Urgent Reforms Needed for Perinatal Mental Health Care in Australia

In November 2023, Rachel Skillington's cousin, Sarah Skillington, tragically died by suicide just 13 days after giving birth, highlighting critical gaps in perinatal mental health care in Australia. At the time of her death, Sarah was receiving treatment at Mitcham Private Hospital's Perinatal Mental Health unit, a facility designed to support new mothers experiencing mental health challenges. However, an inquest led by Coroner David Ryan revealed significant failures in her care, including a likely misdiagnosis of anxiety instead of the more severe postpartum psychosis.

Postpartum psychosis, affecting approximately 1-2 in 1,000 mothers, presents complex symptoms that can confound clinicians. Despite being a recognized psychiatric disorder, it is often underdiagnosed or misdiagnosed due to overlapping symptoms with anxiety disorders. Dr. Emily Carter, a psychiatrist specializing in maternal mental health at the University of Melbourne, states, "Timely diagnosis and treatment are crucial, yet many practitioners lack the training to recognize the severe signs of postpartum psychosis."

The inquest revealed that Sarah was only seen by a psychiatrist once during her four-day stay at the hospital, and before she could receive further evaluation, she succumbed to her mental health challenges. This tragic incident underscores a broader issue within the Australian healthcare system, where perinatal mental health remains underfunded and undervalued.

According to the Australian Institute of Health and Welfare, mental health conditions are among the most common complications of pregnancy and childbirth. Nonetheless, the system's response often fails to adequately support new parents. The PANDA National Perinatal Helpline, for instance, does not operate on weekends, forcing families like Sarah’s to navigate crises without immediate assistance.

Experts argue that systemic changes are essential to prevent similar tragedies. Dr. Liam Thompson, Director of Mental Health Services at Melbourne Health, emphasizes the need for a coordinated approach: "There must be a seamless transition between maternity and mental health services to ensure continuity of care for new parents. This is vital for early intervention and support."

Further compounding these challenges is a lack of public awareness regarding perinatal mental health. Many prospective parents receive minimal education on the mental health challenges they may face, contributing to a stigma that discourages individuals from seeking help. Dr. Fiona Lee, a psychologist at the Women’s Health Research Institute, adds, "Educational resources must be improved to equip families with the knowledge needed to recognize and respond to mental health issues during the perinatal period."

Despite recent efforts by the Australian government to address mental health funding, many advocates argue that these measures remain insufficient. Rachel Skillington, who has experienced the devastating loss of her cousin, calls for urgent reforms: "We must prioritize mental health care within the maternal health system. Mental health should not be an afterthought."

Looking ahead, stakeholders in the healthcare sector must work collaboratively to enhance funding, training, and resources dedicated to perinatal mental health. As the system currently stands, it fails to meet the complex needs of new mothers and their families. Without significant changes, the tragic story of Sarah Skillington may be repeated, underscoring the urgent need for a comprehensive approach to perinatal mental health care in Australia.

For those in crisis, support is available through the PANDA Helpline at 1300 726 306, Lifeline at 13 11 14, and Beyond Blue at 1300 224 636. In emergencies, individuals are urged to call 000.