Summary of the case: In Mosjøen, they have a unique treatment offer where mothers with postpartum depression can take their baby with them during admission. Psychologist Malin Olsen Johansen believes that mothers who are not separated from their infants have a shorter and less severe course of illness. In the whole of Norway, there are only two beds where a mother can bring her baby with her during treatment; one in Orkdal in Trøndelag, the other in Mosjøen in Nordland. A lack of such services can lead to mothers being admitted to emergency psychiatry, where they are not allowed to bring their baby with them, which can worsen the condition. Olsen Johansen believes that there should be such offers as in Mosjøen at all district psychiatric centers in Norway. The Directorate of Health has been commissioned by the Storting to investigate the need for a treatment center where the mother can be with the child in case of severe postpartum depression. (The summary is made by an AI service from OpenAI. The content is quality assured by news’s journalists before publication.) Postpartum depression affects many thousands of Norwegian women every year. More than every ten women. Nevertheless, there is almost no inpatient care in Norway where a mother is allowed to bring her newborn child with her. Johansen says all experience shows that mother and infant should not be separated. – We do know that the mothers who are not separated from their infant have a shorter and less serious course of illness, says psychologist specialist at Helgeland’s hospital, Malin Olsen Johansen. In the whole country, there are only two beds where a mother can bring her baby with her. Both at district psychiatric centres. One in Orkdal in Trøndelag, the other in Mosjøen in Nordland. – The offer here is primarily distinguished by the fact that you can bring your baby into the ward. I have not been successful in finding other such offers in mental health centers in Norway today. So it stands out. Recently, news told about Julianne Joakimsen Rydberg, who experienced becoming so ill when she had her first child in 2019 that it was about to go completely wrong. Julianne missed an admission to psychiatry. But what she experienced has made her get involved in the case. – Terribly heavy The psychologist in Mosjøen is also engaged. – I have seen how terribly heavy it has been for women hospitalized with postpartum depression to have the burden of being separated from their baby as an additional factor. Facts about postpartum depression: – The cause is not clear-cut. Postpartum depression is a general term for mental disorders that occur in the perinatal phase. That is, from conception to approx. one year after birth. Postpartum depression affects between 7 per cent and 13 per cent of women who give birth (Stewart, 2016). In Norway, this means that between 4,000 and 8,000 women develop postpartum depression each year. There are great variations in the picture of the disease. For some, it will be enough to, for example, visit a GP and participate in maternity groups. For others, psychiatric treatment is necessary. The cause of postpartum depression is not clear. (source Helgelandssykehuset/psychologist specialist Malin Olsen Johansen and FHI) She herself had a hand in the game when St. Olav’s hospital took the lead in 2018 and created the offer. This year she started the same offer in Mosjøen. Malin Olsen Johansen is a psychologist specialist at the adult psychiatric inpatient ward in Mosjøen. Photo: Private – Mother is admitted together with infant and partner in our ward. And then they are placed in a separate house or a separate apartment in the area. She says that the mother can take turns going between the adult ward and the house the family lives in. And then the psychiatry for adults and children work together to provide the best possible treatment. The turnout has been great despite the fact that they have not been particularly active in talking about the offer in Orkdal and Mosjøen. – We have also received inquiries from other health regions. Actually also from Eastern Norway. She emphasizes that you will be offered treatment regardless of where you live in the country if it is serious enough. – But the difference between the offer we have and the rest is that we offer to bring a baby into the ward. CLOSE COLLABORATION: Psychologist specialist Erlend Lorentzen at the Inpatient Department for Children, Youth and Families in conversation with Malin Olsen Johansen at the DPS Inpatient Department for Adults Mosjøen. Infant and toddler teams can have interaction guidance, while in the inpatient ward for adults they treat the mother. Photo: Stine Skipnes/Helgelendingen Shortage in the rest of the country The offer of own beds where the mother can bring the baby with her is therefore in short supply in the rest of the country. As a result, the only offer is often admission to emergency psychiatry. The mother is not allowed to bring her baby there. For those who are admitted to emergency room, it is often “a confirmation of the feeling of being a bad mother”, she explains. – You just want to go home to your baby. There is a lot of shame and guilt associated with being ill, and leaving the responsibility to those at home. This can lead to the patient being discharged, but coming back in, sicker than the first time, she explains. If the mother is admitted to the emergency department, it is important that mother and infant are reunited as soon as possible, according to Malin Olsen Johansen. She says that having a mother or father depressed after childbirth can lead to abnormal development in the infant. – Can admission to emergency psychiatry be avoided if there had been such services as in Orkdal and Mosjøen? – There is reason to assume that. If you manage to come in with treatment as early as possible. Norwegian Psychiatric Association: Emergency psychiatry is not always the right place Photo: Thomas B. Eckhoff / Den norske legeforening Leader of the Norwegian Psychiatric Association, psychiatrist Lars Lien, says this about the fact that there are only two such services in Norway: – I think that says something about how neglected perinatal psychiatry is both in the professional field, but also by the authorities. – Can it be harmful for mother and child to separate? – Yes, especially if it happens over a longer period of time. It is not only about connection, but also about getting milk production started with all the important elements involved. – What does emergency psychiatry want for these patients? – I believe that emergency psychiatry wants the best, but today’s wards with high occupancy and patients with many different diagnoses and behaviors are not always the right place to create good perinatal mental health. A good alternative, if possible, could be follow-up by the mental health team in the municipality and an experienced psychologist, says Lars Lien. Will there be a plan in the new year In 2023, the Directorate of Health was commissioned to “investigate the need for a treatment center where the mother can be with the child in case of severe postpartum depression” It was the majority in the Storting that instructed the ministry to investigate this. In the letter from the ministry, it is specified that “there are few or no such offers (…) as of today in Norway”. The Directorate of Health’s response to the questions from news: Photo: Rebecca Ravneberg Director of Department Torunn Janbu in the Directorate of Health says in an e-mail to news that they are not aware of individual services in the health regions. – In any case, it is nice to hear about healthcare services that people are satisfied with, she says. – Is this the future and if so when will more such offers be put in place? – This question must be asked of the RHFs who are responsible for the health service provision. – You are working on investigating the need for similar offers – what can you say about it and when will you finish “answering” the Storting on this? – The report was completed in August this year, and submitted to HOD. – Today, most women with severe postpartum depression have to be admitted to the emergency department without their child – is this an offer that is good enough? – It is the Norwegian Health Authority that can assess this, says Torunn Janbu in the Directorate of Health. The Ministry of Health and Care refers to the National Health and Cooperation Plan which will be presented in the new year. – We are concerned that pregnant women, women about to give birth and new parents should have as good and safe an experience of the birth and maternity services as possible, State Secretary Karl Kristian Bekeng told news in November. He is positive about the development of the new treatment options. A mother can get sicker without her child In a number of other countries, such as Great Britain, Australia and France, mother-child wards in psychiatry are considered “best practice”. There are integrated maternity and psychiatric units. We don’t have that in Norway. Landsforeningen 1001 days: – Hope the model is rolled out nationally Photo: PRIVATE Landsforeningen 1001 days works with mental health during pregnancy and after birth. – We are very happy that such offers are finally being developed. We are excited to hear from women who have used the offer to find the good balance again. – Mental illness in this phase of life can develop quickly. It is therefore positive that those who need treatment receive an offer that includes the whole family and thus reduces the total burden. It goes without saying that two such offers in Norway are not enough, emphasizes general secretary for 1001 days, Lena Yri Engelsen. And adds: – We hope that this model will be rolled out nationally. – Political will, resources and a solid boost in knowledge are needed. In order for women and their unborn/newborn children and families to be met well enough, it is essential that health personnel are trained in perinatal mental health and work interdisciplinary, says Lena Yri Engelsen in 1001 days to news. Olsen Johansen says it can worsen the mother’s condition if she has to be admitted to emergency without her baby. Adult psychiatric inpatient department, DPS Mosjøen. The inpatient department for adults has treatment responsibility for the mother, while the infant and toddler team at the inpatient department for children, youth and families (BUP) is responsible for babies and measures aimed at the family. Photo: Privat/Tor Espen Forsmo – These depressions are not just ordinary depression. If we only treat the mother in isolation, the results are worse than when we treat the mother and child together. Today, it is coincidence that determines what kind of offer you get, she believes. – I would definitely say that it is bingo. It is about who you meet and what expertise they have both in the municipalities and in the specialist health service. She is already researching the treatment method and will take a doctorate in this. Will research to find out if the Orkdal model works Helgeland’s hospital and St. Olav’s hospital are now starting a “multicentre study” to investigate if the Orkdal model works in practice. Those behind it want the offer to be spread to the rest of the country. Malin Olsen Johansen is affiliated with the research group “Clinical psychology” at UiT and is now applying for funding for a doctorate. This is a national project in which several institutions collaborate: UiT and NTNU, and St. Olavs and Helgeland Hospital. – What do you think that this is what we have to offer today, that there are only two beds? – No, I think it’s terribly sad. Our experience is that it is absolutely necessary. And that we achieve good collaboration across adult and child psychiatry. Ideally, there should have been such offers as in Mosjøen at all district psychiatric centres, Malin Olsen Johansen believes. – It should be possible to bring about similar cooperation basically everywhere. It’s a bit about prioritization.
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– A unique offer – news Nordland
