Baby on board: exploring infant mental health and dyadic assessment, management and philosophy of practice in Australian Mother and Baby Units

Objective: Mother and Baby Units (MBUs) provide specialist inpatient psychiatric care for women experiencing perinatal mental illness while enabling co-admission with their infant. These settings offer a unique opportunity to support early relational health and address both maternal and infant mental wellbeing. However, national data on the scope and consistency of dyadic assessment and intervention remain limited. This study addresses this gap by mapping service models, workforce capacity, and therapeutic approaches to dyadic care across Australian MBUs.Method: A cross-sectional survey was conducted across all 14 public MBUs in Australia. Unit representatives completed a structured questionnaire examining unit characteristics, infant-focused staffing and supervision, and approaches to infant screening, assessment, and intervention.Results: Findings revealed substantial variation in how MBUs address infant mental health and the mother-infant relationship. Disparities were evident in training, assessment tools, and approaches to infant outcome monitoring. Commonly reported challenges included limited access to, and funding for, staff with specialised infant mental health expertise.Discussion: The findings support the development of evidence-based, relationally focused models of dyadic care. They also provide a basis for benchmarking, workforce development, and informing best-practice guidelines for multidisciplinary teams working in perinatal inpatient psychiatric settings.