Awareness days are not enough

Did you know November 12 to 18 Perinatal1 Mental Health Week?

PMHW is a collaboration of 56 state-based and national government funded, non-for-profit and business-based professional services for those after fertility, pregnancy, loss, birth, postnatal and early parenting support. This united front aims “to raise awareness, provide information, referral pathway support and de-stigmatise perinatal mental health issues.” This is an important initiative because, as it says on the website:

“The transition into parenthood can be tough. 1 in 5 new mums and 1 in 10 new dads experience perinatal depression and anxiety, which is around 100,000 Australian parents each year.”

It’s such important work, and I hope it sparks many conversations that need having…

AND

Representation matters, and it’s not there.

We know parents who are part of marginalised collectives have worse perinatal mental health rates due to systemic, rather than individual, reasons. As part of the campaign, each day of PMWH has its own theme, which has been paired with an image to share on social media. Every person in every one of the seven images is white-presenting, gender conforming and straight-sized. All “family” images feature a mum and a dad, or a mum and babies only.

Likewise, the parent title options on the referral pathway tool are:

A. A mum

B. A non birthing partner

C. A dad

D. Other eg: friend

E. A health professional.

There are many parents this list leaves out, and the binaried options may preclude parents from accessing relevant resources.

There are no disabled, queer, First Nations, refugee or migrant-specific parent support organisations or business partners amongst the 56 collaborating partners, even though I know they exist.

Did someone forget to invite them? Or is it only okay to destigmatise and raise awareness for support services for people who are abled, white, thin, cis and straight?

Additionally there are no links to domestic violence services, despite research referred to by partnering organisations in their own clinical practice guidelines that showed pregnant women experiencing intimate partner violence were four times more likely to report depressive symptoms and ten times more likely to report anxiety symptoms than others, and 40% of women reporting depressive symptoms in the first year postnatally were experiencing intimate partner violence.

Again, was this exclusion an innocent oversight, or is DV still too taboo for a mainstream campaigns? Support services for dads, yes, support services for those abused by dads, no.

A final note, before I get off my high horse, that today’s theme is “caring for the carers”. The accompanying image shows a baby in a bath being washed by their beaming mother.

I’m wondering where in this image, of the mother performing a care task for her baby, the care for the carers is meant to be?

Seriously, how hard is it to snap a photo of someone bringing the parent a snack while they feed the baby, or someone else rocking the baby/toddler while mum lies in bed??

Perhaps the “care for the carers” is meant to be from the presence of a uniformed nurse, who also smiles broadly at the baby. The nurse’s shirt is emblazoned with the name of a government funded behaviourist sleep training school in Sydney that instructs parents to withhold responsiveness2 to children’s cries overnight. While some have told me their experience at said sleep “school” was good, many others have told me how it sent them to the depths of despair and depression, leaving their babies distressed for weeks and them feeling far more like “broken failures” as parents than ever before. I can’t believe I still need to spell this out in 2023 but pitting the needs of babies and children against the needs of their parents is not supporting carers!

I really, really didn’t set out to bag people doing good work or pick apart this campaign. I’m reminded of the times when Dreamtime Aroha post images of the branded supplies they’re taking to houseless people or those in remote communities and some bright (surely white) spark pipes up from their glass tower that they should’ve shopped at Aldi instead. I am okay with being the one throwing stones (particularly in the line of work I do that tries hard to support families of all kinds) if it means that more people are included and represented next year and can therefore begin to access the support they need.

That said, even if all “representation” boxes were ticked, awareness days and weeks can only do so much, and it should be recognised they also have the potential for both hijacking and harm. Zelma Tolley of The Postnatal Project wrote3 earlier this year about the roles we play on days such as R U OK? Day, sometimes shelving our own needs to play a “superior” role.

“The OK person must ask the Not OK if they are OK. OK?… [yet] those with the insight to ask [R U OK?] are often asking because they’ve ‘been there’. This means the mental load is shifted to those with lived experience – who probably need to just look after themselves a bit, you know?”

Put differently, awareness days are often bandaid solutions we as little individuals are supposed to apply while powerful organisations and systems bandwagon-jump onto them. The effort to participate in such dialogues therefore distracts us from the collective nature of our problems - and threatens to diminish our likelihood of agitating together for the systemic restructuring that would do much to solve them.

As Jasper Peach wrote in their (justifiably!) salty ode to R U OK? Day:

“If anyone asks you if you’re ok today, or a cheerful poster, company email or a cupcake suggests this is a helpful thing to do, feel free to direct your honest answers to the health minister, the PM, your local member or whatever deity you subscribe to.”

I wonder…

What might the effect be of initiatives like Perinatal Mental Health Week or R U OK? Day for example in reducing perinatal deaths, compared to say properly paid parental leave for two adults for 7 months each4, a universal basic income, increasing social housing, freezing rents and interest rates before they became untenable (jokes! Too late!), moving to a four day working week, and/or implementing all the things we know from a zillion research papers and inquiry recommendations reduce both domestic violence and birth trauma?

I’m not saying conversations about perinatal mental health or mental health in general are not important. The late Don Ritchie, who talked hundreds of people out of suicide attempts at The Gap in Vaucluse is testament to that. Conversations and caring relationships are why and how many people decide to carry on. Yet top-down approaches could alleviate much of the stress all people, whether they’re in the perinatal period or not, face almost instantaneously. That the powers that be choose to allocate their resources towards stop-gap “solutions'“ (and campaigns that exclude major groups of our society and put the responsibility onto those already struggling) rather than using that money to take meaningful actions tells us just about all that we need to know about their priorities.

I also send out 1-2 members-only posts as part of my Default Parent Project membership. It’s $8 (standard price) or $6 concession and single parent price per month. You can find out more about the membership here.