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Perinatal mental health and COVID-19: Navigating a way forward
Katharine A Smith1,2,3, Louise M Howard4, Simone N Vigod5,6
1Department of Psychiatry, University of Oxford, Oxford, UK.
Insights
The COVID-19 pandemic worsened perinatal mental health, increasing anxiety and depression. New guidance is crucial for clinicians and patients navigating limited access and exploring telepsychiatry options.
Area of Science:
- Perinatal mental health
- Epidemiology
- Public health
Background:
- The COVID-19 pandemic exacerbated existing inequalities, significantly impacting perinatal mental health.
- Perinatal mental disorders, already underdiagnosed and undertreated, faced magnified challenges due to reduced access to psychiatric and obstetric services and restricted in-person contact.
- Increased rates of perinatal anxiety and depressive symptoms were observed during the pandemic.
Purpose of the Study:
- To highlight the urgent need for clear guidance in perinatal mental health for patients and clinicians.
- To assess the available resources and identify gaps in guidance, particularly concerning new variants and ongoing infection rates.
- To explore the potential of telepsychiatry and hybrid models in addressing challenges in perinatal mental healthcare.
Main Methods:
- Systematic search of available guidance resources on perinatal mental health during the pandemic.
- Review of existing evidence on telepsychiatry in general mental health.
- Analysis of challenges related to care planning, varying infection rates, and access to services.
Main Results:
- A paucity of comprehensive guidance was found, with existing resources primarily focusing on the acute pandemic phase.
- Telepsychiatry presents a viable solution for maintaining access to care amidst social restrictions and offers integration with digital technologies.
- There is a need for further research into the specific application of telepsychiatry within perinatal mental health.
Conclusions:
- Clinicians require specialized training to implement hybrid care models, blending in-person and remote assessments effectively.
- Coordinated efforts and updated guidance are essential for prevention, treatment, risk assessment, and symptom monitoring in perinatal mental health.
- Addressing wider issues of care planning amidst variable global health conditions is critical for equitable perinatal mental healthcare.
Abstract:
The COVID-19 pandemic and its aftermath have increased pre-existing inequalities and risk factors for mental disorders in general, but perinatal mental disorders are of particular concern. They are already underdiagnosed and undertreated, and this has been magnified by the pandemic. Access to services (both psychiatric and obstetric) has been reduced, and in-person contact has been restricted because of the increased risks. Rates of perinatal anxiety and depressive symptoms have increased. In the face of these challenges, clear guidance in perinatal mental health is needed for patients and clinicians. However, a systematic search of the available resources showed only a small amount of guidance from a few countries, with a focus on the acute phase of the pandemic rather than the challenges of new variants and variable rates of infection. Telepsychiatry offers advantages during times of restricted social contact and also as an additional route for accessing a wide range of digital technologies. While there is a strong evidence base for general telepsychiatry, the particular issues in perinatal mental health need further examination. Clinicians will need expertise and training to navigate a hybrid model, flexibly combining in person and remote assessments according to risk, clinical need and individual patient preferences. There are also wider issues of care planning in the context of varying infection rates, restrictions and vaccination access in different countries. Clinicians will need to focus on prevention, treatment, risk assessment and symptom monitoring, but there will also need to be an urgent and coordinated focus on guidance and planning across all organisations involved in perinatal mental health care.
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