The role of health visitors in postnatal depression

Most health professionals working with women and their families around the time of childbirth are by now aware that having a baby leads to a greatly increased risk of mental illness and emotional distress. Women with puerperal psychosis and severe depression are likely to be identified as needing psychiatric help, but they are unfortunately only the tip of the iceberg. This chapter concentrates on the role of the health visitor in relation to the needs of women whose depressions have until recently remained unrecognized. They are a large group; at least one in every ten women develops clinical depression in the months after delivery. They are also an important group, not only in terms of personal suffering but because they have direct responsibility for other vulnerable members of the community. Without help or treatment, postnatal depression can not only mar a woman's experience of herself as mother, it can affect her infant's social and cognitive development. Her other children may be affected, also her relationship with her partner. The consequences may be long-term and expensive both on an individual level and in terms of health care.