79 NÚMERO ESPECIAL 25 ANOS — 2009 Saúde mental Maria Isabel Loureiro is a medical doctor in Public Health and associate professor at ENSP-UNL. CIESP, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa. Ana Rita Goes is psychologist, master in Public Health — Health Promotion, Research Assistant at ENSP-UNL. CIESP, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa. Teresa Maia is MD, psychiatrist, invited assistant professor at ENSP-UNL. CIESP, Escola Nacional de Saúde Pública, Universi- dade Nova de Lisboa. Gisele Paim da Câmara is nutritionist, research assistant at ENSP- UNL. CIESP, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa. Luís Saboga Nunes is sociologist, master in Public Health, assistant professor at ENSP-UNL. CIESP, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa. Submetido à apreciação: 19 de Setembro de 2009 Aceite para publicação: 30 de Setembro de 2009 Mental health promotion during pregnancy and early childhood: an action-research project in primary health care MARIA ISABEL LOUREIRO ANA RITA GOES TERESA MAIA GISELE PAIM DA CÂMARA LUÍS SABOGA NUNES Background: Primary Health Care (PHC) is usually the first contact with the health system, and health professionals are key mediators for enabling citizens to take care of their health. In Portugal, great improvements have been achieved in the biometric indicators of maternal and child health during the last decades. Nevertheless, scant attention has been paid to the mental health dimension, in spite of the recognition of its importance, being pregnancy and early childhood crucial opportunities in the lifecycle for mental health promotion, especially in the early years of life, with a strong impact in the health of the child. The impact of early attachment between mother and baby on maternal and child health has long been recognized. This attachment can be influenced by some factors, as the mother’s emotional adjustment. Attention to these factors may facilitate implementation of both positive conditions and preventative measures. Family support during the transition to parenthood has been highlighted as an effective measure and PHC professionals are in a privileged position as information sources as well as mediators. Aims: The project we present describes an action-research process developed together among academic researchers and health professionals to embrace these issues. We intend to enable health professionals to support families in the transition to parenthood thereby promoting children’s mental health. Approach: The project is driven by a participatory approach intended to lead to reorganization of health care during pregnancy and early childhood. Effective change happens when those involved are interested and motivated, what makes their participation so important. Reflection about current practices and needs, and knowledge about evidence-based interventions have been guiding the selection of changes to introduce in clinical practice for family support and development of parenthood skills and self-confidence. Development: We summarize the main steps in development: the initial assessment and the picture taken from the community under study; the decision making process; the training programme of PHC professionals in action; the review of the protocols of maternal The work described in this article is part of a project that is financially supported by the Portuguese High Commissioner for Health, a central service of the Health Ministry.