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Monday, April 29, 2013

Post partum depression as a child protection issue

Post partum depression (PPD) occurs in about 20 - 25% of women after giving birth. Some level of the "baby blues" might well occur in larger numbers. The risks of PPD are that women can then go on to experience longer term depression or, in a small number of cases, go on to post partum psychosis. The latter can often be quite dangerous as it can include risks of suicide and homicide. It tends to be a psychiatric emergency.

PPD has the potential to interfere with the attachment process between mother and child. It can reduce the mother's desire to interact with the baby and to provide stimulation (physical and emotional).

The good news is that it is highly treatable. A review by The Cochrane Library has shown that some very simple interventions can make a significant difference.

The piece of their extensive review showed that one intervention that is simple to manage and effective is peer support. Simply having someone touch base and ask, "How are you doing?" makes a difference. In essence, it is someone who just cares, is there and allows for the expression of a mother's true feelings. This can be a major preventative tool that reduces PPD. The Cochrane review found this to be the case.

The research also found that home visits by such people as community nurses are beneficial. Interpersonal psychotherapy was also valuable.

When we reduce PPD, we improve the situation for families which in turn will reduce the need for child protection intervention. What is most appealing about the results of this research is that we do not need to build new and elaborate programs. Peer or lay support by phone works. Keeping up with nursing post delivery visits work. And, when needed, access to basic mental health support.

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