Commissioners & Service Providers

Prevention, detection and treatment of perinatal mental health problems requires the close coordination of a number of different services, including maternity services, health visiting, GPs, mental health, children’s services and the community sector (also known as the third sector).

These services are commissioned by different national, regional and local organisations including NHS England, CCGs and Local Authorities in England, and their equivalents in the devolved nations. Effective partnerships – both at the strategic and clinical level – are therefore critical to ensure that all women can access integrated and effective pathways of care.

A wealth of useful resources are available to those working in the commissioning and provision of services for women with perinatal mental health problems and their families. These resources are set out at the bottom of this page. They are listed in alphabetical order, and for each resource we have given a brief description of their aims and content.

Information for different audiences

We have also identified resources which are of specific interest to commissioners; to particular health professionals and providers, and to those working in the voluntary and community sector. To see these resources click on the links below:

Resources for commissioners in health and local authorities

Resources for health professionals

Resources for those in the community sector

Mums and Babies in Mind

We recommend that all commissioners and providers of services access the Mums and Babies in Mind Project blog and tools. The Mums and Babies in Mind project supports local leaders to improve services and care pathways mums with perinatal mental health problems and their babies. We capture and share the work we do to inform and inspire those who commissions and provide services across the UK. The Mums and Babies in Mind web page contains a range of resources and reports to support commissioning and service provision.

Animation

To raise awareness and help commissioners and providers understand the complexity of the perinatal mental health care pathway, the London Perinatal Mental Health Network developed this short animated film, featuring personal accounts of participants’ experiences.

http://www.londonscn.nhs.uk/networks/mental-health-dementia-neuroscience/mental-health/perinatal-mental-health/

Useful resources for anyone working in commissioning or service provision

BETTER BIRTHS

Author: National Maternity Review team for NHS England

Publication: February 2016

This report – from an independent review into the future of maternity services chaired by Baroness Julia Cumberlege – sets out wide-ranging proposals designed to make care safer and give women greater control and more choices. It contains seven key priorities to drive improvement and ensure women and babies receive excellent care wherever they live.

FIVE YEAR FORWARD VIEW FOR MENTAL HEALTH

Author: Independent Mental Health Taskforce to the NHS

Publication Date: February 2016

The Five Year Forward View is a National Strategy written by the independent Mental Health Taskforce, which brought together health and care leaders, people who use services, and experts in the field. It signifies the first time there has been a strategic approach to improving mental health outcomes across the health and care system. It includes commitments to improve services for women with perinatal mental illness.

In July 2016, NHS England published an Implementation Plan [hyperlink] to set out the actions required to deliver the Five Year Forward View for Mental Health.

MAPS OF PROVISION

Author: Maternal Mental Health Alliance

Publication Date: 2015-2017

These maps, produced by the Maternal Mental Health Alliance’s ‘Everyone’s Business’ campaign, show the provision of specialist perinatal mental health community teams, and Mother and Baby Units across the UK. They demonstrate how patchy the current provision of services is. This means a postcode lottery determines whether women receive the care they need or not.

MATERNAL DEPRESSION DURING PREGNANCY AND THE POSTNATAL PERIOD: RISKS AND POSSIBLE MECHANISMS FOR OFFSPRING DEPRESSION AT AGE 18 YEARS

Author: Rebecca Pearson, Jonathan Evans, Daphne Kounal et al.

Publication Date: December 2013

This academic article reports the findings of a cohort study investigating the hypothesis that there are independent associations between antenatal and postnatal depression with offspring depression and that the risk pathways are different. It found that antenatal depression was an independent risk factor for adolescent depression. Postnatal depression was also a risk factor for mothers with low education, but for more educated mothers, there was little association.

MUMS AND BABIES IN MIND LEADERS’ TOP TIPS REPORTS

Author: Maternal Mental Health Alliance

Publication Date: October 2016 onwards

These short reports capture key messages on particular themes relating to perinatal mental health. They are produced after the Mums and Babies in Mind Masterclass events. The reports contain top tips from leading experts to support the work of local commissioners, providers and clinicians.

So far, four Top Tips reports have been published

  1. Developing a Specialist Perinatal Mental Health Community Service
  2. Commissioning Perinatal Mental Health Services.
  3. Health visitors and midwives in perinatal mental health
  4. User insight and engagement

MUMS AND BABIES IN MIND MAPPING TOOL

Author: Maternal Mental Health Alliance

Publication Date: September 2016

This is a tool to help local partners to understand the quality and sufficiency of the services that exist in their area for women with perinatal mental illness and their families. We suggest that local partners look through the worksheets and assess the extent to which they meet the standards shown. The tool can create traffic light ratings to show the quality of different elements of the local pathway.

NICE GUIDANCE FOR ANTENATAL AND POSTNATAL MENTAL HEALTH (CG192)

Author: National Institute for Health and Care Excellence

Publication Date: December 2014

This guideline covers recognising, assessing and treating mental health problems in women who are planning to have a baby, are pregnant, or have had a baby or been pregnant in the past year. It promotes early detection and good management of mental health problems to improve women’s quality of life during pregnancy and in the year after giving birth.

NICE have also produced quality standards [hyperlink] for antenatal and postnatal mental health.

NICE GUIDANCE ON SOCIAL AND EMOTIONAL WELLBEING IN THE EARLY YEARS (PH40)

Author: National Institute for Health and Care Excellence

Publication date: October 2012

This guideline covers supporting the social and emotional wellbeing of vulnerable children under 5 through home visiting, childcare and early education. It aims to optimise care for young children who need extra support because they have or are at risk of social or emotional problems.

PERINATAL MENTAL HEALTH EXPERIENCES OF WOMEN AND PROFESSIONALS

Author: Boots Family Trust, Netmums, Institute of Health Visiting, Tommy’s and the Royal College of Midwives.

Publication Date: October 2013

This report describes the key findings from two surveys about experiences of perinatal mental health. One survey included around 1,500 women; and the other captured the views of more than 2,000 health professionals including midwives, health visitors and Family Nurses.

PREVENTION IN MIND

Author: NSPCC

Publication date: July 2013

This ‘spotlight report’ looks at what is known about perinatal mental illnesses and their impact on women and children, and what can be done to ensure better prevention, identification and treatment of these illnesses. This report is part the NSPCC’s All Babies Count spotlight series on issues that affect families from pregnancy through the first years of life.

RISKS AND PREDICTORS FOR READMISSION FOR A MENTAL DISORDER DURING THE POSTPARTUM PERIOD

Author: Trine Munk-Olsen, PhD; Thomas Munk Laursen, PhD; Tamar Mendelson, PhD; et al.

Publication Date: February 2009

This academic article compares mothers and non-mothers in Denmark to assess whether childbirth increases the risk for psychiatric readmission and to identify predictors of psychiatric readmission during the postpartum period. It finds that the first month after childbirth is associated with increased risk of psychiatric readmission, and women with a history of bipolar affective disorder are at particular risk of postpartum psychiatric readmissions.

SAVING LIVES, IMPROVING MOTHERS’ CARE

Author: MBBRACE-UK (Mothers and babies: reducing risk through audits and confidential enquiries)

Publication Date: December 2015

This is the second report of the Confidential Enquiry into Maternal Deaths. Led by the MBRRACE-UK team at the National Perinatal Epidemiology Unit at the University of Oxford, the report details the findings of maternal mortality surveillance 2011 to 2013 in the UK and the lessons learned from the confidential enquiries into maternal deaths of women with mental health-related problems, substance misuse, cancer and blood clots and women who died by homicide.

Alongside the full report, the MBRRACE also produce an infographic of key messages and a lay summary, which can be found here.

THE 1001 CRITICAL DAYS

Author: A Cross Party Manifesto

Publication Date: Republished December 2015

The 1001 Critical Days manifesto highlights the importance of intervening early in the 1001 critical days between conception to age 2 to enhance the outcomes for children.

THE COSTS OF PERINATAL MENTAL HEALTH PROBLEMS

Author: Annette Bauer, Michael Parsonage, Martin Knapp, Valentina Iemmi & Bayo Adelaja

Publication date: October 2014

This report, written by the London School of Economics and the Centre for Mental Health, finds that perinatal mental health problems carry a total economic and social long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK. It also finds that the NHS would need to spend just £337 million a year to bring perinatal mental health care up to the level recommended in national guidance. The report is part of the Maternal Mental Health Alliance’s ‘Everyone’s Business’ campaign.

A summary document is also available.

THE LANCET’S PERINATAL MENTAL HEALTH SERVICES

Author: The Lancet

Publication Date: November 2014

The Lancet’s Perinatal Mental Health Series reviews the effects of perinatal mental disorders on mother and child. The first of three papers examines non-psychotic mental illness, such as depression, anxiety, and post-traumatic stress disorder. The second paper looks at serious mental illness, focusing on bipolar disorder, psychosis, and schizophrenia; and the third paper summarises evidence for the effects of parental mental health on the child: from fetal development to adolescence across a range of low and high income countries.

WELLBEING PLAN

Author: Boots Family Trust, Netmums, Institute of Health Visiting, Tommy’s and the Royal College of Midwives.

Publication Date: October 2013

The Wellbeing Plan is a two-page plan, endorsed by NICE, that helps women to start thinking about how they feel and what support they might need in your pregnancy and after the birth. Ideally, the Wellbeing Plan will be used by midwives as a tool to raise awareness of the possible emotional challenges new mothers face. The plan is a result of research described in the report, Perinatal mental health: experiences of women and health professionals.

 

 

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