Why Are Healthcare Providers Not Listening?

I met with a new client the other day. One of the first things she said to me was: "Thank you for seeing me so quickly. And thank you for calling back as promptly as you did Monday when I called." I smiled with reservation, after all, I was just doing my job, so to speak. My intention was to let it go, but she continued. "It's hard for me to believe, actually. I called my OB last week. I thought we had a pretty good relationship. She knew I had a history of depression, we had discussed it before I had my baby. So when I called and told the nurse I wasn't feeling good and left a message for the doctor to call me back, I was surprised when I didn't hear back. I mean, c'mon, I told her I was depressed! And she still hasn't called me back. What's up with that?"

I displayed my unabashed frustration with the scowl on my face, "It's hard for me to believe, too." I've never been one to withhold my opinion and in my effort to be honest and forthright, I could only hope there would be therapeutic value in supporting her dissatisfaction with my brash grimace.

"I called a therapist, too, " she continued. "Someone the nurse referred me to because they take my insurance. She hasn't called me back either." Hmmmmm.....

I know this therapist, I thought to myself. She's good. She has a wonderful reputation. Why hasn't she called back either? It's been a week. That's not okay.

Are these healthcare providers all busier than I am? Do they have so much filling up their precious days that neither of them have time to call back a patient and/or potential client who is suffering from symptoms of depression? We're talking about a return phone call.

When these incidents are brought to my attention, I can't help but think about the way we run our practice and how we prioritize every call. Making a postpartum woman who has reached for our help, wait more than a few hours for a return phone call is not acceptable in our offices.

I understand that we are the exception. Not because we do anything so spectacular, but because our Center specializes in the treatment of perinatal mood and anxiety disorders. And because this is what we do, we make certain we do it in the manner that is most likely to meet the needs of postpartum women.

But an Obstetrician? And a psychotherapist who specializes in depression? They don't have time? They don't care enough? Their work schedules are too demanding? They dismiss the potential catastrophic outcomes?

Frankly, this is a subject that is particularly discouraging to me and it feels very personal. For almost thirty years I have blazed these trails. I've done my time knocking on doors, posting flyers, offering my services, donating my time, writing books, providing inservices, teaching professionals, spreading the word. And for a while, I actually began to believe that efforts to increase public awareness of postpartum depression were, indeed, making a difference.

But moments like these with this client bring me back to the harsh reality. And just when I think this topic is old news, I read in Katherine Stone's postpartumprogress blog today that she and her warrior moms are all worked up about the same thing, starting a letter writing campaign to call attention to the gaps in medical responses. Really? Is this how far we have come... that we are all still fighting the same battle for recognition? Women are still pumped up to point out how grossly their case was mismanaged. (True, some women are also waiting in line to announce how helpful their doctor was and this is always good to hear.)

We should NOT have to keep telling physicians and therapists who are treating women that 1 out of every 8 of their patients/clients are experiencing a depressive disorder after the birth of their baby. 1 out of every 8. That is not the baby blues. That is not a transient moodiness that will go away on its own. That refers to symptoms that meet the diagnostic criteria of a major mood or anxiety disorder.

But apparently, we do have to keep telling them. And those of us who are dedicated to this work will continue to tell them, until they no longer need reminding and postpartum women who are suffering no longer have to wonder if their doctors are taking them seriously.

So here, again, is my message to healthcare providers. And this includes therapists. Please pay attention:

• One out of every eight postpartum women coming into your offices is experiencing a major clinical depression.
• You cannot tell by looking at her.
• You cannot assume that if she looks good, or says what you hope to hear, that she is fine.
• If you do not ask the right questions, you have NO idea how she feels.
• If you do not ask every postpartum woman if she's suicidal, you do not know whether she is thinking of harming herself or not.

Postpartum Depression Essential Reads

Supporting Your Postpartum Partner

New Treatment Option for Postpartum Depression

And finally, please return her phone calls. Please get her into your offices for assessment and treatment. Please to not make her think twice about her decision to reach out for help. There is a great deal at stake and a lot that can happen between the time she calls you and the time you call her back.

Copyright 2012 Karen Kleiman postpartumstress.com