Podcast: Social Isolation for New & Expecting Parents: A conversation with Julie Borninkhof

Sally:

Hello, welcome everyone to the Nicholes Family Lawyers podcast.  My name is Sally Nicholes, Managing Partner of Nicholes Family Lawyers.  Today I am speaking with Julie Borninkhof, the CEO of PANDA, which stands for Perinatal Anxiety and Depression Australia which is a national not-for-profit organisation that provides confidential information, support and referrals to anyone affected by depression and anxiety during pregnancy and after childbirth, including mothers, partners, family members and friends.

PANDA operates a weekday helpline staffed by trained counsellors and volunteers. Its website boasts a wealth of resources for people seeking information and support, including a separate website called “How’s Dad Going”, dedicated to supporting new and expectant dads who may be experiencing perinatal anxiety and depression.

While this organisation provides essential mental health support to new mums and dads at the best of times, this service is even more crucial during the current COVID-19 pandemic.

Welcome, Julie, thank you for joining me for this podcast.  How are you?

Julie:

I’m well, thanks Sally.  Thanks for having me; I think this is such an important area to talk about outside of COVID but especially at the moment.  It is definitely a big area.

Sally:

Oh absolutely, now tell us a bit more about PANDA; I’ve given it an introduction, but I think people would love to hear from you about its goals and services that it provides to new and expecting parents.

Julie:

Yes, look I think as a custodian and CEO of an organisation such as PANDA, there are so many facets to it which make up its whole; I’ve been on board since late last year, late 2019, and it’s been really wonderful to get among the organisation.  While we are mainly known for our national helpline, which provides phone-based and email support to callers and as you said, they are not just mums, they are dads and carers.  We do have so many other things which wrap around that -so we have online tools and resources; we have probably one of the largest used self-screening tools in our mental health checklist for new and expecting mums, dads and carers which sits on our website which is quite fascinating because that is a space where people can go to do a self-assessment.

We’ve had, I think we are sitting at about 40,000 uses of that screening tool at the moment in about a year and a half of it being online which is fantastic.  We also do a lot of advocacy, so we have over 320 community champions and they are people who are actively participating on social media to raise concerns and awareness around people’s perinatal mental health and wellbeing. They help support us to actively advocate and communicate with the media to provide education and training, to help professionals to upskill them better.  So we have lots of different parts of our business: we do some policy work, we do some research which is really exciting. At the moment, we have a research project under the Suicide Prevention Australia Grant looking at maternal suicide which is the highest rate of death in the pregnancy period and first year of life which is really tragic.  So this allows us to upskill not only our own organisation but bring the voice of lived experience and the challenges that mums and dads face really to the forefront.

PANDA was formed 36 years ago by two women who were sitting at a kitchen table and were talking very much about their struggles after having had their babies.  They had been connected up, I believe, through an informal mothers’ group at the time.  They were sitting and having a conversation in an Australian mental health context at a time when we were very much in the midst of de-institutionalisation where the Commonwealth and states were trying to pull apart formalised mental health supports and really where in a national and international context we did not have a lot of words around perinatal vulnerability so it was still very much around historical struggles which someone might have brought with them into their parenting journey or the phenomenon: “ just get over it, you’ve got a baby”, so these two women had a conversation about how they built support for themselves and then invited a couple of other women to join.

When I met with Anne last year when I was new to the CEO role, she spoke about the fact that they had hired a hall to bring together some women with interests and very quickly realised that they had well over a hundred women when they thought they would only have about 20 and they were ringing up the local council and asking could they bring in more chairs because they were overrun with the number of people who came along to this event which they thought was going to be only a very small one.

Then from there it has just grown; I think the beauty of an organisation like PANDA is that we are creatively flexible and we go where the need is as we develop as an organisation, and I would say we still have the continued luxury of doing that because we hold true to being client-centred and person-centred in our model.  Over time PANDA has just grown and evolved and very much still holds at its core those two women who had a conversation and connected and shared the need for a service which would wrap around them and embrace them at this time when other services weren’t able to.   And so in the model which we have now, we still hold true to our model but now we work more holistically with the service sector and health sector.

Sally:

It’s a really inspiring story and such an important service at all times, but particularly because of COVID and resulting social isolation measures, I can imagine that they are causing greater anxiety in our community and with, amongst, new and expecting parents.  So how might the COVID – 19 experience be unique or new for expecting parents and has the PANDA helpline experienced a surge in calls for support as a result of this?

Julie:

Yes, PANDA was already experiencing increasing calls in dealing with a different client story, when they were ringing as a result of the bushfires, so as we came out of Christmas we had already been in touch with the Ministers for Health and the government to seek support for an additional funding, right before COVID really hit, as a result of the bushfires and we’d seen a 5% increase during that time, from people who were both directly and indirectly affected so we were already on high alert as a result.

5% doesn’t sound like much but when you are already bursting at the seams in terms of not being able to meet a demand that is significant for an organisation like PANDA.  Then quite quickly we saw that grow from 5 to 15% in terms of increased need.  What was fascinating was that whilst we have always experienced callers ringing about their mood or their stress levels or who had anxiety or depression symptoms, we were hearing from a different kind of client that perhaps would traditionally have functioned OK and would have been ticking along and would have self-managed with their family and their support, but more so we were seeing an increase in stress in the general population that was then exacerbating symptoms of anxiety and depressed mood.  So it was a different kind of caller and probably more complex in nature because a lot of the calls were starting to relate to financial pressures, to familial pressures in terms of not being able to connect with families in the same way that people had historically.  And we started to see in the early days, the displacement that was coming from people who were being stood down or needing to move to a work-from-home position, more so than probably two weeks post that initial view of the increase.  We found that callers were then really distressed as a result of their child/maternal health nurse visits shutting down and mum’s groups shutting down because of the social isolation position

That had a significant impact on our callers and we sort of hit 20-23% increase now  from our standard baseline of callers that is ongoing.

Sally:

That is incredible.  Have you been able to put in place measures or suggestions, practical suggestions for those callers who are definitely missing that support of the mothers’ group, which I know is the nexus of how PANDA was formed, have there been some alternatives?

Julie:

Yes, so more so than ever, we are connecting people up to the resources that we have available on our website.  We very quickly put in place a COVID banner and a page on our website that talked about and tried to normalise peoples’ experiences as a result of the isolation and pressure that had on peoples’ health and well-being. We have also been looking at how we support more transparently our guide for groups, so PANDA has worked across some state-funded activities to help support and develop groups during our normal course of business.

We thought it was really important for Facebook groups and Mum’s groups that were self-starting, that they have a think about how they structure those groups to provide support to each other and also of course, the shared ethic about how they flag concern about one another and the like, so we made available some of those resources that had probably sat more in funded program areas and make those more available to the public more broadly.  And also making sure that our check-list was advertised on lots of social media, because we have a broad social media following, and getting information out to primary health networks and states as much as possible.

Sally:

Sure so if anyone was listening to this and concerned about a new parent, there are checklists, or offers which will drive them to your website, and obviously at the bottom of this podcast we will try to put as many online links as we can.  I guess the issues I know, when I was a new parent, the issue of sleep-deprivation was a big issue and also getting the little bub or bubs to sleep.  In terms of being able to access sleep schools at the moment, for example, are they still available, running as an essential medical service?

Julie:

I believe that in some states they are, and look this is probably one of the issues at the moment, is the universality of access is not as known, we do hear that most of those services are considered as essential, but then again, because people aren’t getting…we are seeing a much quicker turnaround in maternity hospitals. Historically, people would have been discharged in a “normal” time – 3 days post-birth as an average, but what we are seeing is a 6-hour departure after birth at the moment, and for those who have gone through a Cesarean, we would normally have expected a week post-Cesarean for people to have been discharged, but it is now a 3-day turn around.

What we know about those quick turn-arounds is that mums and dads are not getting as much exposure to things like  lactation consultants, to the support of midwives on the floors in the wards around day-to-day care for the bubs, and they are the things that callers are ringing about in terms of not feeling that they can cope as well, so as you are saying when we are not sure whether the sleep clinics are operating in every state and territory as per usual, the need for them is exacerbated because the skill set that mums and dads would have learnt about in the hospitals is not as ingrained or habitual for them before they leave.

Sally:

Sure and I can imagine the positive thing about technology, I know people….we have talked about online safety for kids and kids at home-schooling, that has been driving a few parents spare at the moment!  But also, the internet provides such a wealth of knowledge, I would presume that PANDA would direct parents to the appropriate YouTubes for example in terms of if you are having issues  and you need  to look at a particular training video to educate you, you have the appropriate links on your website?

Julie:

Yes, that’s a hard one, I think.  One of the things that we hear from all of our callers  and we ourselves are experiencing is just the huge range of information that is out there.  One of the things that I personally have been advocating for is that we consider not necessarily throwing more money at services and building more, but we just get better at how we sign-post people to resources and how we weave that content together to make peoples’ journey through information a lot more seamless.  A lot of people are saying “I’m getting overwhelmed with all the information that is out there, and it is not clear which I should be listening to or referencing”.  I think you make a really good point: whilst we would like to have really clear information around where to access key support, and we do for much of the part, there is so much out there that it becomes really difficult, specially when you overlay peoples’ individual differences and preferences and family make-up and situations, so we try to adhere to some fairly core content, which is emailed out to all our callers once we have had that first call with them to provide them with localised supports – it’s never easy in terms of accessing that stuff.

Sally:

No and I can imagine that there would be cultural issues and a lot of people missing grandparents, who are a huge support in this period of time. To keep a lot of our grandparents safe, that is one of the main reasons for self-isolation, so I can imagine there are a lot of people missing that continuity or just that break as well.

Julie:

Most definitely, and interestingly, we have seen an increase in the number of grandparents calling PANDA to raise concerns about the mental health of their sons or daughters, and it’s been fascinating in itself  because I think we rely so heavily on them being a part of it and reading how people are going, and when you are not exposed to that, I think people do second-guess and their concerns are amplified because they cannot check in as readily, so we have seen an increase in that number of grandparents calling to seek support and to find out how to give that support then to their families.

Sally:

That is such a fantastic service.  In relation to maternal health nurses, are they actually able to have virtual consultations?

Julie:

Yes, so we are hearing that there are lots of opportunities and most of the states now have their maternal health nurses doing video and phone-based check-ins. That’s wonderful again for those who have access to internet and to phone systems and we know that there are rural and remote parts of Australia where that is not so easily done but across the board we are hearing that there is a connection with mid-wives after people have had the baby.  I think that probably the gap is again that face-to-face modelling and support that comes from mum’s  groups and we are seeing some wonderful initiatives where people are doing stuff via video-conferencing and phone, but I think that nothing for new mums and dads, nothing will replace that ability to sit around as a group and watch how each other parent and engage with their bubs, depending on how you like to engage in a social setting, of course, and what you get from that, and the meaning that you are able to take away and folding into your own parenting picture.  I think that this is a big gap which is fundamentally there at the moment.

Sally:

Yes and I’ve seen….we have such limited  reasons for going outside; exercise, I guess,  is the one avenue where I have seen new mums and chatted with them at an appropriate distance when I am going for a walk; with their prams and asking about their baby and I guess that is one thing that possibly new mums could do or new parents, is to take that bub for a walk, to get that exercise and get the mental relief as well, but it is a group of two, I guess, so that’s fairly limited.

Julie:

Yes, we received a number of calls from mums asking PANDA to advocate at the time  when the social isolation really did hit and making it really clear that you couldn’t be meeting or within 1.5 metres of anyone, and mums calling in to question whether or not there could be some leniency around two mothers and their new babies, you know, going out for walks and the like.  We were very clear about the fact that there was that need for social connection and for the supports to be built and formed early on, not just for the mums but for the babies themselves, and also, on the flip side, the other piece that was interesting was about face-masks and the impact of face-masks on how children learn about facial modelling … from their parents: such a fascinating time, and this would be a great time to be doing some really nice longitudinal research around those sorts of things.  But I think being able to engage, and hopefully we will see that as some of the states and territories start to bring in people engaging with smaller numbers, that mums will naturally find each other again in that space.

Sally:

A priority! What is your key piece of advice for socially-isolated mums and dads who may be really doing it tough – what would you recommend that they do?

Julie:

Go easy on yourself, first and foremost.  It is really easy to think about the should and musts and to second-guess everything that you are doing, as though there is a rule book around being a parent.  The first think we remind everybody is that there are no rules, that near enough is good enough, that even rocks crumble, so you are going to have good days and you are going to have bad days.  So I think being real about the fact that we don’t all love being parents every day, you know, and that is the natural reality: we are great parents regardless, but you don’t have to like it all the time.  I think that the next thing is to trust your inner flags, and especially for first-time parents, you are starting to split away a part of yourself and form a new identity as a mum or a dad, you second-guess the internal flags that you have and your ability to self-check and you kind of suppress your own needs because you are heightened on this new bub.  We need to continually remind ourselves that if you think it is concerning, that if you think that areas of struggle are emerging, then do something about this as early as possible.  Do ring PANDA or sources and services like PANDA and seek support, even if it is just a one-off check-in, do that rather than leaving it, because ultimately we know that whilst relationships can be formed and stormed and are over time, we know that early stage of attachment and sense of self-confidence adults have as they become new parents, really does need to be given as much space and time and nurture as possible, because ultimately us parents are creating parents of the future and our babies.

So I think just going easy, trusting your flags and taking time-out for yourself, even if that means putting your bub on a quilt on the bathroom floor so you can get a shower in each day.  Go easy, do all those things…..and that basic self-care stuff which is not necessarily needed because your baby is the most important thing, no you need to look after yourself in this space.

Sally:

Yes. A healthy parent …often we talk to psychologists in Family Law and they say: if the parents are doing OK then the kids will be doing OK, so really, really important to look after yourself, that is really good advice. Was there anything else?  We will obviously have all the online services for people who are concerned with the podcast. Was there anything else which you want to go out in relation to PANDA in terms of if anyone wants to assist PANDA as a volunteer or to assist financially?  Is it pretty obvious on the website where they can go to?

Julie:

Yes, look I think that if you visit the panda.org.au website, the first thing that you will see is a feel-free to donate button, it pops up quite clearly.  You know, fundamentally, we are there to support new and expecting parents, we do build a really unique set of client-centred tools, such as translated resources, such as our social media campaigns, all of our fliers and the post-out associated with those, all done as a result of the funding that we receive from donations, and we also have the opportunity for organisations that are interested in investing in parents now and in the future to partner in some really key activities that we have identified that we need to get going, to build the fabric of the work we do for our communities so reach out to us, but ultimately, the tools and resources are there, the mental health check-list is often the first port-of-call that we direct people to. That allows you to undertake a 30 question internal self-screening in your own space and be able to check how you are going, and then if you need to reach out to our help line, our amazing counsellors and volunteers are there from 9 am until 7.30 pm Monday to Friday and are able to take calls.  If you are unable to get through to somebody in the moment, leave a message and we will get back to you as soon as possible.

Sally:

Well that has been fantastic. What a delight to speak to you, Julie, thank you very much for that and I wish you good luck with the home schooling!

Julie:

My little 8 year old has been standing in the corner of my vision in the doorway, chewing on an apple and watching me!

Sally:

I think it is something where parents aren’t teachers and you mention being easy on ourselves and I think we all have to with that phenomenon as well.  I can imagine someone trying to home school and with a new baby as well would just be a whole new level

Julie:

Oh my goodness, could you imagine…and that’s again where we are juggling multiple balls and one of them drops from time to time, that’s fine.

Sally:

Good advice.  I think there will be a lot of people listening and gaining so much from this, so thank you very much, Julie

Julie:

Thanks for the opportunity, Sally, it’s been great.

Useful Links:

www.panda.org.au/

Disclaimer: Nicholes Family Lawyers intends the information provided in this podcast as general information only, please contact Nicholes Family lawyers if you require specific information and advise in relation to any family law matter.