Dáil Éireann - Volume 630 - 31 January, 2007

Written Answers. - Mental Health Services.

Mr. McCormack asked the Minister for Health and Children the safeguards in place to protect the welfare of children when mothers commit infanticide due to psychological problems, that is, postnatal depression. [2192/07]

  Mr. B. Lenihan: Many women in immediate post-partum will experience emotional changes sometimes described as the baby blues. While distressing, this is usually transitory and responds well to family support and encouragement. In a small number of cases, a more sustained and significant psychiatric disorder can be expected, two thirds of which can be described as affective (mood) disorder with significant depression or periods of elation, one third of which may take on a psychotic aspect. Nursing staff in maternity hospitals would be familiar and alert to this phenomenon and mothers to be would be advised of same in antenatal preparation classes. The family support and follow up visits by primary healthcare professionals, General Practitioner and Public Health Nurse, act as a support and guidance to new mothers and would be alert to symptoms of post-natal distress or depression.

The three Dublin hospitals Rotunda, Coombe and Holles Street have four sessions of dedicated consultant psychiatry each and these work in close liaison with community based mental health services to provide specialist intervention when required. With the development of liaison psychiatry similar arrangements are available to other maternity hospital outside Dublin. The recently opened Elmount Unit in St Vincent’s has 3 mother and child beds so that a mothers mental health needs can be addressed without disrupting the important bonding process between mother and baby. Similar facilities are available in acute inpatient setting nationally. If there is any clinical indication, concern or risk to the health and welfare of the child, mental health professionals will intervene to support and treat the mother’s illness while ensuring the child’s safety needs are met. [576] For women who have experienced post-natal mental health difficulties, subsequent pregnancies are managed in collaboration with local mental health services and occasionally it is possible to begin a treatment regime before the delivery with due regard to the impact of medication on the developing foetus.

Under the Child Care Act, 1991 the Health Service Executive (HSE) is responsible for promoting the welfare of children who are not receiving adequate care and protection. One of the major principles underlying policy in this area is that a child should, in so far as possible and having regard to his or her safety and welfare, be cared for within their own home. Family support programmes are provided by services such as the Community Mothers, Family Support Workers, Teen Parents Support Projects, and Springboard Projects and encompass specific interventions such as Parents Plus programme and the Family First Parenting Initiative, as well as a range of general parenting programmes and supports.

Under the Child Care Act, 1991 children can be taken into the care of the HSE, and placed in foster care or residential care, in accordance with the Child Care Regulations, 1995. In the case of women with post-natal mental health difficulties where clinical indication suggest any significant risk to the baby or other children, HSE child care services may provide for short term fostering with supervised access until the mother’s mental health has been restored.