This video is about an unusual dilemma I found myself in
while working in a Community Mental Health Team.
One day, I was asked to follow up a patient who had
recently been discharged from the local psychiatric unit.
Elaine was 20 years old. She had been admitted after taking
an overdose. Looking at her discharge notes, I saw that she had been born with
foetal alcohol spectrum disorder.
She was a pleasant and polite young woman, but I could see
that she had some of the facial characteristics often associated with the
disorder.
She told me that she had had some physical problems
associated with her congenital issues and had needed some heart surgery as a
young child. She told me that she had been brought up by her father, and had never
met her mother.
She also told me that she had always been impulsive and had
taken the overdose after a disagreement with her boyfriend. She regretted it
and did not think she would do it again.
Now here’s the thing. Although I had never met Elaine
before, I knew a lot about her, from even before she was born.
Because 20 years previously I had worked with her mother,
Janine.
Janine had had a serious alcohol problem. She had been in a
very unstable relationship with a university lecturer. They were living
together, but had frequent arguments, some of which had resulted in the police
being called out. All of this culminated in her being thrown out of his house
one evening.
At the time, I had helped her get a room in the local
hostel and had also attempted to work with her to manage her alcohol problems.
It was then that she had discovered she was pregnant.
She continued to drink very heavily and was very erratic
about engaging with antenatal care. Consequently, a child protection case
conference was convened.
Because of the high risk of the baby being born with foetal
alcohol spectrum disorder, the unborn child was placed on the child protection
register. It was resolved that the child would be made subject to an emergency
protection order at birth.
Despite my efforts to encourage Janine to engage with
antenatal and alcohol problem services, she continued to drink, and inevitably,
when Elaine was born, she was removed from her.
Her father managed to obtain custody, and Janine then
disappeared.
Now here was the dilemma, which had only arisen because I
had worked in the same area for so many years.
Elaine had lived with her father more or less since birth,
but she had never met her mother, and knew nothing about her.
But I had known Janine and was in the unique position of
being able to give Elaine some information about her birth mother and the
circumstances of her birth.
However, I was also aware of issues of confidentiality. I
shouldn’t divulge any information about a service user to another person
without their permission.
So should I just sit there and keep quiet about it?
Or should I tell Elaine that I had known her mother and offer to tell her something about her?
