title: Perinatal mental health service provision in Switzerland and in the UK.
abstract: OBJECTIVE
  The epidemiology of maternal perinatal-psychiatric disorders as well as their effect on the baby is well recognised. Increasingly well researched specialised treatment methods can reduce maternal morbidity, positively affect mother-baby bonding and empower women's confidence as a mother. Here, we aimed to compare guidelines and the structure of perinatal-psychiatric service delivery in the United Kingdom and in Switzerland from the government's perspective.
  
  
  METHODS
  Swiss cantons provided information regarding guidelines and structure of service delivery in 2000. A subsequent survey using the same questionnaire was carried out in 2007. In the UK, similar information was accessed through published reports from 2000-2012.
  
  
  RESULTS
  Guidelines for perinatal psychiatry exist in the UK, whereas in Switzerland in 2000 none of the 26 cantons had guidelines, and in 2007 only one canton did. Joint mother-baby admissions on general psychiatric wards were offered by 92% of the Swiss cantons. In the UK, pregnant women and joint mother-baby admissions are only advised onto specialised perinatal-psychiatric units. In Switzerland, in 2007, three specialised units (max. 24 beds) were in place corresponding to 1 unit per 2.5 million people, while in the UK there were 22 mother-baby units (168 beds) in 2012 (1 unit per 2.8 million). In the UK, less than 50% of trusts provided specialised perinatal-psychiatric health care.
  
  
  CONCLUSIONS
  The main difference between the UK and Switzerland was the absence of guidelines, regular assessment and plans for future development of perinatal psychiatry in Switzerland. There are still geographical differences in the provision of perinatal-psychiatric services in the UK.
authors.affiliation: Imperial College London, Faculty of Medicine, Institute of Reproductive and Developmental Biology, London, United Kingdom; University of Zurich, Department of Psychology, Clinical Psychology and Psychotherapy, Switzerland.
authors.forename: Rita T
authors.initials: RT
authors.lastname: Amiel Castro
authors.affiliation: University of Basel Psychiatric Clinics, Centre for Gender Research and Early Detection, Basel, Switzerland.
authors.forename: Katrin
authors.initials: K
authors.lastname: Schroeder
authors.affiliation: University of Applied Sciences Zurich, Department of Applied Psychology, Switzerland.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pinard
authors.affiliation: University of Applied Sciences Zurich, Department of Applied Psychology, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Blöchlinger
authors.affiliation: University of Applied Sciences Zurich, Department of Applied Psychology, Switzerland.
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Künzli
authors.affiliation: University of Basel Psychiatric Clinics, Centre for Gender Research and Early Detection, Basel, Switzerland.
authors.forename: Anita
authors.initials: A
authors.lastname: Riecher-Rössler
authors.affiliation: Imperial College London, Faculty of Medicine, Institute of Reproductive and Developmental Biology, London, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Kammerer
mesh_terms: D005260:Female; D006760:Hospitalization; D006801:Humans; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000592:standards / Q000706:statistics & numerical data; D009313:National Health Programs; D018743:Perinatal Care / Q000379:methods / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data; D011570:Psychiatry; D011795:Surveys and Questionnaires; D013557:Switzerland; D006113:United Kingdom