LAUSR

The National Task Force on Women’s Reproductive Mental Health, which was founded in 2013, has concluded that it is time for all psychiatrists to acquire basic knowledge and skills in reproductive psychiatry [1]. While working to create a clear subspecialty definition, the Task Force has identified several critically important topic areas to teach. These include the influence of sex hormones on women’s health, premenstrual dysphoric disorder, antenatal stress and depression, postpartum depression, and the risks of treatment to both the mother and fetus, among others [1]. The Task Force has suggested that the reproductive mental health education of psychiatrists has been lagging behind clinical, public policy, and research initiatives [1]. In this issue, members of the National Task Force have published two important and innovative research articles concerning the education of psychiatrists on reproductive mental health [2, 3]. The first concerns a web-based survey of psychiatry residency training directors (response rate 29%) regarding the current state of reproductive psychiatry in residency education [2]. Reproductive psychiatry was defined in this survey as the study and treatment of psychiatric illness during reproductive transitions. Those reproductive transitions were characterized by hormonal flux and/or social role change and specifically included pregnancy, the postpartum period, infertility, pregnancy loss, the premenstrual period, and perimenopause. The survey included an open-ended question that allowed program directors to describe the current educational offerings in reproductive psychiatry. Most program directors reported that some training was required in reproductive psychiatry [2]. Nearly all programs that required reproductive psychiatry education taught about related mood disorders and psychotic disorders. Family planning was not formally mentioned, however [2]. The second article identified post-residency training programs in reproductive psychiatry by an online search, a listserv query, and an announcement at a national meeting [3]. Of the twelve Women’s Mental Health training programs identified, the most common clinical experiences occurred in specialized inpatient consultation-liaison services and specialized outpatient clinics. Only two of the six programs that offered their full didactic programs for review reportedly offered didactic sessions on family planning [3]. A third article [4] surveyed residents across specialties (family practice, internal medicine, obstetrics-gynecology, and psychiatry) in order to ascertain their perceived adequacy of training on contraceptive prescribing and family planning for patients with major mental disorders. Although only a very small percentage of the target population responded, those who did tended to agree that education and training on family planning and contraception was lacking for this population of patients. Our goal for this editorial is to highlight the critical importance of including family planning in the purview of reproductive psychiatry. We aim to emphasize the importance of routinely assessing and attending to the family planning needs of adult and adolescent patients and the importance of teaching on this topic. Scope, or the sum of all activities and learning experiences, is a basic principle of curriculum construction and organization [5]. Formal inclusion of family planning in the reproductive psychiatry curriculum should enable its integration and articulation with the other topics taught on reproductive psychiatry. This in turn should remind learners of their * John Coverdale [email protected]