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Decision-making about management

Who should be involved?

Managing mental health disorders is collaborative.  After diagnosis of a mental health disorder, primary care professionals play a critical role in providing information, monitoring, potential referral, support and care.

Specific mental health expertise is required to develop a management plan for women with more severe symptoms.

It is important to refer to or consult a psychiatrist if a woman has the following risk factors or symptomatology:

Refer to or consult a psychiatrist if a woman has:
Passed history of severe mental health disorder including bipolar disorder or puerperal psychosis
Marked changes in mood, thoughts, perceptions and behaviours that may indicate puerperal psychosis or bipolar disorder
Severe depression and/or anxiety
Significant risk of suicide or harm to herself, the infant or other children
Moderate depression in the presence of significant risk factors
Continued inability to manage despite supports being mobilised
No improvements after treatments (e.g. psychological therapy, medication)
Other issues requiring ongoing therapy (e.g. trauma, grief, loss)

Selecting appropriate management options

The choice of treatments will depend on the woman’s disorder, her preferences and the health professional’s training, skills and experience.

Relevant contextual factors include ongoing psychosocial factors, ethnicity and cultural background, age and demographic situation.

To inform decision-making, women should be given relevant and culturally appropriate information about treatment options, with full discussion of their suitability and acceptability to her and her significant other(s).