Dr. Anne Jeffers:

To start with, we would see it as a question on the absence of biological markers, rather than clinical markers. I do not think people will be asking obstetricians to explain how they do their job. It is really difficult for me to distil down the amount of training and expertise I have, the 30 years' experience and working with multi-disciplinary teams, to try to adequately get across the expertise of a psychiatrist in assessing suicide.

I will give an example of somebody who might come to us in this situation, Often, it is a young woman who may herself have had experience of extreme abuse in her childhood, may have been raised in care, may already have had children taken into care, and may be coming to us with the prospect of going through another pregnancy when she fears that the child may be taken into care also. These are women who, because of their circumstances, have not been able to build up the normal social supports that the rest of us rely on to get by. They come to a psychiatrist and a multi-disciplinary team. A social worker will meet with them and a psychologist will be involved. Between us all, we will be offering support to this woman. We are not just talking about a once-off assessment, we are talking about ongoing care and support. The important thing is that we identify where the hopelessness is coming from, identify what the issues are and what we can do about them. That might describe how we, as psychiatrists, assess clinical risk.

I was interested in Senator van Turnhout's statement that we may only be speaking about one case of somebody who is in care or a child in care. A lot of the women we see in these stressful situations would themselves have been in care and often have children in care.