The rise and fall of a psychiatric antenatal clinic: development of a perinatal psychiatric service linked directly to the provision of antenatal care

A mother-baby psychiatric day hospital: History, rationale, and why perinatal mental health is important for obstetric medicine

BACKGROUND

Women frequently experience depression, anxiety, or other mental health concerns during pregnancy and postpartum, impacting her and her infant's health. Patients who require management of medical conditions during the perinatal period are even more likely to experience depression and anxiety compared to those without comorbid medical issues. Despite the availability of effective treatments, perinatal mental health utilization rates are strikingly low.

METHODS

To address common treatment barriers, we developed a specialized mother-baby day hospital for women with psychiatric distress during the peripartum. In this report, we summarize findings from 800 patient satisfaction surveys collected from women treated at the program between 2007 and 2012.

RESULTS

Findings suggest that women are highly satisfied with the treatment received, often noting that the inclusion of the baby in their treatment is a highly valued feature of care.

CONCLUSION

The relevance of perinatal mental health services for patients who are followed by obstetrical medicine specialists is discussed.

Completing the cycle: The use of audit to develop a mental health service in times of austerity

BACKGROUND

A published audit demonstrated that a pilot psychiatric clinic failed to capture predicted numbers of women with severe and enduring mental illness.

METHODS

On the basis of recommendations from this audit, along with those from the Royal College of Psychiatrists and NICE guidelines, a more comprehensive psychiatric service was developed to meet this demand and therefore manage risk more effectively.

RESULTS

Over the course of a year, the new service attracted a higher rate of referrals of pregnant women with severe and enduring mental illness. The majority referral source continued to be midwifery-led.

CONCLUSIONS

Audit is a useful tool for evaluating and informing service development and helped us identify further improvements needed to deliver an effective mental health service.