1. Margaret Trivasse Lead Psychologist Therapist Bradford City Primary Care Mental Health Team

2.  Depression  Peri-natal depression  Anxiety  Insomnia  Poor appetite  Isolation  Post traumatic stress

3.  Flashbacks and nightmares  Avoidance, eg confined spaces, people in uniform  Sleep problems  Irritability or outbursts of anger  Difficulty concentrating or dissociation  Hypervigilance  Exaggerated startle response

4.  FGM: physical and emotional aspects  Pregnancy as a result of rape  Previous birth trauma  Language: not being able to communicate needs or understand adequately  Mother’s mental health has impact on unborn child

5.  Problems in attending appointments, due to not understanding letters, having no money to travel, lack of childcare for other children  Poverty, especially when support is via Azure card and not cash  Not knowing entitlements and how to apply

6.  Post natal depression  Problems in bonding  Guilt at not being able to provide adequately  Fear of future for self and child  Difficulties in maintaining adequate hygiene in asylum properties

7.  Giving birth alone  Separated from child’s father  Homelessness  Staying alive only for baby, and thinking Social Services could give better care  Trying to put on brave face for baby so no space to express own distress  Poverty, especially Azure card, a major issue

8.  Within City Primary Care Mental Health Team, maternal mental health is fast-tracked  Counselling, art therapy, mental health support and groups working with stress  Interpreters are used  Mum’s Wellbeing specialist, offering “Watch, wait and wonder” (applicable cross-culturally) and use of interactive video

9.  Referral is via Single Point of Access 01274 221181 (fax 01274 202579)  Maternal Mental Health Specialist is Lisa Milne via 01274 322644  Other local agencies include Bradford Action for Refugees (01274 762100); Red Cross (01274 223293); Bradford Rape Crisis (01274 723896); BIASAN; HALE project (01274 271088)