Citation

Rowan C, Bick D. Evidence Based Midwifery 2008; 6(4): 112-118.

Copyright

(Copyright © 2008)

DOI

unavailable

PMID

unavailable

Abstract

Background. Maternal mental health problems range from transient depression and anxiety to severe depression and psychosis, which in some cases may result in suicide. The 2004 Confidential Enquiry into Maternal and Child Health highlighted the importance of screening and appropriate management of women at risk. Maternity service guidelines published by the National Institute for Health and Clinical Excellence also include recommendations for screening and care of women with perinatal mental health problems. Aims. To undertake an evaluation of service provision in two strategic health authorities (SHAs) to identify and report on how far recommendations had been implemented in 2007.

METHODS. This paper reports on the first stage of a two-stage study. For this stage, a survey was conducted of maternity services in the SHAs to ascertain the extent to which guidelines and protocols for screening for maternal mental illness and subsequent management had then been implemented.

RESULTS. Responses were received from 24 of 39 maternity units. Most had guidelines to assist staff to identify women at risk of mental illness during pregnancy. However, less than half had access to a specialist psychiatrist or midwife. Although units were attempting to strengthen liaisons with psychiatric services, many faced planning and resource issues. Units acknowledged that they did not comply with all the recommendations for services to meet perinatal mental health needs, but several had plans in place to develop this.

DISCUSSION. Although most units were implementing screening at booking, there were variations in referral mechanisms and liaison with mental health professionals. It is likely that measures that require less intensive resources are more likely to be implemented.

CONCLUSIONS. Many units within the two SHAs were attempting to revise services to meet the needs of women with mental health needs, however, it is clear that there was some way to go before policy and practice recommendations were fully integrated into practice. © 2008 The Royal College of Midwives.

Language: en

Keywords

Policy; Mental health services; Screening; Mental illness; Childbirth; Perinatal mental health; Postal survey