The term "perinatal period" is the time in family life from the beginning of a pregnancy (the antenatal period) through to the birth and baby's infancy (the postnatal period).

Perinatal mental health refers mainly to the mental health and well-being of a parent or care-giver, often the mother.

Infant mental health is about the developing baby - from birth to age three – and the baby's ability to experience, express and deal with emotions, form close and secure relationships with others and explore their environment and learn about the world. For the baby, their development happens in the environment and influence of family, community and cultural expectations for young children. It is a time of huge growth and development. Good mental health of parents and care-givers and responsive care-giving of their infant is very important for the growth and development of the infant.

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Why Perinatal and Infant Mental Health (PIMH)?

As well as being a time of great excitement and joy for most families, some parents may experience changes in mood or mental health concerns following childbirth. It is well recognized that becoming a parent for the first time or receiving a new member into the family can be a very stressful time for all. It is also well recognized that these stressful periods (sometimes called periods of transition) can leave people more vulnerable to social and health challenges.

Most families adjust well; some women have a higher risk of experiencing a mood disorder during pregnancy or following childbirth. Women with pre-existing mental health disorders may experience a relapse or recurrence of their condition during this period. Mental disorder or illness occurring at this time may have an adverse effect on the parent, their partner and family and on the future development of the infant.

Women who have experienced an episode of bipolar illness or severe depression are estimated to have a one in two to one in three chance of illness relapse following childbirth. Men are also at greater risk of depression postnatally if their partner is depressed.

Because of this, more and more health and community services are developing ways of better supporting families and assisting families to access services sooner. More help is available in these times, within Northern Sydney Local Health District Services and in the local community.

PIMH is part of the 'core business' of many services including Maternity and Child and Family Health Services; Adult and Child and Youth Mental Health Services; Drug and Alcohol Services; GPs; Non-Government Organisation support programs and Child Wellbeing/Child Protection services.

How does Northern Sydney Local Health District (NSLHD) support perinatal and infant mental health of families in the perinatal period?

The primary services best known for assisting families during pregnancy and shortly after birth are:

  • Women's, Children's andFamilies Health (who provide pregnancy , birthing / Maternity Services);  and
  • Child andFamily Health Services (including Child and Family Health Nurses; sometimes called Early Childhood Nurses who work in Early Childhood Centre's.

SAFE START / Supporting Families Early

SAFE START is a NSW Health policy initiative, aiming to improve the health outcomes of NSW families. Emotional and psychological care are included as a routine part of antenatal and postnatal care (together known as perinatal care) and identify early any family social and mental health vulnerabilities in pregnancy and the early postnatal period. Every family choosing to receive care from NSLHD Maternity Services and Child and Family Health Services will be offered the chance to talk about social and psychological factors which may be affecting them during the perinatal period. Midwives and Child and Family Health Nurses include some questions about mental health and social circumstances as part of routine assessment and care of every patient.  

Women and families may choose to not participate in this discussion. However, research has shown that most women find this type of care very supportive during the perinatal period.

When vulnerabilities are identified, options for support are discussed with and offered to the family. As well, some more complicated family situations are confidentially discussed with a larger specialist group of clinicians, who may suggest additional ways to support the family (called the SAFE START meeting).  The aim is to offer families access to more expertise, provide coordinated care to families from all NSLHD Services that focuses on family needs and enhances family strengths. Privacy and information exchange legislation is strictly adhered to.

Other Perinatal and Infant Mental Health (PIMH) Services

Secondary services in NSLHD

A range of clinicians work in partnership with and accept referrals from midwives and child and family health nurses including social workers, psychologists, occupational therapists, speech therapists, paediatricians and mental health nurses. The best way to access these services is to talk first with the Midwife (antenatally) or Child and Family Health Nurse (postnatally) providing your care.

Tertiary services in NSLHD

Mental Health Services, Child and Youth Mental Health Services and Drug, Alcohol and Gambling Services are also available in NSLHD in the perinatal period; these services participate in the SAFE START meetings with Maternity and Child andFamily Health Services and are able to accept referrals.

Mental Health Services provide Psychiatry clinics in Maternity Services at Hornsby, Manly and Royal North Shore Hospitals. As well, a community based Perinatal and Infant Mental Health Team (currently funded to June 2015) provide care to families where severe and complex parental mental illness is impacting on the family's ability to care for their infant.

The following link will take you to a list of services in Northern Sydney Local Health District with contact and access information.

http://www.nslhd.health.nsw.gov.au/services  

Mental health care available in the community

Many families receive all of their health care from the family General Practitioner (GP). Your GP is also able to discuss psychological or mental health concerns during the perinatal period and refer you to mental health care available in the community. The Access to Allied Psychosocial Services (ATAPS) program enables GPs to discuss mental health concerns with the person, create a Mental Health Care Plan and refer eligible persons to a mental health care provider in private practice. If the person's situation meets the referral criteria, there is no cost to the person as the Federal Government meets the cost for a set number of sessions.

People living in the Hornsby, Ku-ring-gai, Ryde and Hunters Hill Local Government Areas can access Northern Sydney Medicare Local's website for more ATAPS information: http://www.nsml.com.au/programs-services/mental-health

People living in the Lane Cove, North Sydney, Willoughby, Mosman, Manly, Warringah, Pittwater Local Government Areas can access Sydney North Shore and Beaches Medicare Local for more ATAPS information: http://www.snsbml.org.au/Programs/Mental-Health/ATAPS.aspx

Other services in the community offering support to families

Not all challenges in the perinatal period are about mental health and require treatment. Many community based services and non-government organisations provide families with support programs specifically designed to reduce everyday stress, help make community connections and networks and provide information and skills. One of the easiest ways to find out about the services and programs available in your local community is by asking your local Child and Family Health Nurse or visiting your local community or neighbourhood centre.

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Perinatal and Infant Mental Health services are available at:

  • Maternity Services across NSLHD
  • Child and Family Health Services across NSLHD
  • Mental Health Services across NSLHD

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Perinatal and Infant Mental Health Coordinator / SAFE START Consultation Liaison Worker: 02 8877 5159

or contact your local
Maternity, Child and Family Health or Mental Health Service.