Unit of Perinatal Mental Health

The Perinatal Mental Health Unit (USPM) at the Hospital Clínic treats women with a mental disorder, whether previous or new onset, known as a perinatal mental disorder (PMD). PMDs include all those mental disorders that women have during pregnancy and/or the first 12 months postpartum, and in particular those specific to the perinatal stage such as postpartum depression, postpartum psychosis, bonding disorders due to maternal mental pathology, postpartum post-traumatic stress disorders and perinatal disorders associated with perinatal grief.

The Perinatal Mental Health Unit currently has two healthcare facilities, the Outpatient Clinic, which attends patients from the Barcelona Esquerra Integrated Health Area and the Mother-Baby Day Hospital, which treats patients from all over Catalonia.

Perinatal Mental Disorders (PMDs) have been highlighted in recent years as a major public health issue, due to their impact on the health and quality of life of women and their children in both the short and long term. The urgent need to improve their detection, prevention, and specialized treatment has been emphasized.

It is estimated that 1 in 5 women will experience a mental disorder during pregnancy and/or postpartum, with depression being the most common complication of pregnancy. Women with a history of mental disorders are also at high risk during this period. PMDs require a multidisciplinary and specialized model of care with shared evidence-based decision-making, in order to implement a Personalized Intervention Plan centered on the mother–fetus/neonate dyad.

The perinatal stage involves additional complexity for women with mental disorders, both due to the impact of maternal illness and the exposure to psychotropic medication or other therapeutic interventions (electroconvulsive therapy, hospitalizations) during pregnancy and breastfeeding.

The Perinatal Mental Health Unit (PMHU) currently has two care facilities: an Outpatient Clinic that serves patients from the Barcelona-Esquerra Integrated Health Area, and the Mother-Baby Day Hospital, which admits patients from across Catalonia. The Day Hospital has 10 places for mothers and 10–12 for babies, with an average stay of about three months. To serve more mothers and adapt schedules to different needs, the stay can be partial or full-time, extending capacity to 20 places. This way, 60 mothers and their babies can be treated each year.

The care for different mental disorders managed by the PMHU is organized into three main areas:

Axis 1: Perinatal stage at which consultation is requested (4):

• Family planning in women with a mental disorder.

• Care and follow-up during pregnancy, childbirth, and postpartum in women with a mental disorder.

• Diagnosis and intervention in the postpartum stage (up to 12 months after delivery).

• Perinatal bereavement.

Axis 2: According to the mental disorder and severity, three programs have been developed:

• Care and intervention program for Postpartum Depression.

• Program for women with Bipolar Disorder and/or Postpartum Psychosis (BiPPSI Program).

• Program for women with High-Complexity Pregnancy and/or Postpartum.

Axis 3: Hospital-based consultation:

• Joint Visit Program for Mental Health and Maternal-Fetal Medicine.

• Hospital consultation for Perinatal Psychiatry.

• Consultation for Health Psychology.