Megan should have seen me

Freud. He started all this, yet when his theories are tested like any other drug against results they are ineffective

I wish Meghan had come to see me. I would have known just what to do. People see their GPs about mental health problems all the time, it’s something I manage almost every week (and recently most days). I could have easily squeezed her in to my Monday clinic, or even done an initial assessment over the phone.

If someone comes to see me saying they ‘just don’t want to be alive any more’ I take it very seriously indeed. I know what questions to ask and who to refer to.  I know how long it takes to go through everything (at least twice the length of a normal consultation.) I know that everyone else that morning will be seen late, but that doesn’t matter, it’s a priority. That’s just how it is.

I could have taken a thorough history, offered her tissues in case crying blurred her mascara and included Harry in the consultation. I am sure he would be there too, both to support her and to give any extra information if she didn’t feel confident speaking about it.

My assessment of Meghan would not just have been about medical things like low mood and anxiety. I would also have been checked how she was getting on with her partner, her family, her work and who she was living with, to get a proper sense of how she was coping. As well, I would have asked about basic things like seeing friends, exercise, sleep and appetite. These are all part of a proper GP assessment, that’s why it takes a certain amount of time.

If someone made the same statement to you, what would you do? I hope everyone reading this would know to call up their GP. You could also go to a&e. You could speak to a private psychiatrist. You could ring 111. You could telephone the Good Samaritans. Or you could look up information on the NHS website.  Because the one thing you would know is that a remark like that is serious. I bet you would do something about it the very same day. Unlike Harry who had ‘no idea what to do.’

The fact that Meghan was pregnant when she was feeling like this meant that it should have been taken even more seriously. Symptoms like this should really have set alarm bells jangling, both for her, for Harry and for their GP.

In the last Confidential Enquiries into Maternal Deaths and Morbidity 2015-17, published in 2019, mental health disorders accounted for 10% of maternal deaths during that 3 year period.

Although maternal suicide is only the fifth most common cause of women’s deaths during pregnancy and immediately afterwards, it ‘is the leading cause of death over the first year after pregnancy.’ https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202019%20-%20Lay%20Summary%20v1.0.pdf

The Maternal Death report doesn’t just count deaths, it analyses each person’s notes and works out what care went well, and where mistakes were made. Each patient’s notes are analysed by up to 15 health professionals including midwives, anaesthetists and psychiatrists as well as obstetricians. This is in order to identify potential areas of improvement.

With regard to mental health care in pregnancy the report particularly identifies that ‘disengagement from care should be regarded as a potential indicator of worsening mental state.’ Its hard to know whether Meghan disengaged from care and was at increased risk of a worsening mental state, because it is not clear from the interview whether she ever managed to engage in care in the first place.

Patients like Meghan, who are both pregnant and suffering from mental health symptoms, need urgent assessment and support. They may need counselling, carefully chosen medications to reduce any risks to the baby and attentive follow up and support.

In my area we have a specific perinatal community mental health team. The psychiatrists and counsellors on the team have links to midwives, social workers and nursery nurses. There is even a mother and baby unit where patients and their newborns can be admitted together if needed. The mental health team always writes to us in General Practice to keep us in the loop. When they hand over care (usually by 12 months) we make a note on both the patient’s and the newborn’s notes so that all clinicians are aware. Communication is where health care so often trips up, so careful documentation is key. Most patients recover really well but if there are ongoing worries, we involve the health visitor who can visit patient’s homes and help out with advice, right up until the infant is 5 years old.

If Meghan had perinatal mental health symptoms in her first pregnancy she should be identified as increased risk during her second and picked up earlier. Let’s hope her American obstetrician was watching the interview and will pick up the baton that has somehow been so disastrously dropped the first time round and offer her the care and support she should have had from the start.

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22 Comments on Megan should have seen me

  1. The new “Diversity” inside Bonkingham Palace will have to stop at “Equality” if we are to retain an hereditary monarchy. But Wokism is against that too – read “The Guardian” for straws in the coming tornado. “It is no accident” (Trotsky).

  2. Dear Dr Berenice Langdon,

    In your diagnosis of your patient Meghan Markle, you seem to have missed the obvious fact that she is suffering from both acute and chronic Lying Privileged Bitch Syndrome.

    According to drafts of the sixth edition of the famous Diagnostic and Statistical Manual (DSM), Lying Privileged Bitch Syndrome (LPBS) can be diagnosed if the patient exhibits all of the following symptoms:

    1. Lying.
    2. Being privileged.
    3. Being a bitch.

    Please update your diagnosis, and arrange to have your patient sectioned accordingly.

    • And so, with the insight born of vast experience in the field of human affairs, PJR here advances the public’s comprehension of one of the most prominent conditions that afflict females in search of celebrity.

      That is, celebrity-seeking females -and there are male versions- who lack the talent necessary to create useful wealth and who also lack the intellectual-emotional means to comprehend what must be done, in compassionate material terms, to save the several blighted billions from violence, poverty, and ignorance.

      LPBS has some similarities to the syndrome displayed by one Naga Munchetty, but I will not elaborate on her condition at this time, except to say:

      Living in the West, esp in the Anglosphere, there are many non-Whites, of limited capability, now enjoying kinds and degrees of celebrity, wealth, and power that they could never have even aspired to, let alone attained, in their non-White countries of origin (or the native countries of their non-White forebears). Barack and Michelle Obama are obvious examples, as are other politicians, millions of non-White sportspersons, media-faces, entertainers, and artists.

      And where is the gratitude? None and nowhere. Just demands for “more, more, more!”

  3. My concern is not for the world Harry, or even for your life, virtuous and well lived though you assure us it is. Do you think others, myself included, have not contributed to the world, but feel no need to proclaim it?
    If you have not already taken medicines prescribed for your choler then I suggest that you arrange to see your GP forthwith. If that is, they are not to busy gardening in their gites, refreshing their wine cellars or prescribing the ideal course of treatment for self indulgent millionaire American Princesses, which, rarther neatly, brings me back to my original point.
    I enjoyed your meanders though.

  4. Pre and Post natal depression is a sometimes fatal (suicide) disorder of pregnancy that the “time to get a grip’ brigade can’t process in their minds. Visiting Americans go in fear of falling ill outside America, although American death rates and life expectancy figures are horrendous. So no fear of Megan getting her treatment on the rates

    • Plenty of US and French docs in London.
      And no need for them to observe NHS restrictions in how they treat patients.
      And Meghan is a showgirl who only asks that she be celebrated as the most-widely known showgirl on Earth.
      And until she seeks help for that condition, no doc can help her.

  5. Yes, all excellent points made by Dr Langdon.
    And while wish to avoid panic and certainly hysteria, I suggest that young Archie be taken into the care of social workers -pronto.
    The Actress Markle might be at risk of unraveling at this important time.
    And her husband is a lost boy.

    • Why should the British taxpayer fund the treatment of a multimillionaire American citizen now departed these shores in order to live in privacy?

      • Black privilege?
        Reparations?
        Expression of (fake/false) virtue.
        Woke-ism?
        Perhaps Buddhist-inspired compassion?
        Utter idiocy?

        • So you have no idea either why our medics should assume that their expensive psychiatric services should be provided free of charge to all and sundry who, uninvited, they deem may require them. No wonder the national debt and liabilities are £4 Trillion and rising!

          • You a serious fellow, and no mistake. And very angry too, it seems. And misinterpret others’ utterances at times. And in your upset, it seems you blindly want to denigrate people who might actually be on your on your side.
            That’s alright.
            My gentle encouragement: Before trying to right the wrongs in human affairs, try accepting one’s hopelessness and helplessness, first.
            When your head clears a bit, and you are feeling more grounded, ask for God’s help. Then, gather allies, and once in the fray armed with a sound strategy, fight like hell, and be prepared to sell your life dearly.
            Thing is, God helps us when we help ourselves, but being open to God’s help can be a mysterious process. Curiosity and a gentle attitude are required. And misdirected anger, self-righteousness, and attempts to dominate the scene while fueled by ignorance -all these sorts of things are barriers to effectiveness.
            All best wishes to you, Mr Right on Danton – Harry.

          • Mr Right on Danton!,
            Please set out your strategy, succinctly, for saving Western Civ.
            Perhaps start with the task of saving it from parasites-
            -those both home-grown and brought in from everywhere.
            Whites, non-Whites and anti-Whites.
            Please account for the differences, both across and within groups, in propensities to violence, educability, trainability, productivity, contributory citizenship, fantasy, the extreme use of recreational drugs incl alcohol, and determinedly self-inflicted ignorance.
            And please include treatment of how these differences are now covered up by censorship and lies by governments and by the self-imposed anti-empirical groupthink among naive idealists and anti-Westernists in all walks and stations of life -and what to do about all that.
            If you are inclined, please also deal with the matter of the sham/scam of the suicidal hysteria that insists that humans are causing the climate to change in a catastrophic direction by burning fossil fuels.
            What to do about CCP agents now infiltrating all Western institutions, and those of all other countries too, perhaps requires its own special section.
            There’s more to it of course.
            But I -and many others- will appreciate your initiative in these matters.
            All Best -Harry.

          • You do portray yourself as a humble fellow, Harry, but I seem to detect a righteous sanctimony behind your blindscreen of verbiage.
            Am I wrong?

          • RoD!,
            For more than 50 years, I have worked in groups, on various continents, whose work required gettings things right -as the stakes were high in lives, livelihoods and other people’s money.
            I hold no righteous sanctimony as a result of this experience.
            Just gratitude, and yes, a bit of humility that I, a lad born far, far down the economic/social ladder, should have received the opportunities to contribute as I have.

            Now please, say your views on how to reduce parasitism. Instead of “contributory citizenship”, parasitism is now strongly encouraged and endorsed within the education systems, within the mainstream media, and by polticians. Your views might help arrest this destructive trend.
            All best, Harry.

          • My concern is not for the world Harry, or even for your life, virtuous and well lived though you assure us it is. Do you think others, myself included, have not contributed to the world, but feel no need to proclaim it?
            If you have not already taken medicines prescribed for your choler then I suggest that you arrange to see your GP forthwith. If that is, they are not too busy gardening in their gites, refreshing their wine cellars or prescribing the ideal course of treatment for self indulgent millionaire American Princesses, which, rarther neatly, brings me back to my original point.
            I enjoyed your meanders though.

          • Resentment and scorn as a way of life RoD!?
            Please consider healthier alternatives.
            And also:
            Please say your proposed remedy for parasitism.
            Over and out -Harry.