title: Delivering perinatal psychiatric services in the neonatal intensive care unit.
abstract: OBJECTIVE
  To describe characteristics of mothers who would likely benefit from on-site short-term psychiatric services while their infant is in the neonatal intensive care unit (NICU).
  
  
  METHODS
  For 150 consecutive mothers who were referred for psychiatric evaluation and psychotherapeutic intervention in an innovative NICU mental health programme, baseline information was collected. Data regarding their referrals, diagnosis, treatments and infants were analysed.
  
  
  RESULTS
  Most mothers were referred because of depression (43%), anxiety (44%) and/or difficulty coping with their infant's medical problems and hospitalization (60%). Mothers of VLBW infants were disproportionately more likely to be referred. A majority of mothers accepted the referral and were treated; most only required short-term psychotherapy. A minority resisted or refused psychiatric assessment; a quarter of these had more difficult interactions with staff or inappropriate behaviours. In these cases, the role of the psychiatrist was to work with staff to promote healthy interactions and to foster maternal-infant bonding.
  
  
  CONCLUSIONS
  Overall, on-site psychiatric services have been accepted by a majority of referred NICU mothers, and most did not require long-term treatment. A considerable need exists for psychiatric services in the NICU to promote optimal parenting and interactions.
authors.affiliation: Departments of Psychiatry and Pediatrics, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, OH, USA. susanhfmd@hotmail.com
authors.forename: Susan
authors.initials: S
authors.lastname: Hatters Friedman
authors.forename: Ann
authors.initials: A
authors.lastname: Kessler
authors.forename: Sarah
authors.initials: S
authors.lastname: Nagle Yang
authors.forename: Sarah
authors.initials: S
authors.lastname: Parsons
authors.forename: Harriet
authors.initials: H
authors.lastname: Friedman
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Martin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000628:therapy; D015331:Cohort Studies; D003376:Counseling / Q000379:methods; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D011181:Postnatal Care / Q000379:methods / Q000523:psychology; D011247:Pregnancy; D011614:Psychotherapy, Brief / Q000379:methods*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
keywords: Anxiety; Coping skills; Depression; Neonatal morbidity