How should I approach the immediate management of a patient presenting with suspected postpartum psychosis in a primary care setting?

Immediate management of suspected postpartum psychosis in primary care should include:

• Urgent referral to specialist perinatal mental health services for assessment and treatment within 2 weeks of referral, as postpartum psychosis is a psychiatric emergency requiring specialist input ¹.
• Ensure the woman is medically stable and assess the need for rapid intervention, including possible hospital admission, given the high risk of harm to the mother and baby ¹.
• Do not delay referral or treatment initiation because of the severity and rapid onset of symptoms in postpartum psychosis ¹.
• Provide increased contact and support through primary care while awaiting specialist assessment, monitoring symptoms closely ¹.
• Discuss treatment options sensitively with the woman, including the potential need for psychotropic medication and psychological interventions, balancing risks and benefits in the postnatal period ¹.
• Coordinate care with maternity, health visiting, and mental health services to ensure a comprehensive care plan that includes monitoring the impact on the baby and the mother’s mental health ¹.
• Record and share the care plan with all involved professionals and the woman herself to ensure continuity and clarity of care ¹.