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To my health visitor…

1st May 2019

A guest blog, on World Maternal Mental Health Day and during UK Maternal Mental Health Awareness Week 2019, by Jane Fisher – a Registered mental health nurse who experienced perinatal mental illness after the birth of her third child and now works to raise awareness and understanding, she is available for teaching sessions/presentations.

Jane Fisher


Thank-you doesn’t quite do it justice. It seems too empty and overused. Unoriginal and clichéd. What I feel is deep gratitude that transcends the platitudes on a greetings card.

Unlike other mums’ experiences, you were my health visitor for all my children. And, for this, I thank divine intervention! Continuity is a sacred rarity, yet common sense labels it a logical idea. Why not send the health visitor you’ve already met?

You had already proved your professionalism, evidence-based knowledge and reliability. We trusted you. This made what was to come more bearable.

What was to come was a deep descent into mental illness. Symptoms too many to list. A depression that was blacker than the sky at night. Anxiety which crippled and paralysed me, incapable of moving. And a brush with psychosis. Making logical and rational thoughts, for a time, extinct. Racing, intrusive, terrifying thoughts flooding through my mind.

A mental health nurse to a mental health patient. On a cocktail of psychiatric medications. Medications I’d administered, recommended and educated patients on their benefits.

Seeing the familiar names, olanzapine, quetiapine, zopiclone, sertraline on the medication boxes was an almost comforting sight. I was, remember, a nurse on maternity leave. My life now revolved around feeding, washing, tantrums and nappy changes! Seeing medication boxes was an almost a welcome distraction! Yet my name was on the medication boxes, not my patients. These medications had been prescribed for me. I wasn’t the nurse. I was a mentally ill patient.

Over the next 12 months I would see health professionals of all disciplines, come and go. Some would come once then never be seen again. Others made their mark. Leaving hope, and assisting recovery. Others unfortunately left frustration.

Life became about waiting for sacred appointment letters to arrive. Hoping that this would be the golden ticket to the appointment/team/specialist who would guide me from illness to recovery. Enable me live again, work again, be a mum and wife. Be me again.

And more basic than that, help me leave with house without fearing for our safety. Help me battle the thoughts that I was worthless, inadequate, incompetent, inept, inferior, broken, useless, second rate, deficient, defective, hopeless, weak.

All these professionals came and went. But you remained. The universal service that didn’t make me feel different, marginalized or stigmatised. Everyone has a health visitor!

Thank you for noticing those early signs of mental ill-health. Thank you for the simple question of ‘and how are YOU?‘ You didn’t need a specialist perinatal mental health qualification to ask me this. You needed to put down your paperwork, look me in the eyes and ask ‘and how are YOU.‘ This paved the way for open and honest conversations in the months and years to come.

This letter would not be complete without a salute to Empathy. The most significant characteristic of a therapeutic relationship. Student nurses are taught its value and importance, probably wrote an assignment on it. We had to prove to mentors and lecturers that we had ‘demonstrated empathy in clinical practice.’

But, until I was the ‘patient’, I undervalued the true significance of this complex aspect of care.

When you listened, and I mean really listened, I felt heard. I felt seen, in a world that was all about my three small humans who took up every minute of the day and night. When you listened, your silence told me I was important. I mattered. The message you conveyed was ‘I see you.’ I see past the red books, the scales, the growth chart, the checklists. And I see you.

Thank you for making the time to visit. I appreciate how busy professional life is. I know the pressures you were under. Targets, financial cuts, the infamous ‘service redesign.’ I know my listening visits were not easily quantified or justified in terms of simple, measurable outcomes. I was not a straightforward tick box. But then who is?

What you offered me was more profound and complex than what could be summarised on a monitoring form. Because what you offered me was hope. You offered me a safe space to share my mental pain and distress. You contained my distress and allowed me to feel heard and valued.

I know there were times when you were unsure about which direction we should go and I thank you for staying alongside me and working this out WITH me. You didn’t know if you were adding value or improving my situation. I know there were times when you were torn between me and other families in need, between your paperwork and even your own family. But I want to thank you for being there.

Thank you for not being afraid of language. For not shying away from asking about thoughts of ending my life. For not thinking you needed to leave this to the ‘mental health professionals.’ By mentioning suicide, you weren’t going to cause me to consider it. You weren’t going to give me any ideas.

There were so many seemingly ‘small’ things you did. Weighing my baby at home so I didn’t have to face a baby clinic, where my anxiety levels would have escalated to me struggling to breathe. Prescribing creams for son’s eczema, saving me from the crowded GP waiting room. Here, I would perceive all eyes to be on me, judging and condemning me as a mother and as a human being.

Thank you for making me an appointment with a GP sympathetic to perinatal mental health. Thank you for giving her the ‘heads up’ that I was coming in to discuss my mental health.

Thank you for asking me if I want another visit. I always said yes, because I always felt better after you had been. Asking me also empowered me that I was in control of my care.

And you came with me to get my baby’s tongue-tie cut. Meeting me at the clinic, attempting small talk to distract me from my fears. Facing this alone would have been insurmountable. And yes, I know you were making small talk to distract me! I didn’t really want to talk about the weather, and I’m pretty sure I gave you blunt answers. But you were present with me. And that made the experience tolerable.

Words cannot describe the deep sense of relief and gratitude when you answered your phone at 9.15am on Friday 26th September 2015. I finally knew I had come to the end of my ability to keep myself safe. And I needed you to get me more help.

Then you fought for me. When I had no strength to fight for my own care. You fought for every mental health referral and every appointment. You spoke up for me, for my needs. You were the voice for our family. Alone in this struggle, we would have no voice. We did not know what to say. But you did.

And that brings us to hope. Thank you for believing that things would change. When I could see no way out, no future, no hope this would ever end, you saw hope.

I gave up on myself daily, if not hourly. But you never gave up on me. And that is the most powerful, permanent gift you gave to us. Hope. And it is for that, we say thank you, and we remember you.

quote by Maya Angelou:
“People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

Jane Fisher


Read Jane’s blog at

A big thank you to Jane for helping support the Institute’s work in mental health – she appeared in our recent Channel 4 film and attended a meeting with Jackie Doyle-Price. Jane is currently working with the iHV on a book for young children to open the conversations up about PMI.

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