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. 2021 Aug 29;18(17):9122.
doi: 10.3390/ijerph18179122.

Current Issues within the Perinatal Mental Health Care System in Aichi Prefecture, Japan: A Cross-Sectional Questionnaire Survey

Kei Fujita  1   2 , Tomomi Kotani  1   3 , Yoshinori Moriyama  1   4 , Takafumi Ushida  1 , Kenji Imai  1 , Tomoko Kobayashi-Nakano  1 , Noriko Kato  5 , Takeo Kano  6 , Fumitaka Kikkawa  1 , Hiroaki Kajiyama  1
Affiliations

Current Issues within the Perinatal Mental Health Care System in Aichi Prefecture, Japan: A Cross-Sectional Questionnaire Survey

Kei Fujita et al. Int J Environ Res Public Health. .

Abstract

Mental illnesses commonly occur in the reproductive age. This study aimed to identify the issues that exist within the perinatal mental health care system. A cross-sectional survey was conducted in Aichi Prefecture in central Japan. Questionnaires on the situation between 2016 and 2018 were mailed to the head physicians of 128 maternity care units, 21 neonatal intensive care units (NICUs), and 40 assisted reproductive technology (ART) units. A total of 82 (52.6 per 100,000 births) women were admitted to mental health care units during the perinatal period, and 158 (1.0 per 1000 births) neonates born to mothers with mental illness were admitted to NICUs. Approximately 40% of patients were hospitalized in psychiatric hospitals without maternity care units. Eighty-four (71.1%) and 76 (64.4%) maternity care units did not have psychiatrists or social workers, respectively. Moreover, 20-35% of the head physicians in private clinics, general hospitals, and ART units endorsed the discontinuation of psychotropic drug use during pregnancy. However, the corresponding figures were only 5% among those in maternal-fetal centers. Resources for perinatal mental illness might be limited. Perspectives on psychotropic drug use differed based on the type of facilities where the doctors were working.

Keywords: multidisciplinary; preconception; psychotropic drugs.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The system of maternity care units in Aichi Prefecture. Most maternity care was provided by private clinics. The map was created by Japanese Map Maker (https://www.start-point.net/maps/map_maker/Public Day (accessed on 8 October 2020 18:39:43) (last updated on 8 October 2020 20:29:51).
Figure 2
Figure 2
The annual number and prevalence of women admitted to mental health care units during the perinatal period. The number of admissions in 2018 (73.6 per 100,000 births) was approximately twice that in 2016 (36.0 per 100,000 births) (p = 0.01).
Figure 3
Figure 3
Multidisciplinary perinatal mental health care resources across different units: Maternal-fetal (MF) centers, general hospitals, and private clinics. (a) The distribution of psychiatrists. (b) The distribution of hospital social workers. (c) Experience of seamless multidisciplinary collaboration between medical units and community health centers.
Figure 4
Figure 4
The availability of psychiatrists in maternal care units: (a)The percentage of maternity care units that have one or more psychiatrists or none. (b) The percentage of maternity care units with psychiatrists on duty 24 h a day to manage emergency admissions is shown.
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