Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-27T21:28:19.172Z Has data issue: false hasContentIssue false

2 - Antenatal and postnatal mental health

from I - Disorders

Published online by Cambridge University Press:  02 January 2018

Rehan Ahmed Siddiquee
Affiliation:
Birmingham and Solihull Mental Health NHS Foundation Trust
Clare Oakley
Affiliation:
King's College London
Azghar Ali
Affiliation:
Birmingham and Solihull Mental Health NHS Foundation Trust
Clare Oakley
Affiliation:
Institute of Psychiatry, King's College London
Floriana Coccia
Affiliation:
University of Birmingham
Neil Masson
Affiliation:
NHS Greater Glasgow and Clyde
Iain McKinnon
Affiliation:
National Institute for Health Research, Newcastle University
Meinou Simmons
Affiliation:
Cambridge and Peterborough Foundation Trust
Get access

Summary

Setting

The audit is specific to the specialty of perinatal psychiatry yet is relevant to all psychiatrists, as well as midwives and primary care professionals. It relates to out-patients.

Background

The National Institute for Health and Clinical Excellence (NICE) has produced guidelines on the prediction, detection and management of mental illness among pregnant women (including but not exclusively concerning those with established mental illness) and also the criteria for referral to perinatal psychiatric services.

Standards

The following standards come from the NICE guidelines Antenatal and Postnatal Mental Health (National Institute for Health and Clinical Excellence, 2007):

ᐅ Healthcare professionals should ensure that adequate systems are in place to ensure continuity of care and effective transfer of information, to reduce the need for multiple assessments.

ᐅ At a woman's first contact with services in both the antenatal and the postnatal periods, healthcare professionals (including midwives, obstetricians, health visitors and general practitioners) should ask about:

  • ▹ past or present severe mental illness, including schizophrenia and bipolar disorder

  • ▹ psychosis in the postnatal period and severe depression

  • ▹ previous treatment by a psychiatrist or specialist mental health team, including in-patient care

  • ▹ a family history of perinatal mental illness.

  • ᐅ If the woman has, or is suspected of having, a severe mental illness, she should be referred to a specialist mental health service.

    Method

    Data collection

    Data were collected from referral letters or referral forms received by the perinatal service. The referral letter and forms were examined to see if the following information was present.

    ᐅ information regarding the reason for referral, e.g. reasons for suspecting a mental illness

    ᐅ details of past psychiatric history

    ᐅ current risk factors for mental illness.

    Data analysis

    The percentages of referrals that met each of the three standards mentioned above were calculated.

    Resources required

    People

    It is recommended that two or three people conduct the audit, which is suitable for multidisciplinary involvement.

    Time

    Around 3–4 weeks should be allowed for data collection and analysis.

    Results

    The frequencies with which the different types of information were recorded in the referral letters and forms are given in the table below, for both an initial and a re-audit performed 1 year later.

    Type
    Chapter
    Information
    Publisher: Royal College of Psychiatrists
    Print publication year: 2011

    Access options

    Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

    Save book to Kindle

    To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

    Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

    Find out more about the Kindle Personal Document Service.

    Available formats
    ×

    Save book to Dropbox

    To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

    Available formats
    ×

    Save book to Google Drive

    To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

    Available formats
    ×