I’ve seen a few patients recently who have made me thinkabout the welfare state.
The first is a young woman in her mid-thirties, Amy, who is depressed. She is a self employed mobile beauty therapist who works in her clients’ homes. She is also one of the sofa surfers that the Northern Doctor blogged about last month. She has been living with some friends since the breakdown of a serious relationship, and the depression has been building since this break up. Her friends are now expecting their first baby and she has to move on. But because she is depressed she has been unable to earn as much as she needs, and certainly not enough to rent a room in this expensive part of the south east. Now she knows, and I agree with her, that her uncertain housing situation is contributing to her depression – she is clearly stressed that she is now homeless, and if she had decent housing she would have more of a chance. But as a single female with no children and no other medical problems the chances of her getting somewhere before she has to leave her current house are pretty small. She told me, bitterly, that getting pregnant would be a disaster for her, but at least she’d get further up the housing list.
The second, Beccy, I heard from for the first time in about a year. She rang up for some advice about a minor post-natal problem, and I was quite surprised, as I hadn’t realised she was even pregnant. I have been seeing her for about three years and she has been in a precarious housing situation throughout. She too used to tell me that she had too much pride to get pregnant to get a flat. When I saw her prior to my most recent maternity leave she was homeless and living in a hostel, waiting for a flat to come up for her. It had taken her months just to get the hostel place. She was broke, depressed and self-harming and lived a very chaotic life. She’s now got a baby, in a nice flat with a good boyfriend, and told me she was “really really happy”. I wonder what came first?
The third, Charlie, is a mum already. She has two children but due to financial problems she and her husband had moved in with her parents when the second was born and the first was very young. She developed severe postnatal depression. Her husband left her. She couldn’t cope with the children and her mum took over the parenting, so much so that Charlie wasn’t really allowed to get involved at all. She left. She now lives with friends three hundred miles from her children and told me that she was such a bad mother that they’re better off without her. She’s pregnant again, father unknown, and doesn’t believe in abortion. She says, I think it will be easier this time as I’ll get my own place this time. It all went wrong before as we didn’t have our own space.
It all paints a rather more subtle picture than the “feckless single mum” headlines, doesn’t it?