Guidance Issued For Antenatal And Postnatal Mental Health Disorders

The National Institute of Health and Clinical Excellence (NICE) has published guidance which is the first of its kind to make specific recommendations on the identification, treatment and management of all mental health disorders in antenatal and postnatal women.

It is estimated that one in seven women experience a mental health disorder in the antenatal or postnatal period. The document includes recommendations on anxiety disorders, depression, eating disorders, bipolar disorders, schizophrenia and obsessive compulsive disorder.

Guidance Recommendations

• Antenatal and postnatal women should be asked by their healthcare professionals about their mental health on a regular basis to detect existing and new mental health disorders. In order to identify possible mental health disorders three questions that should be asked are 1) During the last month, have you often been bothered by feeling down, depressed or hopeless? 2) During the last month, have you often been bothered by having little interest in pleasure in doing things? 3) Is this something you feel you need or want help with?
• A woman has the right to be fully informed about all aspects of her treatment and make decisions in partnership with her healthcare professional. She can ask any questions, and information should include details of possible benefits and risks of particular treatments.
• If a woman is pregnant or breast feeding, her doctor should discuss with her the risks of taking or not taking medication to treat her illness at every stage, to help her come to a decision.
• Women requiring psychological treatment should be seen normally within one month of initial assessment, and no longer than three months afterwards.
• If a women does not have a specific mental illness, but is feeling down or anxious, she should be offered support from professionals, voluntary organisations or other services to help manage her feelings during pregnancy or after birth.
• Healthcare professionals should assess and address the needs of the woman’s partner and family members, including the welfare of the infant and other dependent children and adults. They should also assess and address the impact of any mental disorder on relationships with her partner and other family members.
• There should be clearly specified care pathways so that all primary and secondary healthcare professionals involved in the care of women in the antenatal and postnatal periods are aware how to access appropriate assessment and treatment.
• Managed clinical networks should be established across the whole country, to ensure access to perinatal expertise. This should include a specialist multidisciplinary perinatal service in each locality, which provides direct services, consultation and advice to maternity services, other mental health services and community services and pathways of care for service users.

The full guidance, Antenatal and postnatal mental health, can be downloaded from the NICE website