Perinatal Mental Health Teams
What are they?
A team of NHS professionals which cares for women with mental health conditions whilst pregnant, trying to get pregnant or with a baby up to 1 year old. They have specialist knowledge of the particular issues faced by mothers with mental illness.
Who is in them?
- Psychologist – These are therapists who provide talking therapies, interventions and group work to support those with mental health problems. Ideally in a perinatal team they should have specialist knowledge of the mental health issues that affect new or expectant mothers.
- Psychiatrist – A senior doctor with specialist training in mental illness. They tend to oversee care, carry out assessments and review medication. Again ideally they should have a specialist interest in the perinatal period.
- Community Mental Health Nurse (also referred to as Community Psychiatric Nurses, CPNs) – They will have a broad role in working out what help you need, helping you cope with mental illness, coordinating the care you receive and acting as an advocate for you.
- Occupational Therapist – These tend to work on the more practical aspects of day-to-day life and coping with a baby or pregnancy and mental illness. Examples might be supporting you to live a healthy lifestyle, bonding activities with your child or accessing other support.
- Nursery Nurse – These are childcare practitioners, with similar qualifications to those who work in nurseries or as childminders. Their expertise lies in building relationships with babies, supporting parents to engage with their children, offering tips and advice around the practical aspects of caring for children.
What do they do?
- They will assess you, offer a diagnosis and recommend a treatment plan
- Treatment might include medication, talking therapies (such as Cognitive Behavioural Therapy, group therapy or trauma processing), bonding and attachment work, admission to an inpatient unit, coping strategies.
- They should also be able to advise you on the risks and benefits of mental health medication around having a baby
- They can refer you to a hospital Mother and Baby Unit, a ward where women can be treated with their babies.
- They can support you after you have left a mother and baby unit
- They might point you towards other sources of help, such as voluntary groups or peer support like Happy Mums.
- They can also support your family and partner, by giving them information and advice or getting them extra help.
- They educate other health professionals on mental illness around the time of having a baby, to improve the care they give
Who gets to see them?
- They usually look after women with moderate to severe mental illness – in practical terms this means support from your GP or a universal therapy service like First Step isn’t enough.
- Generally though, the threshold for getting support is lower in the postnatal period than at other times, as women can deteriorate quickly and help is vital for them and their baby
- If you have a history of psychosis, bipolar, schizophrenia, PTSD, OCD or severe depression/anxiety
- If you have a high risk of developing post-partum psychosis (a rare but very serious mental health condition that develops soon after giving birth) – this might be because of family history, or previous psychosis
- If you are being cared for by a mental health team already
- If you have been admitted to hospital for mental health problems
How do I access one?
- You can be referred by your midwife, health visitor or GP
- You should be asked about your history of mental illness by your midwife and followed up if you have a risk of getting worse when you have a baby
- If you are already seeing someone in a mental health team, like a care co-ordinator, they can refer you or arrange joint care
- You might also be referred by an obstetrician (doctor who cares for women giving birth
- If you have contacted a mental health crisis team they might be able to refer you or arrange for a referral
- If you have been in a psychiatric hospital mother and baby unit, they would usually involve the perinatal team all the way through your care
Does every area have one?
No but it is one of the NHS’s priorities for every area of the country to have specialist perinatal mental health teams. Coverage used to be about 40% but this is going up rapidly, including in rural areas like Cumbria.
Why do we have them?
-Mental illness during the perinatal period (pregnancy and 1-2 years after birth) is different to other times – the risk factors, coping strategies, how the conditions look and are treated, the impact on others.
-Getting the right help quickly will not only improve things for mums, but also can have a big impact on their children.
What mums in Cumbria have said:
“I got involved with the Perinatal team from a referral from the midwives and CRISIS Team.
Initially I saw a psychiatric nurse and an OT (Occupational Therapist) for a few sessions, and it was with the help of the OT that I got a place in a mother and baby unit in the North East. This was a very scary time and it was really reassuring to have her there to help make the call and be present when I met with the community team too.
After my discharge from the mother and baby unit I went back to the Perinatal team and the OT worked with me on a lot of play therapy and also developing coping strategies too.
It was the little things to start with, such as learning nursery rhymes to sing to a baby or learning how to play with her. This wasn't something that came naturally at first as I hadn't really been around babies and small children much.
She would turn up at the house with bowls of pasta or cornflakes and flour and water to do messy play with my daughter and show me how to get her involved. Plus it really helps having a spare pair of hands to help clean up!
I really appreciated all the help and support the OT gave both me and my daughter in that first year, it’s really made a difference. “
Royal College of Psychiatrists – More information about specialist perinatal teams. https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/what-are-perinatal-mental-health-services
Best Beginnings - https://www.bestbeginnings.org.uk/
Cumbria’s perinatal mental health team https://www.cntw.nhs.uk/services/perinatal-community-mental-health-team-north-cumbria/ https://www.lscft.nhs.uk/perinatal-accessing-our-service