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Baby blues and infanticide

BY KIMONE THOMPSON Features editor — Sunday thompsonk@jamaicaobserver.com

Sunday, January 20, 2013    

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BETWEEN 20 per cent and 34 per cent of new mothers in Jamaica suffer from postpartum illnesses, the most severe form of which can cause them to harm their babies.

Yvonnie Bailey-Davidson, a former president of the Jamaica Psychiatric Association, who spoke to the Jamaica Observer via email last week cited the more conservative figure, while a study carried out by University of the West Indies recorded the higher prevalence rate.

The study, published in BMC Pregnancy and Childbirth in 2005, used 73 healthy pregnant women tested at 28 weeks gestation and at six weeks after giving birth. The results showed "depression prevalence rates of 56 per cent and 34 per cent during prepartum and postpartum period, respectively". Additionally, the findings noted that 94 per cent of those suffering depression in both periods were single.

On January 10 this year, a St Mary woman, Michelle Stewart, reportedly confessed to the Annotto Bay police that she had killed her 11-month old son Lyndon 'Jerry' Mattison. The cops followed her back to her house on Fort George Road where they discovered the body of the child with mulitple chop wounds. His head was almost severed.

The public debate that followed the horrific incident included questions as to whether the woman could have been suffering from postpartum depression which exacerbated a pre-existing mental condition. However, there has been no medical confirmation that this was the case.

Asked what could lead a mother to commit such an act against her own child, psychiatrist Bailey-Davidson said: "Mentally ill persons who are responding to hallucinations will do things like that."

According to last week's Sunday Observer lead story, Stewart, 40, is known to be mentally unstable and is on prescribed medication for the condition. Baby Lyndon's father Lynval Mattison told the newspaper in that article that he made sure Stewart, with whom he lives, took her medication. He did not, however, say exactly what specific illness she has.

Members of the community said the mother had previously reported her intention to the police, but said they did nothing.

Bailey-Davidson suggested, however, that the incident could have been averted had the mother been monitored by mental health professionals.

"Mentally ill persons need to be supervised and monitored... There are psychiatrists and mental health nurses in every parish and patients are seen at clinics near to their homes [but] we need more staff to better monitor and supervise patients and to address the needs of these high-risk families, she said.

The psychiatrist said she did not know how many of these professionals were employed across the government service. However, according to Sunday Observer interviews carried out in 2011, roughly 25 psychiatrists practice in the public system.

"For a population of almost three million, ideally, we should have 200 psychiatrists to adequately serve the in-patient and community mental health populations, but we only have about 25, and that doesn't include psychiatric nursing aides or mental health officers," said forensic psychiatrist Dr Clayton Sewell then.

Similarly, a doctor who once worked in the north east health region, who asked that her name be withheld, pointed to the shortage of psychiatric professionals and the impact it has on patient care.

"My main problem is that patients are very often neglected... The area is very, very understaffed," she said in the 2011 article titled Paging... the Jamaican psychiatrist.

"If a patient is to come in for medication and doesn't (come in) for like two months, there's nobody to follow up and realise that he is missing. That causes people to fall through the cracks.

"The way things are organised in Cuba, there is one psychiatrist for one (cluster of communities), not for three, four parishes. So you don't have anybody falling through the cracks there. If you miss your medication they will come and knock on your door," she added, making comparisons with the Spanish-speaking country, where she, like the majority of Jamaican doctors, studied.

The lack of adequate monitoring, she said, was one reason mentally ill people roam the streets in the numbers they do in Jamaica.

Postpartum illnesses range from postpartum blues -- more commonly called baby blues -- to postpartum depression and the most severe form -- postpartum psychosis. The blues only last a couple weeks, while the depression tends to be clinical and can cause mood swings, sadness, uncontrollable crying, lack of energy, confusion, anxiety, guilt, worthlessness, trouble concentrating, hopelessness, and loss of appetite and sleep. Psychosis, experts say, can include all the previous symptoms, but is more specifically marked by a sustained lack of interest in the baby, and thoughts of suicide or infanticide.

The UWI study found that "the major determinants of postpartum depression were moderate and severe prepartum depression".

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