Perinatal Mental Health HITIMPROVE

(Improving Mental Health Perinatally through Research and Education)

Implementing evidence; generating evidence

Importance

• Prevalence – Depression approximately 10% at anyone time (antenatal and postnatal). 6% severe depression perinatal, anxiety disorders similar rates.

• Also severe mental illness eg schizophrenia, bipolar. High relapse rate postnatally.

• Impact – antenatal (fetal programming and maternal programming) and postnatal environment in the early years.

• Cost - Perinatal depression, anxiety and psychosis carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK

Aim of the Improve HIT

• Overall aim – raise the quality of perinatal mental health care in order to improve outcome for mother, father and child

Achievements so far

• Bringing together clinicians and managers across a range of organisations and disciplines.

• Forming into work streams.• Raising awareness of the importance

developing the case for a perinatal mental health team.

• Early indication that there is a greater use of appropriate referral for psychological treatment during pregnancy.

The Antenatal

Care Pathway

The Antenatal

Care Pathway

Teaching and training

Teaching and training

Business Case for a Perinatal Mental

Health Team

Business Case for a Perinatal Mental

Health Team

Universal preventionUniversal

preventionPatient and

public involvement

Patient and public

involvement

Research

Audit

Fathers

Team Business

Perinatal mental health - Care Pathway

Audit figures (NBT and UHB)

• NBT 2013-14 there were 6201 births 618 (10%) screen positive to depression case finding questions. Only 186 (3%) requesting help. (Previous year NBT 11.7% and 2.7% respectively)

• UHB 2013-14 there were 5499 births 379 (6.9%) positive on depression case finding questions 117 (2.1%) requesting help.

Research

• Grants– Fathers intervention (in submission)– Fellowship - epidemiology of maternal risk factors

(targeting)– Novel intervention Approach training (piloting)– Medication advice decision aid intervention– External links Acorn trial, Netmums trial, paediatrics

SSRI withdrawal, Swedish data on psychotropic risks and neurodevelopmental disorders.

Festival of perinatal mental health