Appropriate responses to assessments, identifying treatments, actions and providers of support/treatment services for women experiencing perinatal depression, anxiety, bipolar disorder and puerperal psychosis.
The following is a useful guide for appropriate responses to assessments, identifying treatments, actions and providers of support/treatment services for women experiencing perinatal depression, anxiety, bipolar disorder and puerperal psychosis.
Risk or symptoms of mental health disorder
| Treatment | Actions | Who |
|---|---|---|
Treatment Psycho-education |
Actions Discuss mental health and offer sign-up to the Ready to COPE Guide. |
Who Ready to COPE - www.readytocope.org.au |
Treatment Community support |
Actions Give details of support groups, early parenting centres etc |
Who Primary or community care professional or services can be found on the COPE Directory. |
Treatment Lifestyle advice |
Actions Provide advice on sleep, relaxation and physical activity. |
Who |
Previous history of mental health disorder including mild to moderate symptoms of depression/anxiety in the perinatal period
| Treatment | Actions | Who |
|---|---|---|
Treatment Psychosocial support |
Actions Assist with accessing support (e.g. family, peer support). |
Who See community support listed services on the COPE Directory. |
Treatment Monitoring and review |
Actions Consider possible puerperal psychosis/bipolar disorder and referral to psychiatrist. |
Who Primary or community care professional (see COPE Directory). |
Treatment |
Actions Arrange monitoring if symptoms escalate. |
Who |
Mild to moderate depression
| Treatment | Actions | Who |
|---|---|---|
Treatment Psychosocial support |
Actions Provide information on self-help strategies |
Who See community support listed services on the COPE Directory. |
Treatment Non-directive counselling |
Actions Take an empathetic and woman-centred approach. |
Who Primary or community care, mental health nurse, psychologist, psychiatrist (see COPE Directory). |
Treatment Psychological therapy |
Actions Consider CBT, IPT or psychodynamic therapy. |
Who Search the COPE Directory for psychological treatment providers. |
Treatment Medication |
Actions Consider in combination with psychological therapy. |
Who |
Treatment Mother-infant psychotherapy |
Actions Refer to perinatal and infant mental health specialist if there are difficulties with mother-infant interaction. |
Who Search the COPE Directory for mother-infant treatment providers. |
Severe depression
| Treatment | Actions | Who |
|---|---|---|
Treatment Medication |
Actions Consider as a first step and in combination with psychological therapy. |
Who |
Treatment Psychological therapy |
Actions Consider CBT and IPT based on the individual's ability to engage in psychological therapy. |
Who Psychiatrist, psychologist, perinatal/infant mental health specialist. Search the COPE Directory. |
Treatment Mother-infant psychotherapy |
Actions Refer to perinatal and infant mental health specialist if there are difficulties with mother-infant interaction. |
Who Search the COPE Directory for mother-infant treatment providers. |
Anxiety disorder
| Treatment | Actions | Who |
|---|---|---|
Treatment Psychological treatment |
Actions Mild-moderate - consider CBT or IPT and self-help strategies. |
Who Search the COPE Directory for psychological treatment providers. |
Treatment Medication (see Table 1) |
Actions Moderate-severe - consider medication including short-term use of benzodiazepines while awaiting onset of action of SSRI. |
Who Primary or community care, psychologist, mental health nurse, psychiatrist. Search the COPE Directory. |
Treatment Mother-infant psychotherapy |
Actions Refer to perinatal and infant mental health specialist if there are difficulties with mother-infant interaction. |
Who Search the COPE Directory for mother-infant treatment providers. |
Bipolar disorder/puerperal psychosis
| Treatment | Actions | Who |
|---|---|---|
Treatment Referral |
Actions Refer for urgent specialist mental health assessment and inpatient admission. |
Who |
Treatment Medication |
Actions Prescribe medication. |
Who Psychiatrist, psychologist, inpatient care probable. |
At all times when mental health problems are identified, consider the potential impact on the mother and infant interaction.
Note: CBT= Cognitive Behaviour Therapy; IPT=Interpersonal Psychotherapy
