Postpartum Mood Disorder Project

Phase 1 - Read MorePhase 2 - Read More

Ontario Trillium Foundation

Northern Ontario Postpartum Mood Disorder Project

The Postpartum Mood Disorder (PPMD) Project is currently on Phase Two of this multiple phase project working to address issues of PPMD in the province of Ontario. Currently, within Ontario there is no coordinated comprehensive strategy for the treatment of PPMD. More specifically, there are sporadic services scattered throughout the province without coordination nor application of best practices for culturally safe PPMD treatment. Women and their families face difficulties in accessing appropriate integrated services and must navigate a myriad of medical and social services to receive care. Too often they are turned away with nothing.

We call this the postal code lottery for PPMD services. Through the work of the PPMD Project there is a greater opportunity to stop the intergenerational transmission of mental health issues and improve the quality of life for families. By effectively treating the life givers and care givers in our communities we may perpetuate wellness in Northern Ontario families.

Learn More About Phase II

 



 PPMD Impacts...

Support for the Postpartum Mood Disorder Project has been provided by a grant from the Ontario Trillium Foundation



Reflected Truth

"I thought I must be the worst mother in the world to feel this way, to be sick like this, I thought my children would hate me for putting them through this, that I had screwed them up for life. But the truth was always reflected in their eyes, love was there not judgments, they just loved me the way I was. I could also see a light & hope in the eyes of my children that really helped motivate me to get help so I could and get better."

- Michelle Roberts

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Time Stood Still

"This photo represents the time it took to find help. Although I was actively searching for help, waiting to get in to see my doctor and a counselor was senseless. Things are currently this way because of a lack of resources. Help should be available immediately for all who have realized they may be suffering from a PPMD. Currently, immediate help is available for those in crisis, but we need to be proactive so that a crisis is prevented. Mothers helping mothers. It also represents how I was just going through the motions of day to day activities and although the world continued around me, I felt that time was standing still. I have few memories of my children during this time. Although I tried to maintain normalcy in their lives, I was never really present in those moments."

- Sonia

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Turbulent Seas

"It felt like I was caught in turbulent seas, I couldn't see above the waves, it was a struggle to keep my head above water, it felt as if I was being pulled under, the wind was so high it knocked me down, I cried a sea of tears, and I began to panic as I was drowning in Postpartum Anxiety and Depression."

- Michelle Roberts

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The Moment

"This photo represents the moment when I lost myself. That my own light was extinguished. I felt myself slip into someone I didn't recognize. Feelings of hopelessness, anxiety, anger and fear. I was able to recognize the signs that depression and anxiety had overcome me. Prior to this, I was educated in what to look for and although others saw it before I did, I was able to seek help. Women and family members need to be educated to know the signs."

- Sonia

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The Gaps

"When I finally admitted I needed help, I found that there are no direct services in my community for mothers & families who are suffering Postpartum Mood Disorders, There is a real gap in service for such a serious illness. Hopefully this project will bring those gaps to light and we can begin to fill them."

- Michelle Roberts

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Hold On

"Hold on... because this is going to hurt like hell". My husband was my rock. He was my life-saver and held on to me even as I was slipping away. He was my spine as he continued to hold our family together. He listened. He made me feel loved when I didn't think I deserved love. Family members need to have the education and support in how to handle all the feelings that may come with PPMD as well as the burden associated with holding a family together. It is important to know and understand that PPMD has a beginning, and it has an end. So hold on... until you get there."

- Sonia

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Stigma

"Stigma is defined as “a mark of disgrace associated with a particular circumstance, quality or person“.  It is a negative stereotype.  There is stigma associated with most mental illnesses, even PPMD.  Many people view women with PPMD as weak, lazy, unable to handle the challenges of raising children.  Some may think that a woman with PPMD is “ungrateful” for her family, that she “never should have had kids”; she is “just being selfish”.  And, of course, she must be “crazy”.

Most communities can identify their local psychiatric units with a single word or expression, such as “the psych” in North Bay, “Kirkwood” in Sudbury, etc.  During my illness, I did spend time admitted to hospital, “Riverview” being Sault Ste. Marie’s psychiatric unit at the time.  Very few people came to visit me there, many unable to comprehend my illness.  A few implied that I “just needed a break”, a rest from the daily grind of motherhood.  They had no idea of the severity of my illness.  I was removed from my children at a time when I most needed to feel connected to them.  I told almost no one of the scariest thoughts and feelings I was having at that time for fear of being judged.  I was afraid that I would be seen as an unfit mother, a threat, too unstable to be involved in my children’s lives.   

Unfortunately, the stigma of mental illness prevents many from seeking the help that they desperately need as many are judged negatively by those around them.  It takes great courage to talk about those intrusive thoughts, to admit that you’re worried you will harm your baby or yourself!  By asking the difficult questions and acknowledging those scary, unpleasant thoughts without judgment, we can help women and families stay safe and become stronger.  These moms need validation and reassurance that they are not “crazy”, not “monsters”, but that they have an illness that can be overcome.  Friends and families need education about PPMD and how they can support the women and children in need of their help."

- Stephanie

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Chaos

"This collage was created by me during my time in hospital. The images and words helped me to communicate my thoughts and feelings to my caregivers. Putting this collage together was a healing process as it helped me to identify and express how I was feeling.

I know that many women who have seen this collage can relate to some of the images. Women need to have a supportive network of other women with lived experience of Perinatal Mood Disorders to talk to. We must develop this network and make it as accessible as possible so that no mom ever feels alone."

- Stephanie

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Lonely Journey

"Dreary, gray and lonely. For me, this picture represents my journey to wellness. There was no clear path to get there. I could only try to keep afloat until I hit solid ground. It seemed impossible to pick my way through the ever-changing maze while slowly sinking, allowing myself to melt into the cold silence. Each step forward was an unsteady leap.

We need to give women and families affected by PPMD a clear path to follow. They need help to navigate their way to solid ground. We need to support them on their journeys to wellness."

- Stephanie

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A Mother’s Mind

"A mother’s mind is in a constant sway of firing neurons; full of overwhelming and uncontrollable emotions."

- Michelle

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Help!

"What she needed was an expert in the field just to tow her through."

- Michelle

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Lifelong Journey

"Trudging through the cold, dark waters, fighting the way through the pressures of life and motherhood. Only to find that the light at the end of the tunnel is merely a continuing battle of river, feeling as though there is no end."

- Michelle

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"Treatment options. Find what works for you."

- Annie

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"Mothers often put their children’s needs before their own. Raising and carrying a child through life is an amazing but complex job. Mothers need to acknowledge and meet their own needs along with their family’s needs."

- Annie

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"Becoming a new mother can be so overwhelming. Expectations and reality often collide leaving the new mother feeling disappointed, alone, misunderstood, guilty and lost."

- Annie

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"When you’re drowning in post-partum fears and anxieties, there’s no trained expert to save you."

- Bonnie Dart

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"When I desperately wanted information and support, I felt like I was left dangling, cut off from what I most needed."

- Bonnie Dart

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"Post Partum Mood Disorder is a very frightening condition for those experiencing it as well as their family members. They need to know what it is, have a sense of what to do and what signs to look for."

- Bonnie Dart

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"She is an isolated and unfamiliar "reflection". Alone she must navigate her way out of this deep, dense and dark place."

- Kathleen Jodouin

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"This is not a minor pebble in her shoe. But she must carry this "monument" with her from now on."

- Kathleen Jodouin

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"When I desperately wanted information and support, I felt like I was left dangling, cut off from what I most needed."

- Kathleen Jodouin

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"What was needed most was a "break". Without relief from the pressure and stress of the experience she snapped."

- Kathleen Jodouin

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The Fountain

"The sky was bright unlike my future. I felt like all I could do was cry and the tears would burst out of me so violently and so frequently. I felt all alone and out on an island where no one could reach me and a part of me didn't want to be reached. I didn't want people to know how bad I was. I was not me. I was someone else. Someone who was a failing at what was supposed to be the most natural role a woman could have. I was truly unworthy of such a title as mother."

- Janice Ireland

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The Swamp

"It looked so peaceful and so inviting. I could walk in until the water slowly but steadily overtook my body and I disappeared. I would feel the cool water against all the searing pain of being a bad mother. I would welcome the water into my mouth and down my throat to soothe the rawness from all the sobs and I would let the water wash away all the tears from my cheeks. I would just disappear from this brutal and wretched life and no one would even miss me. How could they when I was already gone?"

- Janice Ireland

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Our Hands

"A mother’s mind is in a constant sway of firing neurons; full of overwhelming and uncontrollable emotions."

- Janice Ireland

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Postponed

"During my pregnancy I had so many aspirations for what life would look like when our son was born. I had never expected that my experience with motherhood would be something I hadn’t prepared for; postponed until I could learn to find my identity again as a woman and mother after my post-partum depression swept in like a storm and left its heavy, cold presence on top of everything familiar and hopeful. Even throughout my recovery, much of that snow has remained as a thick blanket of guilt for being unwell in my son’s first few months. In my reflection of this experience, I have tried to figure out what could have helped to brush some of that snow away…and I see a need for women to speak openly and honestly about the transition and transformation that comes along with parenthood and to recognize that all change involves loss, and that loss looks different for every mother."

- Kaarina Ranta

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Journey to motherhood

"My depression encompassed many areas; anxiety, irritability, inability to leave my bed some days, crying spells, full blown outbursts, confusion and an overall feeling of chaos and nothingness . The bricks in the middle of the stream leading to the pool are meant to represent the barriers I had faced. As I started on my recovery journey, fluid and changing, like water,  I had to learn to navigate through these barriers and find myself, unrecognizable on the other side of the bricks, joining the other women who had crossed over into motherhood, some with barriers and some without and learn who I was after this experience."

- Kaarina Ranta

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Overwhelmed

"This photo is meant to depict how it felt to be in the middle of my illness. If the other side of the lake were to represent wellness, it is very far away. This woman is sitting alone and the tone is very cold and ominous, similar to my experience in that this was something I felt, and perhaps still do that no one could really understand the guilt, loneliness and embarrassment for not coping well. Trying to navigate the mental health services and identify what recovery was for myself was a very overwhelming task, exacerbated by lack of sleep and confusion, hidden to everyone except a close few.  I would hope that the message people can take from this photo is that it is a very scary, unsure journey for a women to make and even if options are presented, it is a confusing time to assess what is needed and when to reach out."

- Kaarina Ranta

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Cliffhanger

"This photo depicts how I think many mothers feel after they have gone through the exhaustive process of giving birth and they find themselves somewhat isolated in their motherhood and hanging on for dear life.  The mountains in the photo help illustrate the peaks and valleys that many mothers can feel after delivering a baby and embanking on new motherhood whether it be for their first child or subsequent children."

- Mandy

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Throw Away the Gavel

"Mothers often judge themselves harshly and they certainly do not need more judgment from others when experiencing all the clashing emotions of post-partum life.  It is critical that a mother's support system can move past judgment to seek understanding."

- Mandy

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Always Welcome

"A home away from home was what I needed when I was experiencing severe post-partum depression and my parents were graciously able to provide a welcoming, safe haven for myself, my husband, our toddler and our newborn daughter."

- Mandy

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Overwhelmed

"Having children is overwhelming. Their needs overwhelm your needs and your thoughts.  Their stuff overwhelms your house. Sometimes it feels like things will never be clear again."

- Christine Mackie

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Hope on the horizon. Getting through the darkness.

"The Journey through PPMD is like chasing rainbows.  You know happiness is out there, but the closer you get the further happiness seems to get."

- Christine Mackie

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Forgiving Yourself

"One of the hardest things to come to terms with is that sometimes you can`t be everything to everyone. Remember that kids are very resilient and forgiving. If only we could forgive ourselves."

- Christine Mackie

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Wanting To Connect

- Julie

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Life After

- Julie

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Through the glass

- Julie

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Committees

8 committees accross Northern Ontario came together tp create the Northern Ontario PPMD Strategy:

  1. Muskoka Parry Sound
  2. Nipissing
  3. Algoma District
  4. Sudbury District
  5. Timiskaming District
  6. Timmins District
  7. Thunder Bay and District
  8. First Nations of Northern Ontario
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GLOBAL PERINATAL MENTAL HEALTH INITIATIVES

Mother First (2010)

Country of origin:
Canada(Saskatchewan)

Action:
Recommendations
Education
Screening
Treatment
Sustainability & Accountability

Perinatal Mental Health National Action Plan (2008-2010)

Country of origin:
Australia

Action:
Strategies
Training & Workforce Development
Universal Routine Psychosocial Assessment
Pathways to Care

Healthy Beginnings (2011)

Country of origin:
New Zealand

Action:

  • Guidelines
  • Triadic Services
  • Triad requires access to comprehensive and integrated services
  • Developmental approach to assessment and treatment
  • Tailored interventions that are the least restrictive and most normative
  • Early identification and intervention
  • Family/Service provider collaboration
  • Culturally Appropriate
  • Services need to be evidence based, goal focused, accountable, acceptable and accessible

The organization of perinatal mental health services in Ontario - ECHO (2012)

Country of origin:
Canada(Ontario)

Action:
Recommendations
Service
Education and Training
Policy
Research

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PPMD Working Groups

Muskoka Parry Sound

Nipissing

Sault Ste. Marie

Sudbury

Temiskaming

Timmins

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1: Investment in Families

Addressing PPMD requires an investment in families. As PPMD impacts the entire family a partnership between the Ministry of Health and Long Term Care and the Ministry of Children and Youth Services is required. This invested collaborative partnership will provide a comprehensive continuum of care to families. This continuum of care will provide a menu of services for families and will utilize a variety of models of service delivery including electronic options that recognize the geographic challenges faced by those in the North. This model of care would be delivered in a person-centered, inclusive, holistic manner and would recognize the cultural diversity of the North and the diversity of familial connections. Services will be provided in a timely manner utilizing an expanded understanding of PPMD and will utilize inclusionary criteria rather than exclusionary criteria for admission.

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2: Competency Building

Provision of a system of care will require a coordinated system of competency building within our communities. This competency building should occur within all sectors that are involved with the provision of service and care to families and would respect the scope of practice of each sector. Systems of care include but are not limited to physicians, nurses, peer providers, social workers, early childhood educators, mental health and addiction workers, child protection workers, lay home visitors, psychotherapists, etc. Competency building would utilize best practice evidence related to PPMD in addition to the expertise of Northern communities of practice and Northern families with lived experience of PPMD.

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3: Education Campaign

PPMD is an often an illness of secrecy, silence and shame. Upon the creation of a system of care and the enactment of a coordinated system of competency building we engage in a public education and awareness campaign. This campaign will utilize both traditional and non-traditional communication methods to provide accurate information on PPMD, pathways to care, and systems of support. This education will be provided in accessible and normalized language.

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1: Investment in Families

Addressing PPMD requires an investment in families. As PPMD impacts the entire family a partnership between the Ministry of Health and Long Term Care and the Ministry of Children and Youth Services is required. This invested collaborative partnership will provide a comprehensive continuum of care to families. This continuum of care will provide a menu of services for families and will utilize a variety of models of service delivery including electronic options that recognize the geographic challenges faced by those in the North. This model of care would be delivered in a person-centered, inclusive, holistic manner and would recognize the cultural diversity of the North and the diversity of familial connections. Services will be provided in a timely manner utilizing an expanded understanding of PPMD and will utilize inclusionary criteria rather than exclusionary criteria for admission.

2: Competency Building

Provision of a system of care will require a coordinated system of competency building within our communities. This competency building should occur within all sectors that are involved with the provision of service and care to families and would respect the scope of practice of each sector. Systems of care include but are not limited to physicians, nurses, peer providers, social workers, early childhood educators, mental health and addiction workers, child protection workers, lay home visitors, psychotherapists, etc. Competency building would utilize best practice evidence related to PPMD in addition to the expertise of Northern communities of practice and Northern families with lived experience of PPMD.

3: Education Campaign

PPMD is an often an illness of secrecy, silence and shame. Upon the creation of a system of care and the enactment of a coordinated system of competency building we engage in a public education and awareness campaign. This campaign will utilize both traditional and non-traditional communication methods to provide accurate information on PPMD, pathways to care, and systems of support. This education will be provided in accessible and normalized language.

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