What the APA's mental health and abortion task force should have said
Regular readers will no doubt note the number of posts on abortion, mental health and related topics. I am doing some research and writing on this topic and want to get some of the information I am finding into view. Here is one interesting statement from another mental health association regarding abortion and mental health effects. This from the Royal College of Psychiatrists in Great Britain.
Position Statement on Women’s Mental Health in Relation to Induced Abortion
14th March, 2008
In the Government Response to the Report from the House of Commons Science and Technology Committee on the Scientific Developments Relating to the Abortion Act 1967, the following request was made:
“In view of the controversy on the risk to mental health of induced abortion we recommend that the Royal College of Psychiatrists update their 1994 report on this issue”
The College has undertaken a literature review to inform the following position statement, which includes the recommendation that a full systematic review around abortion and mental health is required.
The Royal College of Psychiatrists is concerned to ensure that women’s mental health is protected whether they seek abortion or continue with a pregnancy.
Mental disorders can occur for some woman during pregnancy and after birth.
The specific issue of whether or not induced abortion has harmful effects on women’s mental health remains to be fully resolved. The current research evidence base is inconclusive – some studies indicate no evidence of harm, whilst other studies identify a range of mental disorders following abortion.
Women with pre-existing psychiatric disorders who continue with their pregnancy, as well as those with psychiatric disorders who undergo abortion, will need appropriate support and care. Liaison between services, and, where relevant, with carers and advocates, is advisable.
Healthcare professionals who assess or refer women who are requesting an abortion should assess for mental disorder and for risk factors that may be associated with its subsequent development. If a mental disorder or risk factors are identified, there should be a clearly identified care pathway whereby the mental health needs of the woman and her significant others may be met.
The Royal College of Psychiatrists recognises that good practice in relation to abortion will include informed consent. Consent cannot be informed without the provision of adequate and appropriate information regarding the possible risks and benefits to physical and mental health. This may require the updating of patient information leaflets approved by the relevant Royal Colleges, and education and training to relevant health care professionals, in order to develop a good practice pathway.
These difficult and complex issues should be addressed through additional systematic reviews led by the Royal College of Psychiatrists into the relationship between abortion and mental health. These reviews should consider whether there is evidence for psychiatric indications for abortion.
In my opinion, this is where the APA Task Force on Mental Health and Abortion should have stopped.