Developing services and pathways for parent & infant mental health

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Bryan Lucas
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1 Developing services and pathways for parent & infant mental health Sally Hogg Mums and Babies in Mind

2 My sessions today. Session 1: A recap what are perinatal mental health problems and why do they matter? The Maternal Mental Health Alliance and Mums and Babies in Mind Project. An introduction to the mapping tool. Mapping services from a baby s point of view. Session 2: Appreciate inquiry what are you good at, and how will you get even better?!

3 What are perinatal mental health problems & why do they matter?

4 What is perinatal mental health? Perinatal mental health refers to the mental health of mothers during pregnancy and the year after birth. There are a range of mental health problems that can affect women during this time, including anxiety disorders, depression and postnatal psychotic disorders.

5 How prevalent are perinatal mental health problems? More prevalent than people think: More than 1 in 10 new mothers experiences some form of perinatal mental illness. Postpartum psychosis affects 1 in 500 new mothers it is twice as common as Downs Syndrome.

7 Depression is the most common major complication in pregnancy. 14% 12% 10% 8% 6% 4% 2% 0%

8 This isn t just the baby blues Mental illness is one of the leading causes of maternal death in the UK today.

9 Admissions Increased risk of hospital admission Women are more likely to be hospitalised with a mental illness in the two weeks following birth than at any other point in their lives Weeks before Weeks after Birth Kendell, 1987

10 If not treated effectively, perinatal mental illness can impact on children Mental health problems can have direct and indirect impacts on fetal development. After birth, perinatal mental health problems can effect how a mother cares for her baby.

11 But problems aren t inevitable Clips from our Breakdown or Breakthrough films

12 We can prevent the harms caused by perinatal mental illness Proper management of an existing mental illness can prevent it from escalating during the perinatal period. Early detection and action to tackle problems in pregnancy or postnatally can prevent them continuing and escalating. Early action to treat mothers with serious mental illness can prevent serious harms to them and their baby. Supporting mothers to provide sensitive, responsive care to their babies can prevent any adverse outcomes for babies.

13 The Maternal Mental Health Alliance

14 There are many gaps across services

15 Specialist perinatal mental health services

16 Mother and Baby Units

17 Treatment of postnatal depression 100% 80% 60% 40% 20% 0% Prevalent PND Cases 40% Recognized Clinically 24% Any Treatment 10% Adequate Treatment 3% Achieved Remission (Gavin et al)

18 Inadequate services cost lives "That chain of failures contributed to Charlotte's death. Zaani's death was contributed to by a chain of failures in her mother's care."

19 There are economic costs of inaction Cost if we don t act 8.1bn 337m Cost of taking action

20 A coalition of over 70 national professional and patient organisations committed to improving the lives of mothers and their infants through better perinatal mental health

23 Successes Seats around the table with Government, NHS England and Health Education England. Pledge to have specialist mental health midwives in every maternity unit. Pledge to turn the map green supported by 360m investment in specialist services and Mother and Baby Units. Funding for a range of projects including training GPs, Midwives and health visitors.

24 Specialist Perinatal Community Services professional 2 professionals full team

25 Mums and babies in mind

26 Mums and babies in mind Working with local leaders to improve services for mums with perinatal mental health problems and their babies. Maternal Mental Health Alliance project, hosted by the Mental Health Foundation and funded by the Big Lottery Fund. Lasts for three years until Sept Working in 4 areas: Gloucestershire, Haringey, Blackpool and Southend.

27 Three levels of support 1. Expert advice and support to each area depending on their needs and priorities. 2. A leader s programme to bring together leaders from the four areas to learn together, share ideas and support each other. 3. Communications activity to share our activity, tools and learning to support others.

29 @MMHAlliance #MABIM

30 MAPPING LOCAL SERVICES

31 A spectrum of services are needed Health Visitors Children s Centres FNP Specialist Obstetricians Peer support services/ groups Specialist PMH community services Midwives GPs Talking therapies Parent & baby groups/activities Mother and Baby Units

32 A focus on families Services that involve and support fathers As fathers of babies As supporters of mums As parents potentially in need of help themselves Services that support parent-infant relationships research has shown that interventions can improve the symptoms of women with depression without improving the quality of motherinfant relationships or infant outcomes

33 This should all be underpinned by: Clear pathways across services A skilled workforce Clear roles and responsibilities Audits, monitoring and quality improvement Understanding of local needs Clinical leadership Structures and processes to support multiagency working

34 Lots of standards exist

35 The MABIM mapping tool A tool to help local partners to understand the strengths and gaps in their local offer. Brings together a range of standards in one place. An interactive tool, with seven themed worksheets. Still under development, but available to download and use on the MABIM website.

39 Any #mabim

40 Today s exercise part 1 Testing your perinatal mental health pathway from a baby s point of view. In your groups read the scenarios on the handout one at a time. For each one, consider what would happen for this baby and his/her family in your area? Who would know they were struggling/at risk? What help would they receive? Is this good enough?

41 Reflections

42 Part 2 Based on your work in part 1, consider what you would like to achieve for babies in your area. What commitments would you want to make to all new babies? In your group, start to draft a baby s charter on perinatal mental health.

43 Our Baby s Mental Health Charter Every one will treat you, your mum and dad with care and respect at every contact. Health visitors, midwives and doctors will ask your mum about her mental health and ensure she sees someone quickly to help her deal with any problems. You will never be forgotten. Every professional dealing with your mum and dad will ask how you are doing. If your mum has to go to an appointment or go into hospital, we ll make sure you can stay with her and that the setting will be comfortable for you

Developing services and pathways for parent & infant mental health

Developing services and pathways for parent & infant mental health Sally Hogg Mums and Babies in Mind #MABIM @salhogg A coalition of over 80 national professional and patient organisations committed to