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Perinatal Mental Illness
Focus on improving attachment Looking for signs Signposting - systems and support
NHS Charities Support groups Social media Campaigns Training
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Perinatal Mental Illness
What does perinatal mean? Covers pregnancy and (typically) 1st year after birth
Antenatal depression relatively under-researched Mums AND dads
Dads can get ‘perinatal mental illness’ too Less well-researched A few support groups (e.g. Fathers Reaching Out –
see later) Coping with partner/spouse mental illness Dads can develop symptoms independently Causes for dads often relate to ‘changes’
Income, relationship, responsibility, emotions, dynamics…
Managing expectations
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Importance of maternal bond
We saw this slide earlier – but worth revisiting… Early mother–infant bond may have sig. impact on
developing infant (e.g. Bowlby, 1953; Ainsworth, 1993) Infant’s internal working model (IWM) is very important
Expectations about themselves in relation to others Model of self and of other
If infant’s carer attends positively and responds to needs Infant has positive IWM:
High self-worth, availability of others, resolution of crises
Infant’s carer inconsistent response and attention Infant’s has negative IWM:
Low or ambivalent self-worth, unavailable others, crises not resolved
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Attachment – what can we do?
How well is mum bonding? Does she maintain eye contact? Is she comfortable with baby? Does mum appear distressed about feeding and bonding? Does baby appear distressed?
Be positive Take care not criticise Empathise and encourage Praise and reinforce Make mum feel good about herself Don’t give too much advice
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Looking for signs and risk factors
Vulnerability factors Genetic vulnerability Life stresses
Moving house, developmental or behavioural difficulties in other children, relationship breakdown…
Social support Experience of childhood
Protective factors Self-compassion Mindfulness Reflection and insight
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Signposting to services
GP surgeries
Specialist midwife team
Mother-and-baby unit (MBU: if your area has one!)
Charities and support groups
PANDAS
Fathers Reaching Out
Action on Postpartum Psychosis (APP)
Maternal OCD
Local/specialist charities and groups
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PANDAS
http://www.pandasfoundation.org.uk/
Twitter: @Pandas_uk
Facebook: https://www.facebook.com/PANDASFoundation?fref=ts
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PANDAS
National charity supporting all perinatal mental health Mums, dads, and families
Especially antenatal and postnatal depression Support groups across UK Telephone support line E-mail support group Campaigns Information Sign-posting
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Action on Postpartum Psychosis (APP)
http://www.app-network.org/
Twitter: @ActionOnPP
Facebook: https://www.facebook.com/ActionOnPP?fref=ts
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APP
National charity offering specialist support Postpartum psychosis & bipolar disorders Information and education
For women, their families & health professionals National events & workshops Signposting to resources or support Secure and confidential online peer-support
For women and partners Specialist advice (via panel of experts) Free referral to specialist second opinion psychiatry
service Research
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Maternal OCD
http://www.maternalocd.org/
Twitter: @maternalocd
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Maternal OCD
National charity offering specialist support
Specifically focuses on Maternal OCD
Talks and presentations – education and advice
Service users
Professionals
Support for 'drop ins'
Interactive training workshops
Research
Currently working with C4 to make documentary
See recruitment clip: https://www.youtube.com/watch?v=VcghErjT5GQ
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Social media
Great way to get message out Support for service users and families Promote information Campaign Tackle discrimination Encourage talk
Examples #PNDHour
Wednesday 8-9pm #Bumpsandmumsocdhr
Monday 7-8pm #APPchat – restarting very soon
Follow me @DrAndyMayers to see more about how we support
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Raising awareness - campaigns
Do you know where the local MBUs are?
How many areas of UK have specialist community teams? Those that are ‘accredited’ to RCPsych standards
How much does perinatal mental illness cost the UK?
How much does UK Government need to spend to put it right?
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Campaigns
Maternal Mental Health Alliance http://maternalmentalhealthalliance.org.uk/
Coalition of 60 national charities, groups and Royal Colleges Everyone’s Business campaign http://everyonesbusiness.org.uk/
Every mother has 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 - http://everyonesbusiness.org.uk/?
page_id=349 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 – http://everyonesbusiness.org.uk/?p=742
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Campaigns
Everyone’s Business – who needs to know this? National Government – Department of Health
We launched economic report in Parliament Oct 21 Need long-term financial commitment
Local government, MPs and Clinical Commissioners I have been in touch with all Dorset MPs
These are vital issues for constituents I am leading plans with local councils (esp. Dorset
CC) Contacting all Clinical Commissioning Groups
They spend the NHS money allocated by Government
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MMHA goes to Parliament
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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
Develop materials for ‘birthing packs’
Training health professionals
Informing local and national media
Campaigning and raising awareness
We have just had first steering meeting
Watch this space!
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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 I am doing some right now!
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
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What next
More campaign work through national groups Maternal Mental Health Alliance Perinatal Mental Health Partnership
Research Working my BU team – academics and students Links to charities and those they support Bournemouth perinatal mother and baby unit
Training Health professionals
Existing health visitor courses Start new courses at BU
HVs, midwives, GPs, obstetricians… PGDip Health Visitors – training post-qualification
students
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What have we learned
Focus on improving attachment Looking for signs Signposting - systems and support
NHS Charities Support groups Social media Campaigns Training
