Dr. Eamonn Moloney:

In relation to suicide in pregnancy and a person who is suicidal because she is pregnant, obviously the importance of the purpose of a consultant psychiatrist carrying out an assessment in this situation is in establishing whether there is a mental illness. If someone is suicidal in the context of a severe depressive illness, then the priority is to treat the severe depressive illness and, in those circumstances, one would not suggest that because the woman was suicidal she should have a termination. The priority there is to treat the mental illness but there are other cases where there may be no mental illness. Those situations are rare but they will occur and have occurred where a pregnant woman in a crisis pregnancy is suicidal and a termination is the only way of reducing and eliminating that suicidality.

In terms of a panel of psychiatrists, ideally the care pathway should be the GP doing the initial assessment and the certification and referring to a local psychiatrist who could do both, so to speak - see the individual, carry out an assessment, begin therapy if it is needed, or recommend whatever therapeutic intervention might be needed, but they could also certify. This will not always be the case but that would be the preference. I reiterate my belief that the role of the GP is very important and is central to this. I see them as being one of the medical opinions. I would see that one could amalgamate heads 2 and 4 so that two medical opinions are necessary and in terms of the panels and this process, and the care pathway mirroring the Mental Health Act, I would say that the executive of the panel would be formed of eligible consultant psychiatrists and, as far as possible, that those assessments would be done by the woman's local psychiatrist so that there would be that continuity of care.