Box 2.

Red and amber flags in mental health assessment¹

Red flags may indicate suicide risk and their presence should prompt urgent specialist input: Recent significant change in mental state or emergence of new symptoms New thoughts or acts of violent self-harm New or persistent expressions of incompetency as a mother or estrangement from the infant Amber flags indicating risk for recurrence of major perinatal mental illness, particularly in early postpartum: Previous history of psychosis gives a 25% chance of recurrence in a subsequent pregnancy7 Women with a family history of bipolar disorder or postpartum psychosis who themselves have mood disorder or change in mental state Personal and family patterns of occurrence and re-occurrence can inform risk management strategies