Background:
Women with a serious mental illness (SMI) are at high risk for pregnancy and birth complications that increase childhood neurodevelopmental risks (Jablensky et al. 2005). Lifestyle hazards, such as smoking, use of street drugs and poor nutrition, as well as failure to access antenatal care, have been implicated in this increased risk. However, evidence from the relevant literature suggests that during pregnancy, many women with SMI continue their contact with mental health services.
Purpose:
With a primary prevention focus, the purpose of this project was to develop an antenatal intervention package for community mental health clinicians as a strategy to reduce risks and improve the reproductive health outcomes for women with SMI.
Methods:
A qualitative exploratory study involved consultation with key stakeholders, an environmental scan to determine current service delivery issues and a review of the literature. Individual and focus group interviews were undertaken with community mental health clinicians, consumers and midwives.
Results:
An antenatal programme of care, including clinical guidelines and information regarding antenatal care and support services to facilitate the role of community mental health clinicians as advocates for their pregnant clients, has been developed. Additional outcomes include an education package to up-skill clinicians in using the resource, a surveillance system to identify at-risk cases and an information system to enable evaluation of the impact on obstetric and child health outcomes.
Conclusion:
This primary preventive intervention has the potential to significantly improve obstetric and neonatal outcomes for this high-risk cohort.
