The National Perinatal Epidemiology Unit (NPEU) has updated information about their work on developing a perinatal mental health indicator in England (PMHI). Four indicators have been selected: the Apex indicator; contact with mental health professional during perinatal period; attended contact with Improving Access to Psychological Therapies (IAPT) during perinatal period; and perinatal IAPT referrals showing reliable improvement/recovery.
The Apex indicator will require new data collection and is thus several years away from implementation. The other three indicators could in principle be created now and adoption depends on the wishes and needs of policy makers. The overarching purpose of the indicator set is: to ensure that maternity and postnatal care services are identifying women with perinatal mental health problems, offering appropriate and accessible mental health services and achieving outcomes acceptable to women and clinicians which minimises potential harms to the woman, her family and the development of her child.
This Mental Elf blog post is about a recent systematic review and meta-regression of the prevalence and incidence of perinatal depression. The blogger concludes that the systematic review estimated that the prevalence of perinatal depression is approximately 12%. Estimates of prevalence are important for increasing awareness of depression during pregnancy and the postnatal period, and informing the allocation of health resources. In particular, this study highlights that depression is equally prevalent during pregnancy as in the postnatal period, and that there is a higher prevalence of perinatal depression in low and middle income countries than in high income countries.
Woody C, Ferrari A, Siskind D, Whiteford H, Harris M. (2017) A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders, Volume 219, 86-92. http://dx.doi.org/10.1016/j.jad.2017.05.003
The Chief Executive of NHS England has announced four new Mother and Baby Units which will allow women to stay with their babies while receiving the specialist care they need. These new units will provide in-patient support for women and their babies with the most complex and severe needs who require hospital care, who are experiencing severe mental health crisis including very serious conditions like post-partum psychosis
“Having a baby should be one of happiest, most life-changing experiences and every mum should have the opportunity to bond with her baby, while receiving the care she needs and remaining as close to her families as possible”
This NICE guideline covers recognising, assessing and treating mental health problems in women who are planning to have a baby, are pregnant, or have had a baby or been pregnant in the past year. It covers depression, anxiety disorders, eating disorders, drug- and alcohol-use disorders and severe mental illness (such as psychosis, bipolar disorder and schizophrenia). It promotes early detection and good management of mental health problems to improve women’s quality of life during pregnancy and in the year after giving birth.
In August 2017, we added footnotes to recommendations 1.2.3, 1.4.27, 1.4.28 and 1.4.29 with a link to the MHRA toolkit on the risks of valproate medicines in female patients. We also updated a crosslink in recommendation 1.8.23 to link to the NICE guideline on violence and aggression. Footnotes were also added to recommendations 1.4.17 and 1.9.9 advising people that the UK Drugs in Lactation Advisory is available as an additional resource when seeking advice about specific drugs.
The Royal College of Midwives has published Every mother must get the help they need (pdf). This report was inspired by the Change.org petition of Lucie Holland, whose sister died in tragic circumstances as a result of mental illness. Lucie set up the petition in 2015 calling for better awareness and care for those affected by perinatal mental illness. This petition received thousands of signatures and many people left comments about their own experiences. The RCM and partners have analysed and collated all the comments to form this report, which aims to highlight the need for better awareness and care for those affected by maternal mental health problems.
The National Childbirth Trust (NCT) has published The hidden half: bringing postnatal mental illness out of hiding. The Hidden Half campaign surveyed 1,000 women who had recently had a baby and found that half had a mental health or emotional problem postnatally or during pregnancy. Of these, nearly half hadn’t had their problem identified by a health professional and hadn’t received any help or treatment. Many of these new mothers said they were too embarrassed or afraid of judgement to seek help.
The NHS Benchmarking Network was commissioned by NHS England to undertake a bespoke data collection on perinatal mental health services. The aim of this project was to inform the Perinatal Expert Reference Group of the current provision of perinatal mental health services in England, covering both inpatient Mother and Baby Units and Community Mother and Baby Teams. This is a high level national report presenting overall national findings.