More support needed for perinatal mental health: psychiatrist
Dr. Archana Vidyasankar receives 30 to 35 referrals a month
CORNER BROOK — As the province’s only perinatal psychiatrist, Dr. Archana Vidyasankar feels the pressure every day of meeting the needs of mothers and fathers who are experiencing mental-health problems during pregnancy or the first year postpartum.
Vidyasankar operates a private practice in St. John’s and is a clinical assistant professor in psychiatry, obstetrics and gynecology at Memorial University. She is chair of the Perinatal Mental Health Alliance of Newfoundland and Labrador and co-chair of the provincial task force on perinatal mental health.
Wednesday, May 1, is World Maternal Mental Health Day and the alliance and task force are launching a survey on www.pmhanl. com to gain insight into the struggles faced by birthing parents and their supports in the perinatal period.
It’s estimated that 28 per cent of new parents will experience a perinatal mood and anxiety disorder. That means approximately 1,000 births per year in this province may result in mental illnesses that could benefit from support and treatment.
Vidyasankar receives between 30 and 35 referrals a month. Her wait list used to be one month and now it’s four.
She has patients from all over the province, from Labrador to the west coast and central and from rural and urban areas who meet with her either in person or virtually via video.
“As a psychiatrist, I see people whose mood and anxiety are causing disruptions day to day.”
Most often they are people who have already sought help through their primary care provider or obstetrician. They are people who may need medications to manage their severe anxiety or depressive symptoms, who have PTSD from childbirth or have experienced complex grief and loss.
“So, when it gets to be unmanageable, it’s interfering with their relationships. They’re not able to let others care for their children because they’re so anxious about what could happen. I see it when it gets to its worst, unfortunately,” she said.
Even before a woman conceives, her mental health can be affected by the struggle to do so and infertility. For those going through in vitro fertilization (IVF) it is a lifechanging experience filled with conversations, travel, treatments and a financial burden.
“Yet there’s no dedicated counsellors or therapists to help navigate that. We are about to change the lives for families here at a such crucial point and it’s the highest time of risk for mood and anxiety disorders. And we still don’t have mental-health supports during this time,” said Vidyasankar.
It’s that lack of support that Vidyasankar said shows a disparity in this province between physical health and mental health.
Someone who is diagnosed with diabetes has an entire team around them to offer care, education, support and followup, while so many women and men who require perinatal mental-health care struggle to get the support they need.
“It’s not right that we will treat physical health differently than mental health,” she said.
Because the province has few supports. Vidyasankar is left to do what she can.
“I love getting referrals
bothernsmde and it so much at the same time that so many people are in need.”
She said it’s sad, but she’s glad they’re seeking help.
There are other psychiatrists and counsellors who see perinatal patients, but it is not their primary focus. Accessibility to help is a factor in terms of cost, and geography can be a hinderance for many. There are general counsellors within the health-care authorities who Vidyasankar said are amazing but who don’t have specific training.
“When you have that specific training, I think it makes the most impact,” she said.
The Perinatal Mental Health Alliance of Newfoundland and Labrador and the Canadian Perinatal Mental Health Collaborative are working to make people more aware of perinatal mental health, where to get help and providing that help. The groups support programs and initiatives that support new parents.
“So, we’re increasing the conversation, but we’re not quite yet matching the supports that we need to support one another and what people actually need,” Vidyasankar said.
Increasing supports is something the provincial task force is trying to do.
The task force is about a year and half into its five-year mandate.
“We have the next two years to really understand what is happening in the province, what people need and what they’re looking for in the province and then make those recommendations,” she said.
Advocating for more training of practitioners, curriculum changes, and educational sessions for nursing staff at the medical school and for licensed practical nurses are all on her agenda.
“We need multidisciplinary shared-care approaches to this, she said.
Vidyasankar is hopeful the government will listen to those recommendations and put some things in place before the five years is up.