1. Perinatal Mental Health in communities
Dr Andrew Mayers
Bournemouth University
Dorset HealthCare University NHS Foundation Trust
DorPIP

2. Who am I? First worked in Hampshire perinatal MH unit in 2003
Now associated with Dorset MBU in Bournemouth
Member of Maternal Mental Health Alliance
Member of Perinatal Mental Health Partnership
Member of Parliament APPG, “1001 Critical Days”
Governor, Dorset HealthCare University NHS Foundation Trust
Patron, Dorset Mind
Chair, DorPIP
For more information:
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3. Perinatal Mental Health in communities
Perinatal MH support
Historical shortage in MBU & community support
Need for MH training for health professionals
Recent advances
What we still need to do
Why ‘perinatal’?
Why help needed in community?

4. Where is Maternal MH support?

5. Campaigns
Maternal Mental Health Alliance
Coalition of 85 national charities, groups and Royal Colleges
Everyone’s Business campaign
Every mother needs access to proper MH services across UK
Major milestones
Mapping of perinatal mental health services – July 2014
Less than 1/6th of UK has sufficient services
See -
Economic impact of perinatal mental health – Oct 2014
Long-term costs £8.1b per one-year cohort births
Perinatal depression, anxiety, psychosis
£335m investment (only) to deliver services needed to address this
See –

6. Campaigns All Party Parliamentary Group (APPG) “1001 Critical Days”
Cross-party initiative
Aims to ensure all children have very best start in life
1001 days = pregnancy to child's second birthday
Perinatal mental health central to these aims
‘Building Great Britons’ report launched at Parliament Feb 2015
Relaunched and reinforced in December
MPs urged to consider how important this is
Government allocated £300million to PMH services over 4 years

7. Campaigns Perinatal Mental Health Partnership
Collaboration of local groups, service users and experts
Local charity leaders, GPs, midwives, health visitors, campaigners, people with lived experience
Working ‘bottom-up’ to influence change
Campaigning and raising awareness
Training health professionals
Mapping ‘Quality’ peer support groups
Informing local and national media
Working with TV – e.g. EastEnders postpartum psychosis story

8. Training
Maternal Mental Health Alliance campaigning for ALL health professionals to get training
Midwives, health visitors, antenatal/birthing nurses, obstetricians, occupational therapists…
Some prof bodies (Royal Colleges, etc.) running some courses
Other centres running additional training
Pre- and post-registration
Content
Diagnosis, symptom recognition, warning signs, risk factors, medication safety, treatment and therapy options, support groups, service user and family education
Mental Health First Aid

9. So has it made a difference?

10. So has it made a difference?
Dots shows areas in receipt of dedicated funding
Specialist community perinatal mental health services
Direct result of MMHA EB & 1001 Critical Days campaign
BUT - map also shows areas of the country currently lacking
So what else needs to be done?
Clearly, clinical services still need attention
But what about those in community not so unwell they need MBU or specialist secondary care services?

11. What needs to be done in community
Why ‘perinatal’?
Pre- and postnatal
Evidence that prenatal anxiety bigger risk factor for…
Postnatal mental illness
Poorer child outcomes
Fathers as well as mothers
Dads need information/advice on supporting wife/partner
Dads can independently develop ‘PND’ etc.
More work needed on fathers’ experience of witnessing birth trauma
Information, support, PTSD

12. What needs to be done in community
Why focus on the community?
Some mums may not be so unwell they need MBU/secondary care
But still need support, advice, toolkits, etc.
Help prevent escalation
Support for mums discharged from MBU/secondary care
Help prevent relapse
Coping skills
Ideally opportunity for peer support
Benefits for those supporting and those being supported
So long as safe and appropriate
Often key focus is improving bond between parents and infant

13. DorPIP We are starting new PMH support programme
PIP UK ( aims to support in 3 ways
Therapy focused on attachment
‘Patient’ is the relationship between mother and infant
Education (parents, health professionals)
Improve prevention
Raising awareness (to get more support)
PIP UK model is to have local programmes (run independently)
Groups in Northamptonshire (NorPIP), Oxfordshire (OxPIP), Brighton (BrightPIP), Liverpool LivPIP)… etc.
We will be starting Dorset version soon! (DorPIP)
Follow progress on

14. Summary Need for perinatal MH support
Campaigns have focused largely on more MBU/secondary care
And need for better perinatal MH training for HCPs
Success of those campaigns welcome
But we need more community support
Mums who do not meet criteria for MBU/secondary care
Still need support
And more support for dads
Charities and third sector may be able to help
DorPIP