Dr. Margo Wrigley:

I hope my colleagues have answered to Deputy Lahart's satisfaction many of the points he brought up. One area I would like to mention in the context of the early discharge after a day in hospital is the small but nevertheless very important number of women, probably around 120 per year, who develop postnatal psychosis, which is a very serious mental illness. I use the word "illness" in this context. That occurs typically within days or so of birth, and if a woman is out of the hospital within a day, it may be that it does not happen when she is in the maternity service but it may happen when she is at home and she has less support. Where there has been a previous episode of postnatal psychosis, obviously there is very careful surveillance kept specifically by the perinatal service mental health services to make sure the woman gets the care she needs.

If it is a first episode of postnatal psychosis, it can be a very worrisome time for women. It is something I am aware of because women are only staying in hospital for a short time after giving birth.

There has been some discussion of terminology with regard to mental health problems, including terms like "mental illness", "psychiatric illness" and "well-being". I will make a general comment on the difficulty we experience in that regard. Dr. Niazi would experience this more than me in his current role. While people are much freer about saying they feel unwell mentally and talking about feeling anxious and depressed and so on, when you are talking about people who have severe and enduring mental illness such as schizophrenia or bipolar disorder, there is not as much of an acceptance of that. The acceptance needs to be there so that it is followed by an impetus to develop services to meet patients' needs. That needs funding as well. Does Dr. Niazi want to say anything further on that?