scholarly journals Psychological services for women giving birth in a large Irish tertiary referral maternity unit

2011 ◽  
Vol 35 (3) ◽  
pp. 92-94 ◽  
Author(s):  
Aileen McAuliffe ◽  
Noirin E. Russell ◽  
Joanne Fenton

Aims and methodTo investigate whether women were being asked about their current and previous mental health, and where risk factors for perinatal mental health problems were identified, to determine whether appropriate referral occurred. Individual case-note review was performed on women where present or past mental health problems were indicated.ResultsIn two-thirds of women where a history of mental health problems was indicated at the booking clinic this was not addressed in their obstetric case notes. Of the women who reported being depressed, nearly a third had no reference to this in their obstetric case notes and only 40% were referred to the Mental Health Liaison Clinic (MHLC). Two-thirds of the women who indicated a history of postnatal depression had no further comments documented in their obstetric case notes. One case of bipolar affective disorder and one case of puerperal psychosis were identified on booking questionnaires and neither had any comments documented in the obstetric case notes. In total 16% of women who reported a history of mental health problems were referred to the MHLC.Clinical implicationsMore robust procedures for the identification and management of perinatal mental health risk need to be implemented.

Mental health problems during and immediately after pregnancy are a major concern across the world. As well as affecting the health of the mother, they can have significant, harmful, and long term effects on the infant if not dealt with effectively. Perinatal Psychiatry honors the work of Channi Kumar, one of the seminal figures in the history of perinatal psychiatry, and presents a comprehensive multidisciplinary review of the field. Bringing together the leading researchers in the area, it covers the causes of perinatal mental health problems, the biology of perinatal depression and its more extreme form, puerperal psychosis, as well as psychosocial and psychological interventions, hormonal and neural substrates of perinatal depression, and risk factors and epidemiology.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045356
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  

ObjectiveIdentify predictors of clinical deterioration in a virtual hospital (VH) setting for COVID-19.DesignReal-world prospective observational study.SettingVH remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (postaccident and emergency (A&E) or medical intake assessment) or postinpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care during VH follow-up and for 2 weeks post-VH discharge.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 postinpatient) were included in the analysis. 76 (8.4%) of these experienced clinical deterioration (15 deaths in admitted patients, 3 deaths in patients not admitted and 58 additional inpatient admissions). Predictors of clinical deterioration were increase in age (OR 1.04 (95% CI 1.02 to 1.06) per year of age), history of cancer (OR 2.87 (95% CI 1.41 to 5.82)), history of mental health problems (OR 1.76 (95% CI 1.02 to 3.04)), severely impaired renal function (OR for eGFR <30=9.09 (95% CI 2.01 to 41.09)) and having a positive SARS-CoV-2 PCR result (OR 2.0 (95% CI 1.11 to 3.60)).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to confirm our findings and identify the reasons for increased risk of clinical deterioration associated with cancer and mental health problems.


2021 ◽  
pp. 34-52
Author(s):  
Kay Wilson

Chapter 2 examines the historical development of mental health law in England (which is similar to the rest of the common law world, including America, Canada, and Australia) and uses that history to consider the justification, purpose, and need for mental health law from Ancient Greece to the present. Contrary to the claims of abolitionists that mental health law has essentially always stayed the same, it demonstrates a history of continuous legal and systemic reform in mental health law. Rather than an over-zealous and interfering state keen to exercise social control over persons with mental impairment, it instead depicts a state which for the most part reluctantly only became involved in the care of persons with mental health problems when informal care by family and friends failed or was non-existent, to prevent abuses by private operators, and as an incident of its administration of the criminal law. When set against the background of the fashions, cycles, and recurring themes of mental health law, the call of abolition can be conceptualized as simply the latest fad in its evolution. Further, many of the issues which arise from mental health problems will continue to exist even without mental health law. Mental health law can be positive and negative, including defining and protecting rights and allocating resources. The chapter cautions against being too optimistic about the promises of sweeping revolutionary changes which have never really delivered (deinstitutionalization or the ‘abolition’ of the asylum being the most poignant example), in favour of solid incremental change.


2019 ◽  
Vol 50 (5) ◽  
pp. 827-837 ◽  
Author(s):  
Elizabeth Spry ◽  
Margarita Moreno-Betancur ◽  
Denise Becker ◽  
Helena Romaniuk ◽  
John B. Carlin ◽  
...  

AbstractBackgroundMaternal mental health during pregnancy and postpartum predicts later emotional and behavioural problems in children. Even though most perinatal mental health problems begin before pregnancy, the consequences of preconception maternal mental health for children's early emotional development have not been prospectively studied.MethodsWe used data from two prospective Australian intergenerational cohorts, with 756 women assessed repeatedly for mental health problems before pregnancy between age 13 and 29 years, and during pregnancy and at 1 year postpartum for 1231 subsequent pregnancies. Offspring infant emotional reactivity, an early indicator of differential sensitivity denoting increased risk of emotional problems under adversity, was assessed at 1 year postpartum.ResultsThirty-seven percent of infants born to mothers with persistent preconception mental health problems were categorised as high in emotional reactivity, compared to 23% born to mothers without preconception history (adjusted OR 2.1, 95% CI 1.4–3.1). Ante- and postnatal maternal depressive symptoms were similarly associated with infant emotional reactivity, but these perinatal associations reduced somewhat after adjustment for prior exposure. Causal mediation analysis further showed that 88% of the preconception risk was a direct effect, not mediated by perinatal exposure.ConclusionsMaternal preconception mental health problems predict infant emotional reactivity, independently of maternal perinatal mental health; while associations between perinatal depressive symptoms and infant reactivity are partially explained by prior exposure. Findings suggest that processes shaping early vulnerability for later mental disorders arise well before conception. There is an emerging case for expanding developmental theories and trialling preventive interventions in the years before pregnancy.


2019 ◽  
Vol 29 (10) ◽  
pp. 18-20
Author(s):  
Jane Fisher

Jane Fisher, a community psychiatric nurse, describes her experience of perinatal mental health problems after the birth of her third child, the treatment and interventions she received from the health service and her personal journey to recovery


2016 ◽  
Vol 22 (4) ◽  
pp. 354 ◽  
Author(s):  
Thi Nguyen ◽  
Sarah Dennis ◽  
Huy An ◽  
Sanjyot Vagholkar ◽  
Siaw Teng Liaw

Objective The aim of the present study was to determine the prevalence of psychological distress among Vietnamese adults attending Vietnamese-speaking general practices and explore possible risk factors in this population. Methods A cross-sectional survey of Vietnamese adult patients was conducted at 25 general practices with Vietnamese-speaking general practitioners (GPs) in south-western Sydney between October 2012 and February 2013. Patients completed the Kessler (K10) scale and a demographic questionnaire, available in Vietnamese or English. Data were analysed using SPSS version 21. Results Of the 350 patients invited to participate, 247 completed surveys (response rate 71%). One-quarter (25%) of participants had a very high K10 score for psychological distress, nearly twice that reported in the NSW Health Survey. Participants with high exposure to trauma were at increased risk of psychological distress (odds ratio 5.9, 95% confidence interval 2.4–14.4; P < 0.0001) compared with those with mild or no trauma exposure. Similarly, risk was increased if there was a past history of mental health problems and a lack of personal and social support. Conclusion The high prevalence of mental health problems in adult Vietnamese people attending Vietnamese-speaking general practices is associated with exposure to trauma. This highlights the importance of personal, social and professional support in effective management. Vietnamese-speaking GPs who see Vietnamese or similar refugee groups should actively seek out a history of exposure to trauma, a past history of mental illness and the existence of support systems.


Midwifery ◽  
2013 ◽  
Vol 29 (2) ◽  
pp. 122-131 ◽  
Author(s):  
Louise Seimyr ◽  
Barbara Welles-Nyström ◽  
Eva Nissen

2020 ◽  
Vol 2 (6) ◽  
pp. 94-100
Author(s):  
Saba Khurshid ◽  
Sidra Mumtaz ◽  
Hafsa Khalil Toor ◽  
Rubina Hanif

The outbreak of COVID-19 pandemic is constantly posing warning and creating mental health crisis among people without any discrimination. Therefore, the current study purpose is to explore mental health upheaval and transition in future perspectives due to COVID-19. Using exploratory study design, semi structure interviews were conducted. Interviews were recorded, transcribed and analyzed by using Thematic Content Analysis. The major themes which were identified showed that COVID-19 is constantly eliciting panic and mental health issues such as anxiety, stress, and depression, fears of death, xenophobia, OCD and uncertainty about future among general population. Results also indicated the major transition in public future perspectives and perception. Concern related to adjustability in life after pandemic is major emerging future concern among Pakistani People. During pandemic outbreak, people are becoming vulnerable to different mental health problems. To overcome these issues successfully, role of mental health professionals cannot be denied. There is strong need to devise activities and strategies which help people to increase resilience and build strong relationships during the period of social distancing. This paper gives a deep insight into mental health problems among general population due to COVID-19 and it also implicates need of psychological services to overcome these issues.


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