'Witches': Elizabeth Sankey highlights the urgency to destigmatize postpartum mental illness

Following the release of her documentary Romantic Comedy, filmmaker Elizabeth Sankey combines her affection for popular culture with her personal experience of motherhood, specifically being hospitalized in a psychiatric ward with her newborn baby, for her film Witches (now on Mubi). A compelling, moving, thought-provoking and emotional story, told with meticulously chosen archival footage of references to witches, including famed films like The Wizard of Oz, it's an honest and revealing evaluation of postpartum mental health issues.

The film begins with Sankey talking about wanting to be a witch as a little girl, from watching them in movies, where these characters were separated into "good" and "bad" witches. The good witches largely depicted as beautiful women who behave, the complete opposite of wicked witches.

"Being good or bad isn’t a choice a woman gets to make for herself," Sankey says in the film.

In exploring this link between this connection Sankey has felt to witches and postpartum mental illness, the filmmaker chronicles her personal experience being admitted into a mother and baby psychiatric unit, which only happened after she joined a support group for mothers called Motherly Love.

With Witches also including women close to Sankey who were in the psychiatric ward with her, her "coven," and others with personal experiences with postpartum mental health illnesses, the film exposes the stigma women face and the misunderstanding of postpartum anxiety, depression and psychosis.

In terms of what compelled Sankey to make this film, it began two months after she had been out of the mother and baby unit.

"I remember going downstairs to my husband in the kitchen and saying, 'I'm going to make a film about what happened to me, and I'm going to tie it into witches,'" Sankey recalled to Yahoo Canada. "And he was like, 'That sounds like a terrible idea,' because I was still so mad, but I don't know, it just stuck with me, and it was a very soothing thing for me to do. It just felt like a very, very natural decision."

A particularly unique perspective shared in Witches is not just the process of Sankey and others being admitted into a psychiatric ward, but the difficult process of leaving that space.

"I think it goes from being somewhere that is very, very scary and you don't want to be, to somewhere ... you feel safe," Sankey said. "And they're very clever in that they start off giving you loads and loads of support, and then gradually they take the support away until you're doing all of the night feeds, you're doing all of the care, and ... they want it to be almost harder for you to be doing it in the ward than it would be at home."

"But I definitely was so scared about going home and, as I said the film, it's not like, 'Oh, I'm completely fine.' I would say it took me at least a year, really, to sort of recover. And that year, in many ways, was just as hard, because I was so scared of deteriorating again. ... But I think at the same time I was very lucky, because I had the option of going back into the unit, and they really supported me. ... In the UK at least, once you've been part of that system you stay in it, and there's a lot of protocol and checks, and you're really, really looked after."

Shame, guilt and stigma

But for Sankey to actually get the help she needed, it really came down to the women in this support group, who started as complete strangers, who needed advocate for her so Sankey could get that level of care. As Milli Richards, the founder of Motherly Love, says in the film, it's a "sad" reality that results in women slipping through the cracks in the health system.

"I think even in the UK, where ... globally we're quite good at providing support and care, we have these amazing specialized treatment centres, like the mother and baby units, suicide rates are still increasing," Sankey said. "Suicide is still the leading cause of death for women in the perinatal and postpartum period, and that's even with all of the funding that has gone into these units, and kind of awareness of those units."

"I think that there's lots of different reasons for that. I think part of it is lack of awareness ... about what these illnesses are like and how they present in women, but also just the shame and the guilt and the stigma attached."

Even Dr. Trudi Seneviratne, a leading perinatal psychiatrist in the UK, who is featured in Witches, has struggled to talk about her postpartum psychosis because of the stigma she would face.

The only male voice in the documentary is David Emson. In 2000 his wife Daksha died by suicide after taking the life of her daughter, Freya, in a postpartum psychosis episode. As Emson shares in Witches, Daksha was not only afraid of being stigmatized for her postpartum psychosis symptoms, but was scared that if she was honest that her baby would be taken away.

As perinatal psychiatrist Dr. Chrissy Jayarajah reveals in Witches, this was a story that "shocked the medical world," that Daksha, a doctor, would take her own life, which also highlighted the differences in how psychosis presents in the postnatal population.

"It’s considered a psychiatric emergency, we don’t have many of them," Dr. Jayarajah says.

'I would have been considered evil'

Sankey stressed that something she believes would have helped her personally is if there was more accessible information about the symptoms of postpartum mental illnesses, and if we were at a place in society where mothers weren't shamed and conditioned to feel guilty about having these illnesses.

"That's really what we're trying to do with the film, is to sort of provide it as a resource of like, this is how it feels. And if you feel like this, there's nothing wrong with it, and they're not going to take your baby away," she said. "It's not just baby blues ... there's what I had, which was severe postpartum anxiety, and that these illnesses manifest in different ways."

"The structural stuff is just so massive and it's so ingrained, and it's been around since at least the 1600s."

Going back to the 1600s, Witches also presents an interesting link to the witch trials from that century. In her film Sankey has the women featured read testimonies of women that had been on trial and were killed, with clear parallels to postpartum psychosis, particularly seeing the devil and hearing voices.

Dr. Seneviratne explains, the devil regularly appears in psychosis.

"I think it's something to do with the way women start to think in that postnatal period, particularly when they're depressed or they're developing a depression and then a psychosis," she explains. "They bring in either their own faith or their own religion, or ... a more sort of global interpretation of good and evil."

“It is chilling to realize that if I had been alive back then, I would have been considered evil and I would have been killed," Sankey says in the voiceover in the film.

Ultimately, what Witches strives to do, and does successfully, is show the urgency for more education, support and resources for perinatal mental health.

"At so many screenings, so many Q&As, somebody afterwards gets in touch with me, or tells me that they've lost someone to one of these illnesses," Sankey shared. "Someone messaged me from Rio saying they'd lost someone six days before they'd gone to the screening, and it really drives home that urgency."