Training Gloucestershire health visitors to promote mums’ and babies’ mental health

dsc_0027By Catherine Whitcombe, Locality Practice Teacher (Infant Mental Health Portfolio), Gloucestershire

When mums experience mental health problems, it can make it more difficult for them to bond with their babies and provide the sensitive care their babies need. In this blog, Catherine Whitcombe talks about the work health visitors are doing in Gloucestershire to promote mums’ and babies’ mental health. Catherine also spoke at last week’s Babies in Mind seminar about the use of the Neonatal Behavioural Observation tool. You can see a summary of the seminar here

In December 2014 the health visiting service in Gloucestershire provided me and a colleague with the opportunity to complete the Neonatal Behavioural Observation (NBO) training. The aim was to gain a greater knowledge about, and learn new skills in supporting parents in understanding their babies.

The Neonatal Behavioural Observation is a tool which enables professionals to spend just ten minutes with new parents, helping them to get to know their baby and understand his or her unique characteristics, strengths and struggles. Research suggests that it helps parents to feel closer to their baby and more confident as a parent, and reduces the incidence of postnatal depression.

Despite practising as health visitors for many years and holding Perinatal Mental Health portfolios, we gained a significant amount of additional knowledge from this course, some of which we were able to disseminate to the health visiting workforce. Subsequently, in October 2015 we completed the Neonatal Behavioural Assessment Scale (NBAS) training, with a greater focus on working with families where there are specific concerns, including safeguarding, babies born prematurely, congenital disorders or developmental delay. This further enhanced our skills and expertise.mabim main image

We have been working very closely with and have had strong support from the commissioners and other providers within Gloucestershire to develop our parent and infant mental health offer. This has been facilitated further by the support we have received from Mums and Babies in Mind. Because of this close partnership and the results noted from both the NBO and NBAS training, it was decided that further NBO training should be provided to seventeen other health visitors, with a particular enthusiasm and interest for perinatal mental health. Some of those who attended the training have become Locality Perinatal Mental Health (PMH) Champions, providing advice and support about both parent and infant mental health to colleagues within their localities. These health visitors gave us feedback on the great results they got from implementing NBO with families they were involved with:

“I did my first NBO today with a family whose baby was born with indeterminate sex. It was a lovely and positive thing to do with parents who have had a lot of time in hospital. The Mum gave some wonderfully positive feedback.”

”I really enjoyed the NBO training and feel it will really enhance my practice…I think it would benefit the whole health visiting team to be trained in NBO and this will mean it will be able to be delivered as part of our universal service, making the service equitable.”

“This was an excellent training session that was totally relevant to our everyday work. I have been trained for more years than I care to remember but lots of information on this course was new information. I feel that all health visitors would benefit from being able to attend this training and it would enhance the service that we could deliver.”

Through discussion with our commissioning colleagues and other local providers it has now been agreed that all Gloucestershire health visitors will be provided with NBO training, ensuring equity and high standards of service provision. This is great news.

health visitor2We are now in the process of developing our service and pathways further. The Locality Perinatal Mental Health Champions are currently completing Video Interaction Guidance (VIG) training. Our overall plan is to create a set of criteria to assist health visitors in identifying via NBO if further input with VIG would be beneficial. A flow chart will be developed that guides health visitors through this process with referrals on to other services as appropriate.

Working with commissioners and providers has been an invaluable and rewarding experience. We have appreciated the advantages of going through the process together to ensure that everyone has a voice, that all areas are explored and that duplication is prevented. I feel that exciting times are ahead for the Gloucestershire Perinatal Mental Health service and that increasingly more mums and their infants will ultimately benefit from an improved level of care.

Check out the summary from our Babies in Mind seminar about the use of the Neonatal Behavioural Observation tool: