Unless the patient is found to be dangerous to herself or others, including the baby, there is no option but to discharge. If a Bengali-speaking psychiatrist/therapist could be located within a reasonable driving distance, every effort should be made to connect the two. Husband and wife certainly should be instructed at the first sign of trouble to seek medical/psychiatric assistance, with or without insurance. Is there a possibility of home visits with an interpreter given the potential risks of patient and infant safety? Close follow-up and coordination of care with the patient’s and baby’s primary care physician is needed. Seeking support from the patient’s religious community also is worth considering.
Contributors
Alison M. Heru, M.D. – University of Colorado Denver, Aurora
Ellen Berman, M.D. – University of Pennsylvania, Philadelphia
Annelle B. Primm, M.D., M.P.H. – Johns Hopkins University, Baltimore (adjunct faculty)
Anne E. Becker, M.D., Ph.D. – Harvard Medical School, Boston
Robert C. Like, M.D., M.S. – Rutgers University, Robert Wood Johnson Medical School, New Brunswick
Resources
Farooq S., Fear C. Working Through Interpreters. (Adv Psychiatr Treat. 2003 Mar;9[2]:104-9. doi: 10.1192/apt.01.12 http://apt.rcpsych.org/content/9/2/104.full.)
Chandra P.S. Postpartum Psychiatric Care in India: The need for Integration and Innovation. (World Psychiatry. 2004;3[2]:99-100.)
Ahmad F., Shik A., Vanza R., Cheung A.M., George U, Stewart D.E. Voices of South Asian Women: Immigration and Mental Health. (Women Health 2004; 40[4]:113-130.)
Mantle F. Developing a Culture-Specific Tool to Assess Postnatal Depression in the Indian Community. (Br J Community Nurs. 2003;8[4]:176-180.)
To read about the goals of Curbside Consult, the guiding principles for assessment, and the guidelines for case submission, see “Considering patients’ family, culture,” Clinical Psychiatry News, January 2015, p. 12. The contributors have revised selected patient details to shield the identities of the patients/cases and to comply with HIPAA requirements. This column is meant to be educational and does not constitute medical advice. The opinions expressed are those of the contributors and do not represent those of the organizations they are employed by or affiliated with or the Group for the Advancement of Psychiatry (GAP).
This column is in memory of Dr. Prakash N. Desai, who contributed to this piece before his death earlier this year.