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Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, due to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk. These consensus guidelines aim to provide pragmatic advice regarding these issues. They are divided into sections on risks of untreated illness in pregnancy; general principles of using drugs in the perinatal period; benefits and harms associated with individual drugs; and recommendations for the management of specific disorders.

Farmers are subject to a number of unique occupational stressors, many of which have been aggravated in recent years by changes in farming practice and by economic factors. These are probably part of the explanation for the high rates of suicide in farmers and farm workers, which in the UK account for the largest number of suicides in any occupational group. Suicide is usually associated with mental illness, which, in farming communities, appears to be particularly stigmatized and poorly understood. This affects health-seeking behaviour, which is compounded by the geographical isolation and inaccessibility of many services in rural areas. Our current understanding of these issues suggests a number of potentially valuable interventions.

No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.

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