**7. Solutions/recommendations conclusion**

In conclusion, a sustainable model of postnatal mental health care in private obstetrics might include screening, assessment referral and psychoeducation provided by a midwife. Alternatively, a committed postnatal liaison nurse (midwife) to screen, refer, support and follow up women identified as at risk/concern and also engage with women who decline help. The role of the midwife could be advanced further to provide improved continuity in relation to screening and support for mental health. This could be through the development of a role for Advanced Midwifery Practitioners, who are named and regulated as specialised mental health midwives. This could additionally be endorsed by specialist postgraduate or other higher education programmes for both midwives and obstetricians. There are also online training and face to face training programmes available for midwives – on perinatal screening and assessment. These include the COPE Basic Skills in Perinatal Mental Health, KMMS module for screening Australian First Nations (now also part of iCOPE) women and perinatal loss in practice. The perinatal loss in practice is a practical, comprehensive course for Therapists, including Psychologists, Psychiatrists, Social Workers, Counsellors, and Mental Health Nurses, who work with clients who have experienced miscarriage, stillbirth, and newborn loss.

More experienced midwives and child and family health nurses [58] are known to utilise a variety of strategies to make clinical decisions and to utilise critical thinking to detect women who require follow-up support for postnatal mental health disorders [59]. Midwives who have more experience in psychosocial screening and assessment and who have developed effective screening and problem-solving abilities are in the idyllic position to mentor and support less experienced midwives, however, it is uncertain whether this peer-mentoring occurs.

More support markedly required to identify and promote family and communitycentred approaches to mental well-being for postnatal women, and all Australian families would gain from improved information regarding the benefits, purpose and aims of postnatal mental health screening and assessment. A wide-based educational communication strategy is advised to enhance awareness of postnatal mental health issues, particularly the impact on infant well-being and development and the needs of the family unit. A simultaneous consultation strategy is necessary to identify additional tactics to engage key stakeholders, including private obstetric service providers, in the implementation and evaluation of this essential health promotion campaign. In addition, universal routine psychosocial screening/assessment should be conducted postnatally, regardless of the outcome of antenatal screening.

The Centre of Perinatal Excellence (COPE) has developed an e-directory to assist women in finding local support for emotional and mental health problems perinatally. It includes over 700 services. This includes services and professionals that have a special focus on emotional and mental health during pregnancy and following the birth of a baby. This directory could be promoted to postnatal women by health care professionals. There is also a preparation for parenthood psychoeducation programme through COPE for women. In addition, there is a free ready-to-cope psychoeducation app available for women called, 'Ready to Cope'. This provides weekly updates for pregnant woman, men and non-birthing partners until the completion of their first year of parenting. Monash University have also demonstrated that iCOPE can be successfully used with refugee women by offering screening in their own language [60].
