Refer immediately to a secondary mental health service, ideally with a specialist interest in perinatal mental health, if a woman has a sudden onset of symptoms suggestive of postpartum psychosis, which is a psychiatric emergency requiring urgent assessment and possible admission NICE CKS,NICE CKS,NICE CKS.
Referral criteria for specialist mental health services for patients with severe postnatal depression include if the woman is severely depressed and presents a considerable immediate risk of harm to herself or others, or if she shows evidence of severe self-neglect or is unable to look after her baby NICE CKS,NICE CKS,NICE CKS.
Women with a history of severe mental illness, including postnatal depression, puerperal psychosis, or bipolar disorder, during pregnancy or the postnatal period, should be referred for specialist assessment and management NICE CKS,NICE CKS,NICE CKS.
Women who need inpatient care for a mental health problem within 12 months of childbirth should normally be admitted to a specialist mother and baby unit if available locally NICE CG192.