Jay writes:

"Now, the big question:  How do we help them before they go off the deep
end?
Education prenatally?  Education PP?  Follow-ups by HCPs? When we come
into
contact with a mom and WE see that she is suffering from PPD, how do we
respond?  Contact her spouse/partner?  Contact her Dr?  There is only so
much support we can give to her to help her through this time, and I can
guarantee you it is not enough."

Well, in the other part of my life I'm back to being a geriatric social
worker.  While this is a different group from new moms, I still see lots
of depression, psychosis, etc. in people who are reluctant to admit
because someone "might take them out of the home and put them in a
nursing home."  Still, I truly believe that when a person is *at risk* to
either themselves or someone else, it is important that others intervene.
 When I say intervene, I mean calling a spouse, relative at the least.
If you are really concerned, call the MD, pedi, or other professional.
Most communities in the US have a mental health team that will come to
the house.  If no response, it is ok to call the police.  Yes, this is
scary, lots of interventions, etc.  No one should ever feel guilty about
having done this.  Trust yourself and your instincts.  Mom might be very
angry at you, but that's ok.  It's normal.  In time, she will see how bad
things were.  I think that many, not all, of these situations just
require someone to be aggressive and overstep the boundaries of what is
considered *ok*.

The upshot of this is; I've never had a bad outcome when I've been
aggressive.  Get lots of support for yourself.

I also think we need to do a better job of educating about PPD.

Johanna Berger, LSW
Breastfeeding Counselor
Bala Cynwyd, PA