Factors leading to the onset and continuity of illnesses and the course of the illness and the process of recovery may show differences in males and females. These differences can be related to the differences in roles and responsibilities attributed to men and women as well as the biological factors such as sex- specific structure and functioning of our body as a man and a woman.
Domestic violence and sexual abuse are additional sources of stress that affect a significant proportion of women. Women and children constitute the vast majority of people affected by terrorism, civil wars, disasters and forced migration which are still important problems of our age.
For women of childbearing age, periods of both biological and social change, such as menstrual cycles, pregnancy, postnatal, maternal and menopausal transition, are particularly risky periods in which the need for increased sensitivity is felt more.
Depressive, anxiety and stress related physical complaints from mental illnesses occur more frequently in women, and in parallel with the high rates of violence and abuse exposure, post-traumatic stress symptoms are higher in women. On the other hand, a woman with mental illness needs a special support before and during pregnancy and at postnatal period.
All these sensitivities and negativities necessitate a different look and attention when providing women with health services. For this reason, we are addressing women's mental health exclusively, and we strive to offer different support and treatment to women who have mental health problems. However, we are aware that the support provided during treatment is not sufficient alone. For this reason, we are trying to raise awareness by attracting attention to this area both at the level of healthcare providers and at the public level.
We are making efforts to raise awareness on maternal mental health, especially at the community level, because; One out of every 5 female is experiencing a mental health problem during the first year after pregnancy or after having children. Most of them cannot talk to anyone about it and they are suffering quietly. Most women do not tell anyone about what they are experiencing with the concern of what they will think or do. They worry that others will think that she is a weak or bad mother or they will take their children. These concerns prevent getting the help and support that they need.
Maternal psychiatric illness during pregnancy and postpartum is a high risk in terms of affecting emotional, mental, social and physical development in child. These problems increase anxiety, depression, lack of attention, retardation of learning, bad performance in school and criminal behavior. These adverse effects on children can persist until adulthood.
Most of the mother suicides that occurred in the last 20 years are preventable maternal deaths.
Unfortunately, 20% to 25% of pregnancies result in miscarriages or stillbirth. Subsequently, these may lead to mourning symptoms for the mother. Some of these women may also experience postpartum depression following miscarriages or stillbirth.
Parents who are in the process of infertility treatment are also in need of mental health support. However, they are often neglected by the intensity of the process.
Bringing a premature child, or staying in a baby's newborn intensive care unit for a long time can also negatively affect mother’s mental health.
In all these processes, the more the relatives, friends and family of the mother and father are informed and aware, the quicker and more effective the seek for help and proper care will be ensured.
In the context of providing health services; it is obvious that a special effort has been made in terms of services for women in our country. There have been developments such as increasing literacy rates, encouraging small businesses, preventing early mothers, reducing maternal and infant mortality and birth rates, and educating health personnel and parents about antenatal care. Despite significant achievements, women need to be supported for their ability to overcome the problems, roles, and health issues in society. More attention needs to be paid especially to mental disorders related to pregnancy and childbirth.
Regulations and investments made in other countries, especially in the health system for maternal and infant mental health, demonstrate the importance of this issue: In many developed countries there are action plans for the detection,training and treatment of mental disorders associated with pregnancy and childbirth. Especially early diagnosis and treatment for postpartum depression have been accepted as priority and programs have been initiated for them. In the United States, routine screening is performed at the 6th week of postpartum, and this scan is covered by insurance. In England, it is necessary to screen by midwives after 4 weeks of postpartum. In America, a mental action plan activity for mothers under the MOTHERS Act was started in 2007. In 2007, the UK NICE guideline also included depression into the guidelines for antenatal care. In Australia, between 2001-2005 the Postpartum Depression Research Program was implemented. The Israeli Public Health Ministry has been screening all women under state control during pregnancy (about 32 weeks) and in the postpartum period (about 8 weeks) using the Edinburgh Postpartum Depression Scale since January 2013.
Mather-baby units have been established in many countries of the world, especially in England, France and Australia, and mothers in these units can continue their care without having to leave their baby.
The UK government reported that by 2015, the budget for the next 5 years will be £ 280 million, which means that mothers with mental illness during pregnancy and 1 year after birth will receive better care.
We are also continuing to work in our country to get similar applications both at the level of health care delivery and at the social level, to get mental support and help for mothers and fathers.