Mental Health Policy: Implications for Infants and Families
Mental Health Policy: Implications for Infants and Families
The mental health of mothers directly affects the health of newborns and children; however, this fact frequently receives little attention. This article explores the prevalence of critical mental health issues related to pregnancy, postpartum, and parenting; the failure of the health care delivery system to meet these needs; the state of mental health policy; and actions and interventions needed to improve care through policy development and nursing care.
On June 20, 2001, Andrea Yates, a mother of 5 children, ages 6 months and 2, 3, 5, and 7 years, confessed to drowning all 5 children in her bathtub. In her confession Mrs. Yates stated, "That, I had drowned my children." Throughout the trial, this story was on the front pages of most newspapers, and the trial resulted in a guilty verdict. How could a mother kill all of her children, one after another, by forcing them under the water in the bathtub? This is not the only case of a mother killing her children, nor will it be the last. This case of tragic proportions is another signal that we are not meeting the complex health needs of many women who are mothers or will be mothers. Why should mental health policy be of importance to neonatal nurses who seem to be very removed from psychiatric care? Nursing has moved more and more toward a solid recognition that care of those in need means that nurses cannot just focus on one part of a person's health or one specialty. Patients found in clinics, hospitals, and the community rarely come for help with one problem. The following are some examples of situations that many nurses encounter daily as they practice.
This list of examples is only a short list of the many problems that health care providers must cope with in a variety of health care settings. Women who are pregnant and new mothers are not immune to mental health problems. Under normal circumstances, this is a very stressful time. Add a pregnancy, and a woman with a past history or present problem of mental illness or substance abuse now has complex problems. On April 29, 2002, President Bush established the New Freedom Commission on Mental Health to address the nation's problems in delivering mental health care and to improve access to quality, effective mental health care. The President's timely decision to create this commission has great relevance to mothers, infants, and young children, as well as to fathers. This article explores the prevalence of critical mental health issues related to pregnancy, postpartum, and parenting; the failure of the health care delivery system to meet these needs; the state of mental health policy; and what needs to be done to improve care through policy development and interventions.
The mental health of mothers directly affects the health of newborns and children; however, this fact frequently receives little attention. This article explores the prevalence of critical mental health issues related to pregnancy, postpartum, and parenting; the failure of the health care delivery system to meet these needs; the state of mental health policy; and actions and interventions needed to improve care through policy development and nursing care.
On June 20, 2001, Andrea Yates, a mother of 5 children, ages 6 months and 2, 3, 5, and 7 years, confessed to drowning all 5 children in her bathtub. In her confession Mrs. Yates stated, "That, I had drowned my children." Throughout the trial, this story was on the front pages of most newspapers, and the trial resulted in a guilty verdict. How could a mother kill all of her children, one after another, by forcing them under the water in the bathtub? This is not the only case of a mother killing her children, nor will it be the last. This case of tragic proportions is another signal that we are not meeting the complex health needs of many women who are mothers or will be mothers. Why should mental health policy be of importance to neonatal nurses who seem to be very removed from psychiatric care? Nursing has moved more and more toward a solid recognition that care of those in need means that nurses cannot just focus on one part of a person's health or one specialty. Patients found in clinics, hospitals, and the community rarely come for help with one problem. The following are some examples of situations that many nurses encounter daily as they practice.
A 16-year-old girl comes to the clinic 4 months pregnant and abusing drugs.
A pregnant woman tells the nurse that she has a history of depression.
A pregnant woman is taking an antidepressant and wants to breastfeed.
A 17-year-old pregnant girl has a history of suicide attempts and an eating disorder.
A woman comes in for her postpartum examination and is distant, anxious, and complaining of a screaming baby.
A pregnant woman comes in for an appointment during her 7th month, and the nurse observes that she has bruises on both arms. The woman says her husband hit her.
A pregnant woman's partner leaves her and her 2 children. She is now homeless and has a history of alcohol abuse, and she has not been eating regularly so that her children can eat.
Parents are coping with a premature infant and having difficulties. The mother has a past history of depression.
This list of examples is only a short list of the many problems that health care providers must cope with in a variety of health care settings. Women who are pregnant and new mothers are not immune to mental health problems. Under normal circumstances, this is a very stressful time. Add a pregnancy, and a woman with a past history or present problem of mental illness or substance abuse now has complex problems. On April 29, 2002, President Bush established the New Freedom Commission on Mental Health to address the nation's problems in delivering mental health care and to improve access to quality, effective mental health care. The President's timely decision to create this commission has great relevance to mothers, infants, and young children, as well as to fathers. This article explores the prevalence of critical mental health issues related to pregnancy, postpartum, and parenting; the failure of the health care delivery system to meet these needs; the state of mental health policy; and what needs to be done to improve care through policy development and interventions.
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