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Perinatal mental health

Perinatal mental health occurs within in a specific time period, and to someone having or just had a baby. Traditionally this refers to specialist mental healthcare for pregnant people, or those with young babies. 

Over the past few years, perinatal mental health has become much more than that. People planning pregnancy can need to weigh up the risk and benefits to their own and other’s mental health. Having mental health challenges can affect a parent’s ability to form strong positive bonds of attachment with an infant. This applies to dads and other carers as well as mum, and there can be an impact on mental health that could lead to lasting implications in adulthood. 

Perinatal mental health in the NHS 

Five years ago, 40 per cent of the country had no access to perinatal mental health care. As of March 2019, every NHS sustainable transformation area in the country has an operational specialist community perinatal mental health service for women experiencing moderate/severe complex mental health issues in the perinatal period. In 2019/20 they reported seeing over 30,000 women.  

There has also been a significant expansion in the capacity of inpatient Mother and Baby units (MBUs) which support women with serious mental health issues, keeping them together with their babies. Four new inpatient Mother and Baby Units opened in areas of particular need (North West, South West, South East Coast and East of England). There are now 19 units across England and work continues to increase specialist inpatient capacity as part of Five Year Forward View for Mental Health (FYFVMH) PMH commitments.  

There is still further work to do. This is recognised in the NHS Long Term Plan (LTP) published in July 2019, in which NHS England commits to further increasing access to specialist perinatal mental health services. By 2023/24, at least 66,000 women with moderate severe/complex perinatal mental health difficulties will have access to specialist community care from pre-conception to 24 months. HEE is supporting the implementation of the NHS England and Improvement Transformation plan.

Perinatal mental health in HEE 

HEE not only focuses on the individual needs of specialist perinatal mental health inpatient services and community teams, but looks at the workforce training and education implications for the wider pathway in mental health, primary care and maternity services. This is in order to allow services the opportunity to have staff who can care for the mental health needs of mum, baby and family wherever they are. 

Resources for everyone 

Over the past few years, HEE has developed the  perinatal mental health competency framework, aimed at outlining the skills, knowledge and abilities that people need when caring for someone in the perinatal period, whether they are a specialist member of staff or not. This framework is under continuous review and further development. Please note, you can log in or preview the framework as a guest if you don’t have an e-LfH account. 

HEE resources for specific groups of staff 

HEE has developed a range of e-learning modules to help educate and develop the workforce caring for people with perinatal mental health issues. We have worked with the Royal College of Occupational Therapists to develop specific training for specialist perinatal occupational therapists. In addition, we are also working with the Royal College of Psychiatrists provide a range of psychiatry masterclasses. This is now delivered online to support the availability of learning during and in the aftermath of the pandemic. 

HEE has worked with the University of Exeter Clinical Education Development and Research Centre (CEDAR) and the University of Liverpool to provide specialist training to upskill qualified clinical psychologists in perinatal psychological assessment, intervention, and perinatal team supervision and leadership. We have also commissioned a bespoke postgraduate module for mental health nurses and others working in specialist perinatal mental health services, in order to allow them learning which consolidates and deepens their understanding of how they contextualise their practice in a perinatal setting.  

Useful Links

NHS Benchmarking Network: perinatal mental health

NHSE Perinatal website

MMHA

Parent-Infant Foundation