Psychiatric training in perinatal mental health across Europe

Marisa Casanova Dias,Ekin Sönmez Güngör,Howard Ryland,Livia De Picker,Sean Naughton,Thomas Gargot,Franziska Baessler,Athanasios Kanellopoulos,Mariana Pinto Da Costa

doi:10.1007/s00737-022-01216-w

Abstract

Perinatal mental illness is associated with considerable maternal and infant morbidity and mortality. However, there are currently no specific guidelines on the standards and structure of postgraduate perinatal psychiatric training in Europe. We describe the characteristics of available and desired specialist perinatal psychiatry training from the perspective of European psychiatrists in training. An online survey was conducted among 34 national psychiatric trainee association representatives of the European Federation of Psychiatric Trainees (EFPT). Participants from the countries in which perinatal psychiatry training was available were invited to participate in in-depth follow-up interviews. Six countries out of 34 (18%) reported that specialist training in perinatal mental health was available (Finland, France, Germany, Ireland, Malta, and the UK). The nature of available training varied in duration, the supervision and assessment model employed, and the training scheme context. Of the 28 countries where specialist perinatal psychiatry training was unavailable, the majority of national representatives (22 countries, 76%) wanted specialist perinatal psychiatry training to be included in their national training curricula. There is a gap between the expected skills and the available training for psychiatrists to meet the mental healthcare needs of women in the perinatal period. Given the prevalence and impact of perinatal mental illness and the expressed desires of trainees themselves for specialist training, this finding should prompt urgent action.

Highlights

Representatives for 34 of 37 (92%) European Federation of Psychiatric Trainees (EFPT) member countries responded to the online survey
The current study is, to our knowledge, the first survey reporting the state of perinatal psychiatry postgraduate training in Europe from the perspective of trainee psychiatrists
As many as 1 in 5 women have pregnancies complicated by perinatal mental health problems (Howard et al 2014; Jones et al 2014)

Summary

Introduction

Childbirth, and the postpartum (the ‘perinatal period,’ conventionally defined as pregnancy to one year postpartum) is a high-risk time for the exacerbation of existing psychiatric illness and the development of newonset conditions. Perinatal mental illness is associated with considerable maternal and foetal/infant morbidity and mortality (Howard et al 2014; Jones et al 2014). It can have a devastating effect on women, their families, and their child’s development. Perinatal mental healthcare has been gaining momentum in Europe in recent years, with investment in new specialist services in some high-income countries (e.g. UK and Ireland) and mother-baby units elsewhere (Brockington et al 2017; Howard and Khalifeh 2020). Providing high-quality perinatal mental healthcare requires clinicians from allied disciplines to possess adequate skills and ‘think family’. The European Federation of Psychiatric Trainees (EFPT, www.efpt.eu), an umbrella organisation for national psychiatric trainee associations, collaborates with UEMS to produce statements that reflect trainees’ recommendations for high-quality training. Whilst 80% of countries stipulate a placement in a non-psychiatric specialty such as internal medicine or neurology, only 40% do so for substance abuse and 26% for old age psychiatry (Baessler et al 2021)

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