It has been exciting to be part of developing a new service in Beds and Luton to support women who need specialist help and support with their mental health during the perinatal period. We can now start to shape services for local parents, and improve the outcomes for women who experience perinatal mental health difficulties.
There have been a lot of papers and guidance published about the importance of perinatal mental health, but despite this, women in Bedfordshire and Luton did not have access to a specialist perinatal mental health team. It has been well publicised that the cost of not having access to a specialist service is £8.1 billion per year, with 2/3 of this cost linked to the child. In simple terms, it is far cheaper to provide a service than not to, as well as benefitting the families in our area.
Back in early 2018 a successful bid was put in to NHS England to expand the Perinatal Mental Health service provision in Milton Keynes, and set up a new service in Beds and Luton. I was lucky enough to come into post in October 2018, which has been both challenging and rewarding. I am delighted to say that from 1st April 2019 there is now a full team in place, and we are working alongside existing services to add specialist mental health support to women who are pregnant or have a child under 12 months old.
We have a specific remit as in the 5 year forward view to:
- Support women with new and existing mental illness during a vulnerable and risky time
- Manage and observe lower risk thresholds and changing complexities
- Have a specialist knowledge of the impact of maternal mental health
- Educate and train other professionals
- Assess attachment and bonding
- Give preconception advice to women on psychotropic medication
- Plan for mental health care during pregnancy, birth and postnatal period.
- Arrange admission to MBU
- Follow up women discharged from an MBU
- Offer psychological therapies
- Offer practical advice on how to care for a baby to women under the care of the service.
Although there are varying statistics about how many women are affected by perinatal mental health, we know from the stories of those who have had mental health needs during this time, the impact of not having the right help and support can be devastating. Prenatal stress and anxiety release cortisol, which can contribute to low birth weight, premature birth, and sleep difficulties in babies.
We will help women who are at increased risk of developing mental illness, either because they have a previous history of perinatal mental illness, or have a female relative (mum, sister etc.) who has experienced postpartum psychosis or has bipolar disorder. The team will provide advice on mental health medication both during and after pregnancy, as well as monitoring for changes in mental health throughout their involvement.
Women who are already open to community mental health teams, or have a diagnosed mental health need (e.g. Bipolar, Schizophrenia, Severe depression) should always be referred to the Perinatal Mental Health Service, even if they currently are feeling well. This is to enable us to work preventatively.
If there was a key message to get out to parents and health professionals, it would be that mental health medication should not be stopped during pregnancy or postnatally, without first discussing with a specialist service. Reducing or stopping medication could trigger a relapse, so we want to work with mums to plan what they would like to happen in advance. In all cases we would ask that a referral is made to the Perinatal Mental Health Team, in order to have medication advice from our consultant psychiatrist.
Preconception advice will also be available for women who are on medication for their mental health, and are planning or considering having a baby. This will help to ensure that there is a plan in place which will help maintain the mental health of the mother, without impacting on the health and development of her child. Once this advice has been given, the woman will be discharged back to her usual care provider, but should be referred back to the perinatal team when she becomes pregnant.
We hope that by working across the wider pathway we can help to reduce the stigma of perinatal mental health, as we are consistently told by parents that they worry that their child will be taken away if they tell people that they have a mental health need. By working with the Perinatal Champions we can raise awareness of the thoughts and fears of women, and why it is difficult to tell health professionals when things are difficult.
Please contact us if you would like any more information about the service and what we offer. Our contact details and referral form, as well as frequently asked questions are available on the website: https://www.elft.nhs.uk/service/441/Perinatal-Mental-Health-Team-Bedfordshire–Luton