Q&A: Jessica Porten had the cops called on her after seeking help for depression. Now she’s pushing for new laws

The Center for Health Journalism recently spoke with Jessica Porten, a mother of two, about her distressing hospital experience seeking treatment for postpartum depression. A nurse called the cops after Jessica admitted to having violent thoughts while suffering from depression following the birth of her daughter. Without further questions, police escorted Jessica and her baby to a local emergency room, the start of a 10-hour ordeal that ended with a discharge and a few leaflets handed to the exhausted mother. After Porten’s story went viral when she posted about the experience on Facebook, dozens of media outlets interviewed her. Meanwhile, lawmakers in her home state of California are responding to high rates of postpartum depression by introducing four new bills aimed at improving mental health screening and treatment for new mothers. Porten is a strong supporter of the legislation.

The following interview has been edited for length and clarity.

Q: When did you first start showing symptoms for postpartum depression?

A: When Kira was born, she was immediately taken from me to the NICU because she had aspirated meconium, so it’s difficult for me to pinpoint when the postpartum depression began. She was in the NICU for 13 days, so I of course had an amazing amount of situational depression — that was literally the worst 13 of days of my life. But in terms of the anger, that symptom started about four weeks postpartum.

Q: Can you describe the kind of emotions you felt as you struggled with depression following your daughter’s birth?

A: Rage, white-hot rage. I’m not an angry person, but about once every three to four days, usually in the middle of the night, I would become so overwhelmed and so angry, for no reason at all usually, and I would have to get up and hand the baby to my husband and take a break. I can’t even tell you what triggered it. It could be either myself or my baby, but most often inanimate objects like the rocking chair or just completely asinine little things would irritate the hell out of me.

Q: When did you decide to seek treatment?

A: Four weeks postpartum was when I started trying to obtain an appointment with my doctor and it took them three months from when I started trying for them to actually see me (I have Medi-Cal, the low-income state insurance). During that time, my symptoms continued to get worse.

Q: Can you share again what happened once you told the nurse practitioner at your obstetrician’s office that you were having violent thoughts and were seeking treatment?

A: She didn’t even discuss the different medications. She said she would write me a prescription, which she never did. It wasn’t really a conversation. She left the room, and called the cops. She came back in and said unfortunately because you’re describing having violent thoughts, you need to go to the ER to be evaluated and cleared, and we can’t let you drive there by yourself or be alone with your baby, so you’ll have to have a police escort.

So, I’ve been educated since then about what triggered that phone call. She didn’t even ask me about specific violent thoughts, or even to describe these thoughts. She just said, “When you have these violent thoughts, do you have plans?” And I remember thinking to myself that that was a very stupid question, because I thought she was asking if I’m having vague or specific violent thoughts, and I was having specific violent thoughts: When I was extremely overwhelmed I would imagine taking an ax to that fucking rocking chair. I was very angry. So, when she said, “Do you have plans?” I said yes. And what she was actually asking me was whether I was planning to do these things. So that’s where the mandatory reporting came in. But there was no conversation after that — she didn’t clarify what she meant, or what I meant. That was pretty much the end of the conversation, and I was off to the emergency room.

Q: That’s when they removed all your belongings?

A: Yes, and that was another inconsistency, and just more proof that they were only covering their liability and following these protocols blindly, rather than thinking about me. They took my clothes and they took my shoes, but I still had my baby with me. They did have a babysitter watch me, but they allowed me to keep my diaper bag, and they didn’t even search it. So, the reason why they take people’s clothes and shoes is to make sure you don’t have anything on your person that you can harm yourself or other people with. So that protocol makes sense for people that are in a mental health crisis, but not for me. It was all just a charade. My daughter and I got to my initial appointment around 2 p.m., and I didn’t walk out of the hospital until after midnight.

Q: You’ve mentioned they gave you some pamphlets that they said could be of help when they released you. What were in those pamphlets?

A: The leaflets that they handed me were for local mental health resources for postpartum depression. And I’d like to point out that it says on some of those pamphlets that if you believe you have postpartum depression, you should contact your doctor or call your obstetrician. I had just come from that office.

Q: What kind of response has there been since sharing your story?

A: There are articles written about my experience in languages I can’t even understand. It has literally touched every corner of the world. It’s spread a lot of awareness and that’s great, but what I really want is to enact some change. Because up until now we’ve really only been relying on community outreach and it’s not enough. We need equal, institutionalized outreach from within our health care system, and we need to stop expecting postpartum mothers to advocate for themselves. Instead we need to have systems in place to advocate for them.

Q: What would you change about the care that women receive after childbirth in the U.S.?

A: First of all, all obstetric offices need to have mandated screening for postpartum depression and other maternal mental health disorders, because right now it’s voluntary. Second, when someone checks that little box that says, “I’ve thought about hurting myself or others,” there needs to be a second question there and an actual conversation with a doctor before police are involved. And there needs to be someone who can evaluate and clear these women at the obstetrician’s office. Why are there not psychiatrists or some kind of tele-psychiatry program at the OB’s office?  

Another helpful thing would be that before a woman is discharged from the hospital after birth, there should be a coordinator that comes to her room and schedules her first post-partum visit, before she’s discharged. We need to be holding the hands of mothers. And then after women are screened and they test positive [for a maternal mental health disorder], what do we do with them? We really just need a total overhaul for maternal mental health.

Q: Is there anything you think the media gets wrong about postpartum depression?

A: Yes, because often everything is labeled postpartum depression. There’s something called postpartum psychosis and that’s when a woman is delusional. This is when you hear stories about a woman drowning her children or women microwaving their babies. That is postpartum psychosis and should not be confused with postpartum depression. It’s extremely damaging and perpetuates the stigma.

Also, the only reason my story went viral is because, to be honest, I’m a pretty white lady, and I got the cops called on me. But this happens to women of color all the time, and instead of being cleared by the social worker, they would have been institutionalized. And if they were a single mother, their children would’ve been taken from them. But the media’s not covering them. Why? I think the media holds a lot of the blame for perpetuating stigmas.

Q: On that note, you edited your initial Facebook post to imply that as a white, heterosexual woman you might have had privileges, even within this trying experience. What led you to add that on?

A: Because literally when I was in the emergency room with my husband I looked him in the eye and said, “What if we were black? What if we didn’t speak English so well?” And that scared me. I can’t even imagine being an illegal alien, or if I was there with my lesbian partner, how would I have been treated differently? I just I think this would have ended so differently for so many other people, and I had to highlight that.

Q: Assemblyman Brian Maienschein (R-San Diego) is backing a package of bills aimed at garnering federal funding to address maternal mental health and well-being, as well as screening for depression in new mothers. What are your hopes for these bills?  

A: We’re just trying to get some form of support. We need to stop relying on community outreach and start holding doctors and everybody accountable for putting mental health back into medical health. For some reason, mental health is carved out of the body, and it’s so crazy. There’s no way we can treat one without the other. So, we’re hoping that’s what this legislation is going to do.