B.C. moms waiting to access advanced postpartum mood disorder treatment

Grace Lore understands firsthand the struggle to access postpartum services. The mother of two gave birth to both her children in Vancouver.

After receiving extensive and 'incredible care' at B.C. Women's Hospital in Vancouver, her family moved to Victoria.

The staff at Women's Hospital did not know where in the Capital Region to refer her, and she spent months just looking for a doctor when she arrived in Victoria that could provide a refill to the prescription she was taking to deal with depression.

"They had no sense of the services here and no one to refer me to," said Lore. "Whether smaller versions of the Women's model are available in other communities. I think that is worth looking at."

Lore's story is an example of how services in British Columbia for postpartum mood disorders are a patchwork, with different services being offered in different regions.

Types of postpartum mood disorders

Disorders can include postpartum depression, postpartum anxiety and postpartum obsessive compulsive disorder.

There are substantial waits, with mothers diagnosed with postpartum depression and needing mental health psychiatrists waiting more than four weeks to get service in most provincial jurisdictions.

Fraser Health and B.C. Women's Hospital have wait times of one to three months for most cases of specialized postpartum care.

Island Health funds private therapy that mothers in the Victoria area wait four to five weeks to access while psychiatric services takes months to receive.  

All health authorities said that if a mother is diagnosed with severe postpartum mood disorders they skip the waiting list and are seen as soon as possible.

"I wish I could see someone the next day. I get so many sessions a year and I have to divide them up amongst the weeks of the year I am working. There is a limited amount of service." said Traci McGee, a registered clinical counsellor in Victoria.

"Do we have another support? The answer is no we don't. But we have more than most communities. Support is different than therapy, and I think all women that are having babies need support of varying kinds."

Calls for integrated services

Therapy and psychiatric services are not the only options for treating postpartum mood disorders in British Columbia. Each health authority has an initial screening for postpartum that takes place with either a general practitioner or a midwife.

The province says up to 16 per cent of birthing mothers will experience some symptoms of postpartum depression.

New moms are also referred to public health units where they can be diagnosed or take part in either one-on-one sessions or the more common group sessions.

All women are supposed to be offered public health screening for symptoms of postpartum depression within eight weeks of giving birth, according to provincial standards.

I think the thing we are up against is to standardize that treatment.- Traci McGee, registered clinical counsellor

"The services each woman requires will vary and so we offer a spectrum of support but we also need to ensure these are connected and coordinated," said the Ministry of Health in a statement.

"To ensure that the province's mental-health programs work effectively together, the provincial government is also developing an integrated, cross-government mental-health and substance use strategy for British Columbia."

But McGee is concerned that not every region in the province is assessing and treating postpartum depression the same way. 

"If a service exists in one community, it should exist in all communities. It is a matter of what is that service going to be. For example, if you look at public health, and we offer immunization in Victoria, well the immunization needs to be exactly the same as in Terrace and Vancouver," said McGee. "I am a psychiatrist in Victoria. I think the thing we are up against is to standardize that treatment."

Capacity stretched

There has been a heightened awareness of postpartum mood disorders as the search for New Westminster mother Florence Leung continues. Her husband, Kim Chen, says his wife was dealing with depression before she went missing on Oct. 25, 2016.

The Pacific Post Partum Support Society works to raise awareness about the sorts of services that are available. Director Sheila Duffy says the biggest problem can be a lack of resources.

"The wait list can be pretty lengthy at times, so I know that they're stretched. Their capacity is stretched too. It's an issue that needs attention," said Duffy.

New innovations

There are some new, innovative options rural health authorities are looking at. Northern Health does extensive screening and assessment at birth but taps into the services offered in larger centres like Vancouver and Surrey.

The psychiatric care still has wait times, but previously the care was extremely limited in many communities.

"We are embarking on a telehealth strategy that will really support women closer to home with their care," said Vanessa Salmons, the prenatal lead for Northern Health.

"If that psychiatric care is needed, we can link through telehealth services through B.C. reproductive mental health."