Agenda item

Carly Galpin from the Perinatal and Maternal Mental Health Service presented to the forum.  The team have been in existence for 3 years, growing from 2 to 35 staff over the years.

·         20% of women experience mental health conditions during pregnancy and/or after birth from mild, which generally resolved by itself, to severe.  This could be anything up to 12 months after the birth.

·         20% risk of mental health issues during pregnancy is higher than physical risk.

·         The service work with moderate to severe cases.

·         During pregnancy up to 2 years old is the most important time for an infant’s development.  Infant brain development will be affected by how the mother is.

·         Any woman who has had previous experience of mental health issues has a 90% chance of a relapse.

·         Midwife will be asking specific questions on mental health history to find out the best place to signpost each individual.

Red Flag Presentation:-

1.       Significant change in mental status or new symptoms.

2.       New thoughts or acts of violent self-harm

3.       New and persistent expressions of incompetency as a mother or feel estranged from the infant.

Meet with consultant to get evidence based information so the pregnancy can be planned especially around medication.  Stopping medication is not always the best course of action and can have a detrimental effect.

Significant development for the service is to support women who have a miscarriage, still birth, birth trauma or fear of the birth as this did not fit in.

Maternal OCD, suddenly realising all the risks for the infant is normal, but it can become overwhelming and disabling and requires specialist support.  

9,000 babies are born in the county in the year, 5,000 of those are born in Northampton.  The target for referrals of those 9,000 is 65 a month.  Currently receiving about 100 referrals with 50 of those  being seen by the service.  The others are signposted elsewhere.

It is a multi-discipline team including a Social Worker who is also the Safeguarding Lead.

Q&A followed

Poorer outcome for BAME women and pregnancy

Carly responded that the poor outcomes were more associated with physical rather than mental health.  Black women were 4  times, and Asian women 3 times more likely to have physical issues whilst white women were more likely to have mental health issues.  Carly had noticed a disproportionate number of teachers – probably due to them being in control and able to plan their work lives, then they have their world turned upside down!  Similarly with Police officers.  One area of concern was that women who did not have settled immigration status tended to be referred at a very late stage.  The service was open to all, whatever their status was, and the outcomes are going to be much better the earlier they were referred.

Have the Team undertaken any equality and anti-bias training

Equality training has been done, anti-bias training currently being undertaken and LGBTQ training to follow.

Is there any support (website/information) for those who have suffered a miscarriage and for their partners.

Carly said the ambition was to give signposting for partners of those referred to the service as well as peer support. 10% of males suffered with mental health issues during and after pregnancy.  Further information/links to follow.

Is the service for women whose children will be taken away after birth

The service is for mum and baby so this would be mainstream services although there had been cases then they had supported mum through the pregnancy.

How long had the service been running, how did it reach out to the community and was the term ‘mental health’ used in the community as it may be a taboo in some communities.

The service had been running for 3 years.  Referrals come from GPs, Midwifery and Health Visitors.  There had been a lot of talk in the Team about how to communicate with communities and this needed to be put into practice and Community Champions set up.  One of the nurses was of Asian background which had been helpful but the correct language was important and cultural beliefs needed to sit alongside mental health services.

Are there any hampers available for those with NRPF or asylum seekers.

Baby Basics did hampers of essentials and can be applied for through the team or midwife.  Mental Health support was given regardless of asylum status or NRPF.

What can be done around concerns with the maternity service in hospitals.  Feel as a black woman that concerns were minimised in own case.

You can have a birth debrief and go through the notes with a midwifery advocate.  A midwife might see something as not traumatic but the mum might have found it very traumatic and that is what matters.  There is no time limit for a debrief.

The Maternity Voices Partnership is a service user voice that feeds back into the maternity services.  You can ask questions and raise concerns.  They are especially interested in feedback from BAME mums.