Citation

Raffi ER, Gray J, Conteh N, Kane M, Cohen LS, Schiff DM. Int. Rev. Psychiatry 2021; 33(6): 543-552.

Copyright

(Copyright © 2021, Informa - Taylor and Francis Group)

DOI

10.1080/09540261.2021.1898351

PMID

34406106

Abstract

Pregnant and postpartum patients with substance use disorders (SUD) often have other co-occurring mental health disorders. Complications of substance use and mental health conditions, such as overdose and suicide, are a significant contributor to maternal morbidity and mortality. For individuals dually diagnosed with SUD and other mental health disorders, the perinatal period can be both a motivating and a vulnerable period for care. Barriers to optimal care include, but are not limited to, lack of screening, lack of referrals for care, a limited number of psychiatric providers available to care for pregnant patients, and stigma around mental health and addiction care in pregnancy. In this review, we discuss approaches to low-barrier perinatal psychiatric care for women with SUD to promote engagement in care. We review (1) appropriate psychiatric assessment and diagnostic work-up; (2) treatment planning incorporating shared-decision making, non-punitive and culturally sensitive patient-centred care, and principles of harm reduction with a focus on psychopharmacology, and (3) the benefits of an integrated and collaborative multidisciplinary care model for this subpopulation of vulnerable patients.

Language: en

Keywords

Humans; Female; Suicide; Substance-Related Disorders; Pregnancy; Postpartum Period; Pregnancy Complications; Perinatal psychiatry; addiction in pregnancy; low barrier care women's psychiatry; perinatal addiction; Perinatal Care; perinatal substance use disorder; postpartum mental health; reproductive psychiatry; substance use disorder in pregnancy; women's mental health