Perinatal mental health

What is the programme and its aims?
Women can develop a mental illness during pregnancy and after the birth of a child. About 3 per cent will develop a serious mental illness and require specialist care and treatment from a specialised perinatal mental health services (inpatient mother and baby unit and/or perinatal community psychiatric team). 10 to 15 per cent will develop a mild to moderate postnatal disorder and most of these will be cared for by primary care services.

The aim of the programme is to assist in the development of community and hospital services so that all women in the East Midlands who experience a mental health disorder in pregnancy or the postpartum period have access to the services they require to help them recover from their illness.

Improvements in service provision and delivery that we support include improving early identification, the management, signposting and referral of women at risk of or suffering from perinatal mental illness, and the coordination of services across primary care, maternity and mental health care pathways.

We are also providing advice on the £75 million allocation over 5 years and how this could best maximised to improve our services in the East Midlands.

Why is the programme required?
Women who experience a mental illness in pregnancy or in the first year following childbirth will have significantly poorer outcomes if they do not receive the appropriate care and treatment that they require. In the worst cases, this can lead to the mother taking her own life. The Confidential Enquiry into Maternal Deaths (2015) has once again showed that psychiatric deaths and suicide are a leading cause of maternal death. Women can suffer prolonged and unnecessary illness, and the effects on the new born infant can include problems with their social, cognitive, emotional and psychological development. In addition to the costs to both mothers and their families (which can therefore be devastating), there are also associated costs to society and the economy, through delayed and potential loss of employment and the impact on health and social care services.

Who are the partners?
  • patients
  • clinicians
  • commissioners
  • primary care
  • maternity units
  • mental health trusts
How are we making a difference?
  • Facilitating the development and expansion of existing specialised perinatal community psychiatric teams in Derbyshire, Leicestershire and Lincolnshire, as well as providing advice and guidance on the provision of a new service in Northamptonshire.
  • Working in collaboration with an external organisation, FACE Recording and Measurement Systems, to identify childbearing women with mental illness who are not identifiable on current NHS IT systems, by linking all referrals and admissions to psychiatric services in the East Midlands with maternity data from all eight acute hospitals.
  • Developing a common syllabus for the existing perinatal mental health midwifery training programme that is used in Nottinghamshire and support roll-out across the East Midlands. The programme will combine training elements which are delivered through e-learning and face to face teaching delivered locally.
  • Facilitating the development of a regional perinatal mental health training programme for community psychiatric nurses working in specialised perinatal mental health services, aimed at both new starters and existing staff for refresher training. The programme involves a combination of traditional “chalk and talk” methods and experiential learning, through shadowing and site visits. The programme will also have input from an ex-service user. It is intended that the programme will be rolled out to other professional groups including junior doctors.
  • Developing key performance indicators for perinatal mental health that can be populated using data routinely collected by mental health trusts. These key performance indicators will form the basis of future audits against national standards.
  • Working with FACE Recording and Measurement Systems to coordinate the implementation of regional electronic assessment tools for perinatal mental health services that have been developed collaboratively by East Midlands Perinatal Mental Health Network and FACE. It is intended that the tools will be implemented in four out of five of our mental health trusts (Nottinghamshire, Lincolnshire, Derbyshire and Leicestershire).
What’s next?
Working with the mental health network, we will establish networks to coordinate care across the pathway, in line with NICE guidance, as has already been achieved successfully in some areas. We will focus on workforce information and education around perinatal mental health.

Who to contact for further information?
This email address is being protected from spambots. You need JavaScript enabled to view it., Senior Quality Improvement Lead