Collaboration and integrated services for perinatal mental health: an integrative review

Abstract

Background: An integrative review was undertaken to synthesise the research related to professionals’ perceptions and experiences of working in collaborative and integrated models of perinatal care for women with mental health problems. Method: A search of the databases CINAHL, Medline, PubMed, Psychinfo and Scopus was conducted. Studies were limited to English language papers published from 2000 to 2010. Fourteen papers were included in the review. Results: The overarching theme identified in the review related to the process of ‘making it happen’. Eight key elements were identified as central components of this process: funding and resources for collaboration; shared vision, aims and goals; pathways and guidelines; continuity of care; building relationships and trust; role clarity; training and education of staff and support to work in new ways. Conclusion: Perinatal mental health is an emerging field that is particularly challenging as it requires professionals to work across disciplines and timeframes, where there is a risk of dichotomising care, compounding existing barriers to service uptake. Professionals need resources and to feel supported to change clinical practice and work in more collaborative ways. The voices of women and families are missing in the literature.

Maternal mental health and risk of child protection involvement: mental health diagnoses associated with increased risk

“…Services often have a narrow focus and clientele, and families with parental mental health issues have members with a range of needs17 creating a need for service collaboration and integration 18 19. The prevalence of mental health issues within child protection families highlights the importance of collaborative case management of child safety concerns.…”

Maternal Deaths in NSW (2000–2006) from Nonmedical Causes (Suicide and Trauma) in the First Year following Birth

“…Thirdly, there is a weaning of support services as the months from birth increase and a hesitancy for women to seek assistance for mental health issues or to use mental health services [33, 34]. Fourthly, for women who already have a diagnosis or are known to psychiatric services, many services within this setting cease at the 9–12-month point postpartum [35, 36], and finally, for some women the provision of services simply does not meet their individual needs due to a lack of coordination and integration among services [37]. These findings highlight the need for early identification and extended postpartum services for “at-risk” women, such as those with mental health and/or substance abuse issues.…”

The role and competence of midwives in supporting women with mental health concerns during the perinatal period: A scoping review

“…The review process identified 30 papers that met inclusion criteria (see Table ). Included studies regard the knowledge, skills and attitudes of midwives (Hauck et al., ; Higgins et al., ; Jones, Creedy, & Gamble, , ,; Lau, McCauley, Barnfield, Moss, & Cross, ; Legere et al., ; Mathibe‐Neke, Rothberg, & Langley, ; McCauley et al., ; Noonan, Doody, Jomeen, & Galvin, ; Noonan et al., ; Ross‐Davie, Elliott, Sarkar, & Green, ; Rothera & Oates, ), and student midwives (Higgins, Carroll, & Sharek, ; Jarrett, , ; Phillips, ); the effectiveness of educational interventions in improving knowledge and skills (Davies et al., ; Fenwick, Toohill, Slavin, Creedy, & Gamble, ; McLachlan, Forster, Collins, Gunn, & Hegarty, ; Reed, Fenwick, Hauck, Gamble, & Creedy, ); the delivery of counselling or psychosocial interventions by midwives (Clarke, King, & Prost, ; Fenwick et al., , ; Larsson, Karlström, Rubertsson, & Hildingsson, ; Toohill et al., ); and barriers and enablers to embedding midwife‐led mental healthcare in practice (Bayrampour et al., ; Fenwick et al., ; Gamble, Toohill, Slavin, Creedy, & Fenwick, ; Higgins et al., ; Myors, Schmied, Johnson, & Cleary, ; Myors et al., ).…”