When The Worst Happens

This week I came across the story of Julia Lovemore, a severely mentally ill woman who killed her own daughter. It was a tragic intersection of severe bipolar disorder, religious fanaticism, and the shortcomings of mental health care.

Mrs Lovemore came to the attention of authorities in the year before baby Faith’s death, after beating their elder daughter, Angel, over the head with a hairbrush. Angel was put on the ‘at risk’ register, and when Julia became pregnant with Faith, she saw a consultant psychiatrist, who warned of the risk of a psychotic episode after childbirth. The family proceeded with a home birth, and Mrs Lovemore requested that health visitors stop visiting. Finally, on 17 June 2009, a community psychiatric nurse and a health visitor visited the Lovemore residence, and found Mr Lovemore (who also had serious mental health problems) in a psychotic state, praying intensely in a trance-like state. The two workers left for assistance, but it was too late. An hour later, Mr Lovemore walked in to a GPs office, with one child dead and the other doused in white spirits.

This case is old, but it shows some of the flaws with the mental health system of the UK, which is very similar to the one in New Zealand. The various authorities probably did the best they could with the resources they had, and within the guidelines they had. But it wasn’t enough, and to some degree this tragedy, and others like it, can be avoided.

Relatives say that they had been pushed away and branded as heathens, which suggests that Julia was probably isolated to some degree. We don’t know what kind of part the Lovemore’s church played in their lives, and whether they were a good support network. That they were getting regular visits from health workers suggests that perhaps they didn’t  have much support, but scheduled visits really don’t compare to having people to call on.

Mr Lovemore was also seriously mentally ill. The main support person for many people with mental illness is their partner, but that doesn’t work well if you are both unwell at the same time. He also may have seen medical attention as less important than prayer, which may have had an effect on the couple’s attitude to psychiatry. We don’t know whether they were prescribed any medications, or whether they actually took any meds.

Health visitors and psychiatric nurses were visiting regularly, but we don’t know whether she was assessed by a psychiatrist during those critical post-partum weeks. Psychiatric illnesses and childbirth are not a happy pairing, and she should have had at least one evaluation.

Even if the family were getting the best care that outpatient mental health services could give, it was still not enough. Because some people are just too unwell for outpatient services. For this type of family, who are very high needs, sheltered accommodation is the best option (in my opinion). Sheltered accommodation isn’t cheap, but it would keep at-risk families together and keep them safe. The family already had a history of abuse, and severe mental illnesses, and these are things that simply cannot be adequately dealt with in an outpatient setting. This death could well be the tip of an iceberg of families who are struggling, who are trying to deal with mental illness with a lack of tools and support. For this one death, there will be more who are abused by a parent too sick to know better, but who don’t grace the front page of newspapers because they’re not quite dead.

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