Antenatal and postnatal mental health (MH) is an important issue to be addressed by health services, as this affects the stability of pregnancy and postpartum care of the mother and newborn and child development. Many women with mental disorders and mental distresses have difficulty getting pregnant and giving birth due to the symptoms, and they are prone to psychosocial problems, such as unwanted or unexpected pregnancy, non-cooperation of their partners and families, economic poverty, and inadequate obstetric self-management. In this way, when practicing maternal MH, it is necessary to grasp both 'sickness' as a mental disease and 'caseness' as a psychosocial problem, and to plan comprehensive support.
However, inter-professional work to support MH of pregnant women has many practical difficulties. The reasons for this include three collaboration failures: (1) differences in expertise between mental and perinatal care providers, and conflicts between mental and maternal and child health services; (2) the relocation of support, resulting in the loss of significant information on mothers and children and the interruption of intervention for them; (3) the moving of patients back to their family home based on the Japanese custom, which is known as 'Returning home'.
In order to overcome such collaboration difficulties, I produced an MH cooperation model in Matsudo City of Chiba Prefecture. The cooperation model has two inter-professional networks. One is characterized by linking the medical institution network with the regional council on countermeasures for Children Requiring Aid in the city, promoting the sharing of information among medical institutions including obstetrics/pediatrics/psychiatry with the council. In the other network, psychiatrists directly provide technical assistance to public health nurses for improved maternal and child health care. The advantage of the cooperation model in Matsudo City is the ability of psychiatric clinics to participate in this network.
<Author's abstract>
Inter-professional Work with Mental, Maternal, and Child Health Care Providers in Matsudo City, Japan
Gakujikai Kimura Hospital Center for Forensic Mental Health, Chiba University
Psychiatria et Neurologia Japonica
120: 52-59, 2018
<Keywords:antenatal and postnatal mental health, illness and caseness, inter-professional work>