More than 600 Australian women each year suffer crippling pregnancy-related psychosis, but many states do not have hospital beds to treat the condition.
An ABC investigation has found some states and territories are poorly resourced when it comes to helping women deal with postpartum psychosis.
NSW, Tasmania and the Northern Territory are the worst, with no dedicated public hospital beds for helping new mothers with the debilitating condition.
In other states, advocates say there are few beds and long waits for treatment.
Post-partum psychosis, or puerperal psychosis, is the most extreme form of post-natal depression.
It has long been recognised as a condition and affects about one in every 500 mothers.
It can develop during pregnancy or in the months following giving birth.
Experts say there are a number of theories about its causes including genetic predisposition, underlying conditions, hormone changes, sleep cycle interruptions and inflammation.
Women who develop the condition often need hospitalising. In those cases, the best option is special care that allows them to bring their baby into hospital so they can continue to bond with the child.
Advocates have used Postnatal Depression Awareness week this week to reissue their call for better treatment services for women and children.
Pregnancy psychosis a ‘psychiatric emergency’
Professor Philip Boyce heads the Perinatal Psychiatry Clinical Research Unit at Sydney’s Westmead Hospital.
He said when women developed postpartum psychosis it was a psychiatric emergency and women needed to be admitted to a proper facility.
“[The psychosis] may take a variety of forms; she will often have hallucinations, hearing voices and have false ideas,” Professor Boyce said.
“One of the things we do know is that if these women have very strong false beliefs about the baby, they may actually do harm to the baby and that is a terrifying thing for them.”
Professor Boyce said NSW did not have the capability to admit the mother and baby together in a psychiatric facility.
He said he had been told it was impossible because of safety and cost, despite other states having beds.
There are 12 private hospital beds in NSW but they are only available to those with insurance.
“We would love to be able to treat mother and keep their baby with them so we don’t break up the mother-baby relationship,” Professor Boyce said.
“Not to be able to have their baby with them, it can be devastating for women.”
Health experts concerned women are reluctant to come forward
Psychiatrists are also concerned women with the condition are reluctant to come forward because they are worried they will lose their child, something beds would resolve.
“The important thing is getting women into psychiatric care so they can get appropriate treatment,” Professor Boyce said.
“It is very much a hidden experience. It’s very easy to treat if we can get the treatments in place appropriately.”
Professor Boyce has called for four to six-bed mother-and-baby units scattered across the state that link with services.
“It’s a very cost-effective model for treatment, it will save money in the long run.”
NSW Mental Health Minister Jai Rowell said women who needed perinatal care could get it through public mental health inpatient units and private hospitals.
The Government also funded a specialist statewide outreach service which brought specialist mental health expertise to women and their families living in remote, rural and regional areas.
“NSW delivers perinatal and infant mental health services across the state which provide hospital in-reach and specialist consultation for mothers who may be admitted to a variety of inpatient units for mental health care,” he said.
“They also provide assertive in-home mental health care for mothers following transition from hospital and family and community-focused specialist mental health care which involves the woman’s partner, children and other relevant family members.”
‘My brain felt like it exploded’
Tessa Staines was a happily married woman two weeks from delivering her first son when her brain started yelling explicit thoughts at her.
“I just woke up one morning and my head was just kind of filled with intrusive thoughts and I didn’t know what they were or how to get rid of them and I was really kind of scared,” she said.
“I really just thought my brain felt like it exploded.”
The intrusive thoughts were loud and disturbing and she sought help from her GP.
They diagnosed postpartum psychosis brought on by a combination of hormones and stress.
It was a shock to the young Maitland mum who had never heard of the condition.
Ms Staines spent her first months as a mum on anti-depressants until the thoughts resolved.
Her son Cooper is now aged six.
“I was really just quite upset just thinking that that dream of being a mum and that experience was just going to be really different for me,” she said.
“If Cooper wasn’t awake or I wasn’t busy doing things, it was in that stillness where it really took off and I couldn’t rest my mind at all.
“I was still thinking about Cooper and learning how to bath him then I also had these intrusive thoughts so it was almost in a sense like two sides of my brain.”
About a year after Ms Staines’s second child, daughter Matilda, stress and hormone changes brought the condition back with a vengeance.
This time she needed the help of a psychiatrist and anti-psychotics to resolve the symptoms.
But it was not without side effects, including significant weight gain.
“I never would have thought that being pregnant or having a baby would have caused this to happen to me.”
Mothers worried they will be viewed as incompetent
Dr Nicole Highet, the executive director of the Centre of Perinatal Excellence in Victoria, said there was a lot of fear among women about disclosing their symptoms because they were worried they would be viewed as incompetent.
“There’s huge stigma around perinatal health generally,” she said.
“People have very high expectations that having a baby is going to be a wonderful experience. People fear they will be judged against that.”
Dr Highet said Western Australia set the standard for care with a state-of-the-art public mother and baby mental health unit.
NSW, Tasmania and the Northern Territory had no public beds and Queensland was planning on beds.
A spokeswoman for Northern Territory Health said the territory was too small in population to deliver the full range of options available in larger jurisdictions.
“Inpatient care for perinatal depression is available in Darwin and Alice Springs within mainstream mental health wards where mother and babies specific needs are accommodated.”
Victoria and South Australia had a limited number of beds but they could be difficult to gain access.
“Overall there certainly is a shortage. Unfortunately often there’s quite long waiting lists for people to be able to access these units,” Dr Highet said.
“There needs to be a big focus on holistic care and where possible keeping mother and baby together.”