truly awesome ST5 trainee working with me. A good proportion of my day is spent supervising him and discussing patients and broader issues relating to his training.
As the poet John Keats once said, ‘A thing of beauty is a joy forever’. Psychiatry as a profession can be wonderful and it gives me great joy. There are of course challenges, as there are in all jobs. But making a real difference to people’s lives is so rewarding and that is why I choose to be a psychiatrist.
Every day is different, every case is different and psychiatry gives you such an enriching experience. I love each and every aspect of my job and genuinely feel it is a privilege and pleasure to work with patients and colleagues.
Well, how else could I end, but to say, choose psychiatry!