ABSTRACT
Chapter 20, “A vision for the future”, is based on the author’s conviction that perinatal emotional disorders must be taken more seriously than today, and that they should be captured at the units that parents visit for regular check-ups of their infants. He ends the book with “a vision of the future”, which suggests how to organize perinatal mental health care in a more “horizontal mode” than used today. Evidently, some complex cases need to be taken care of in a hierarchical or “vertical” organization with specialist units on top and local centres on the base. Yet, he argues for spreading the horizontal model, in which each local centre hosts a qualified psychotherapist involved in teamwork with the midwives and nurses. His/her tasks are divided in two: one is to supervise the nurses, as delineated in Chapters 6 and 7. Such supervisions also help counterbalance the medical emphasis in doctors’ and nurses’ educations, which can entrench them in diagnostic and non-dynamic thinking, to the detriment of a deeper understanding of what is going on in the parents and the baby. Supervisions provide “maintenance” of their psychological skills with families in distress. The other task of the therapist is to do brief consultations with families in various constellations. He believes this model is applicable in various countries, though their health systems of course vary. The book thus ends on a hopeful note with constructive and concrete suggestions.
