Family planning: an integral part of mental health care.

Discusses problems in the provision of maternal health care to mentally ill women; delineates problems faced in terms of health care and ways in which these problems can be solved. The pregnant woman who is also emotionally ill faces some special problems during pregnancy. Emotional reactions to pregnancy present in all women may be exacerbated to dangerous levels. Also the effect of psychotropic drugs on the fetus is a matter of concern since long term treatment regimens have been found to negatively affect the fetus. Issues of social concern also arise having to do with the frequent and unplanned pregnancies which often typify the mentally ill woman. In this regard selection of a contraceptive method for the mentally ill requires careful thought because of the side effects brought on by the combination of oral contraceptives with certain psychotropic medication. The need for family planning education in psychiatric settings and for effective identification of mentally ill individuals during the general admission process are highlighted. As it is traditional admissions procedures are failing to detect mentally ill maternal patients. Support groups in psychiatric settings have been found to be effective in maintaining motivation towards family planning among women as well as in answering concerns regarding emotional problems. It is suggested that a workshop or a series of inservice classes would be of great benefit in alerting personnel to the special needs of this category of patients and in promoting the integration of family planning with mental health services.