The biggest challenge in perinatal mental health is not financial resources, lack of treatment options, lack of trained talent.
They are all big challenges yes - but the reason we cant address those is because there is a first stumbling block - lack of awareness of the issue.
"no, this does not happen here - you are bringing a western issue to India"
"billions of women have gone through pregnancy and child birth before"
"dont put ideas in these women's heads, they are happy as they are"
"we have done it all - happily, without any epidural, without fuss, all by ourselves"
As a result of these attitudes, despite a 20% ish prevalence of perinatal depression and its well-researched adverse effects on the mother and the child's development, perinatal mental health challenges often go undiagnosed. Instead, symptoms such as fatigue, irritability, mood changes are attributed to lack of sleep, and the “usual” challenges of motherhood. Its all "baby blues" after all.
Awareness of maternal mental health issues is not just for the mothers. Her partner/husband and immediate family needs to be aware of the risks and the benefits of a supportive environment for her during this period. Husband's mental health issues are also important here.
Psychology and social work graduates (and post graduates) are coming out of colleges without understanding the basics of perinatal mental health and child development issues. Doctors may graduate with only a bio-medical perspective on the issue (more on this later).
Policy makers are also not aware of these deep public health implications of this lack of awareness (and the other challenges in this field highlighted in the opening paragraph).
A mental health component should be incorporated as an integral part of maternal health policies, plans and activities. Self care practices, educating the family in creating a wholesome environment, nutrition, sleep and rest - all go a long way in bolstering perinatal mental health.
Thunai has developed various awareness and education sessions for students, health care workers and for mothers and their families. Please get in touch if you would like to know more.