Postnatal screens

GPs should screen women to pick up early signs of antenatal and postnatal depression, new NICE guidelines propose.

The institute's ambitious proposals also recommend GPs offer women psychological therapies within three months of diagnosis, despite nationwide shortages in access.

The guidelines on antenatal and postnatal mental illnesses recommend GPs use a three-question screening tool during a woman's first contact with primary care, to identify depression and anxiety.

Cognitive behavioural therapy and social support are advised for women with depression or anxiety that 'signifi- cantly interferes with personal and social functioning'.

But Mr Stephen Pilling, member of the guideline development group and joint director of the National Collaborating Centre for Mental Health, acknowledged GPs faced 'a real challenge' providing access to psychological therapies. 'We see this as part of a general move towards being very clear that there needs to be better access to psychological therapies.'

Key measures also include discussion about risks of taking medications while pregnant or breast-feeding, and clearly specified care pathways between primary, secondary and community mental health services.