All women who have recently given birth should be assessed for mental health problems, the National Institute for Health and Clinical Excellence is recommending.
NICE is calling on general practice staff to assess the mental health of all women who have recently given birth, as fears some may be left unsupported. It warns that some symptoms of mental health problems, such as changes to appetite or sleeping patterns, can be masked by what is considered normal for pregnant and postnatal women.
NICE proposes that the routine six-week postnatal appointment could provide an opportunity for new mothers to be asked about their mental health.
The Institute has launched a consultation outlining potential new indicators for inclusion in the NICE indicator menu, which includes the proposal for an indicator on postnatal mental health. NICE indicators seek to support GPs and CCGs by identifying areas of care that should be focused on to improve local and national health.
It states that women are at increased risk of anxiety and depression in the post-natal period with 15-20% of women experiencing symptoms in the first year after childbirth. Anxiety disorders such as panic disorder, generalised anxiety disorder (GAD), obsessive - compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and tokophobia (an extreme fear of childbirth), can occur on their own or coexist with depression.
Guidance recommends that during the postnatal period women should be assessed for mental health conditions and referred for specialist care where necessary.
NICE says that clinical commissioning groups (CCGs) should record how many women with a suspected mental health problem during pregnancy or the postnatal period receive a comprehensive mental health assessment. If a woman is referred, it should be recorded how many of these women then gain access to psychological services within six weeks.
Dr Andrew Black, GP at and deputy chair of the NICE indicator advisory committee said: “GPs play a vital role in helping vulnerable people to get the correct diagnosis and the support they need.
“These indicators, put forward by NICE, could help GPs to identify and support their patients who are most at risk. This can only be a good thing.”
Professor Daniel Keenan, associate medical director, Manchester University Hospitals and chair of the NICE indicator advisory committee, said: “Indicators are a key part of NICE’s drive to improve people’s lives, enhance the quality of care in the NHS and use its resources wisely.
“The indicators in this consultation are not final. And I would strongly encourage everyone with an interest in the development of evidence-based indicators to tell us their views. Your feedback will help us finalise the NICE indicator menu in August.”