When to Refer a Patient to a Specialist: A Guide for Healthcare Providers
As a healthcare provider, you’re often one of the first people to see and interact with new and expectant mothers. Your role is crucial in identifying when a patient may need additional support for their mental health. Perinatal mood and anxiety disorders (PMADs) are among the most common complications of pregnancy and childbirth, affecting up to 1 in 5 mothers. This guide will help you recognize the signs that a patient might benefit from a referral to a mental health specialist and how Mothergood Health can partner with you to support your patients.
The Importance of Early Detection
Early detection and intervention are critical for improving outcomes for mothers and their families. PMADs, if left untreated, can have long-term impacts on both maternal and infant well-being. By identifying symptoms early and facilitating a referral, you can make a profound difference in your patient’s journey to recovery.
Using the EPDS to Identify PMADs
Many healthcare providers use the Edinburgh Postnatal Depression Scale (EPDS), a widely validated screening tool, to assess the mental health of new mothers. The EPDS consists of 10 questions that help gauge the severity of depressive symptoms and anxiety, with higher scores indicating a greater likelihood of a PMAD.
When to Use the EPDS: It’s recommended to administer the EPDS during routine postpartum visits and, ideally, once during pregnancy. The scale is a valuable resource to initiate conversations about mental health and determine whether a referral is appropriate.
Interpreting the Results: A score of 10 or higher on the EPDS suggests the need for further evaluation and possibly a referral to a mental health specialist. Scores above 13 are generally indicative of more severe symptoms and may require more immediate intervention.
Key Indicators for a Mental Health Referral
In addition to EPDS scores, here are other signs and situations in which a referral is warranted:
Persistent Sadness or Hopelessness
If your patient reports feeling sad, hopeless, or tearful most days for more than two weeks, it could be a sign of postpartum depression or a related mood disorder.
Severe or Persistent Anxiety
Anxiety is common in new mothers, but when it becomes overwhelming or persistent—manifesting as constant worry, intrusive thoughts, or physical symptoms like heart palpitations—it may be time to seek specialized care.
Difficulty Bonding with the Baby
A lack of connection or inability to bond with the baby can be a red flag. Mothers may express feeling detached, ambivalent, or even resentful, which can be distressing for both mother and baby.
Changes in Sleep and Appetite
While sleep and appetite changes are common postpartum, significant disruptions, especially if unrelated to the baby’s schedule, can be an indicator of a deeper mental health issue.
Obsessive or Intrusive Thoughts
Some mothers experience distressing, unwanted thoughts about harm coming to their baby or themselves. These thoughts can be extremely upsetting, even if there is no intention to act on them. A referral is crucial if your patient is experiencing these intrusive thoughts.
High-Risk Factors
Consider a referral if your patient has a history of depression, anxiety, trauma, or previous PMADs. Other risk factors include lack of social support, a complicated birth experience, or significant life stressors.
Postpartum Psychosis Symptoms
Though rare, postpartum psychosis is a medical emergency. Symptoms may include hallucinations, delusions, confusion, or bizarre behavior. Immediate intervention is necessary, and hospitalization may be required.
How to Approach the Referral Conversation
Discussing mental health with new or expectant mothers can be sensitive. Here’s how to make the conversation as compassionate and effective as possible:
Normalize the Experience: Reassure your patient that perinatal mental health challenges are common and treatable. Use phrases like, “Many new moms feel this way, and there’s no shame in seeking help.”
Express Empathy and Understanding: Validate her feelings by saying, “It sounds like you’ve been through a lot, and it’s okay to feel overwhelmed. Let’s explore some ways to support you.”
Provide Reassurance: Let her know that seeking mental health support does not mean she’s failing as a mother. Remind her that self-care is essential for both her and her baby.
How Mothergood Health Can Support Your Patients
At Mothergood Health, we specialize in compassionate, evidence-based care for new and expectant mothers. Here’s how we can assist:
Personalized Treatment Plans: We tailor our therapy and treatment options to meet the unique needs of each patient, whether through telehealth or in-person sessions.
Collaborative Care: We believe in working hand-in-hand with referring providers. We’ll keep you updated on your patient’s progress (with her consent) and are open to collaboration to ensure the best possible care.
Expertise in PMADs: Our therapists are trained in understanding the unique psychological and emotional needs of mothers, offering a safe, judgment-free space to heal.
When to Make the Referral
The best time to refer is when you notice persistent or concerning symptoms that interfere with your patient’s ability to function or bond with her baby. Trust your instincts, and if in doubt, it’s always better to refer sooner rather than later. Early intervention can prevent symptoms from worsening and improve recovery outcomes.
How to Refer a Patient to Mothergood Health
Referring a patient is simple. You can:
Provide our contact information directly to the patient.
Reach out to us on behalf of your patient with her consent to set up an initial consultation.
Offer to follow up with her to ensure she feels supported and empowered to take the next step.
Conclusion
As a healthcare provider, your role in a mother’s support network is invaluable. By recognizing the signs of PMADs and facilitating referrals, you’re helping to build a foundation for long-term well-being. At Mothergood Health, we’re here to partner with you and provide the specialized care your patients deserve. Together, we can ensure that every mother receives the mental health support she needs to thrive.
Interested in learning more or setting up a referral? Contact us today to discuss how we can collaborate to support your patients.
