This year's Perinatal Mental Health Summit had two central themes: ‘improving perinatal mental healthcare’ and ‘implementing the 2018 national perinatal mental healthcare pathways’. As a result, the event drew delegates from around the UK and with a wide range of job titles, from student midwives to consultant psychiatrists.
Conference chair, Elaine Hanzak opened proceedings with an account of her own experience with perinatal mental illness, illustrating the continuing importance of research to recognise and treat women before it is too late. While thanking health professionals for their work to save women's lives, she challenged them to share best practice and identify gaps in services.
This challenge was then readily accepted by the speakers who followed. Dr Sonji Clarke, senior consultant in obstetrics and gynaecology and at Guy's and St Thomas' Hospital, London, outlined the new national perinatal mental health care pathways and the implications for commissioners and care providers. It was clear that there has been progress: perinatal mental health has come to the fore in the past 5 years, and new pathways feature preconception interventions. However, in addition to ambitious targets to develop equality of access for women, there are still gaps to be filled—not least connecting NHS systems with others, such as Child and Adolescent Mental Health Services (CAMHS).
The theme of preconception advice was continued by counsellor Elly Taylor, who shared her programme, ‘Becoming Us’, a series of antenatal classes for parents in her native Australia, designed to dispel many of the myths that increase stress and mental illness during pregnancy and shortly after birth. As well as expanding the programme to the UK, plans are in development to address other groups who may benefit from this intervention, such as parents of babies who need intensive care and therefore experience a more disrupted start to life as a new family.
For the final session of the morning, delegates heard from Dr Raja Gangophadhyay, consultant obstetrician at West Hertfordshire Hospitals NHS Foundation Trust, who focused on the importance of wellbeing, resilience and self care to prevent mental health illnesses that can have effects on the women, the fetus, the newborn, and the wider family.
In the afternoon, delegates heard more examples of best practice, with a talk from the perinatal mental health services team at Berkshire Healthcare NHS Foundation Trust. The Trust's new birth trauma pathway is designed to triage women more efficiently, signposting to members of the perinatal team (which includes nursery nurses, perinatal and clinical psychiatrists and even a perinatal mental health pharmacist) or more appropriate external services, such as CAMHS or GPs. The new pathway has since provided training for more than 400 staff, including nursery nurses, who are trained in spotting the signs of mental illness and in promoting parentinfant bonding. As well as the successes, the speakers—service manager Samantha Danesh-Pour, perinatal psychiatrist Dr Stephanie Cozzi, and clinical psychologist and pathway lead Dr Martha Nicholson—spoke about the challenges of implementing the service, such as the immediate and total withdrawal of support for mothers who see their babies removed, and a lack of support of fathers. With many delegates also hoping to introduce similar services, this talk also offered a fascinating and useful insight into the process of service development.
The lack of support for fathers and other family members was identified by all of the speakers, and so it was apt that Mark Williams, fathers' mental health campaigner, was next to speak. In an engaging and moving presentation, Mark told his story of perinatal mental illness and the lack of support for fathers who may have witnessed a traumatic birth. Citing a shocking statistic that 510 000 men globally die from suicide each year, Mark urged health professionals address perinatal mental illness in fathers and other family members.
After a short networking break, delegates returned to hear from Dr Jelena Jankovic, consultant perinatal psychiatrist, and Dr Emma Barrow, consultant liaison psychiatrist, on how perinatal mental health services in Birmingham and Solihull Mental Health NHS Foundation Trust have improved emergency assessment during mental health crisis. Using case studies, they demonstrated how classifying crises as ‘emergency’, ‘urgent’ and ‘routine’ has increased timely referrals and can provide 24/7 access to mental health care—no mean feat in one of the largest and most diverse areas of the country.
Finally, to end the day of talks, delegates were treated to a surprise presentation from author Nyna Giles, whose book, The Bridesmaid's Daughter, traces the story of her own mother, a bridesmaid to Grace Kelly, later diagnosed with schizophrenia. Research revealed that the diagnosis may in fact have been postnatal depression—a fitting reminder of the progress that has been made in the recognition and treatment of mental illness in the past few decades.