Perinatal Mental Health
Sue Atherton , Specialist Midwife for Drugs, Alcohol and Mental Health
Manchester Specialist Midwifery Service
Perinatal mental health
‘No health without
mental health.’
The Perinatal Mental Health Team
• Consultant Psychiatrist for Perinatal Mental
Health.
• Consultant Obstetrician for Perinatal Mental
Health.
• Specialist Midwives for Drugs, Alcohol and
Mental Health.
Our aspirations
We expect parity of esteem between mental
and physical health services.
 Promoting good mental health and early
intervention.
 Challenge health inequalities.
 Improve lifetime health and wellbeing.

Our core philosophies
Client at the centre of care.
 The importance of the clients voice.
 Shared decision making.
 Reducing stigma.
 Respect culture.
 Clients to have a positive experience of care
and support they receive.

Drivers to do something different
National institute for Health and Clinical
Excellence (NICE) guideline Antenatal and
Postnatal Mental Health.
 The confidential Enquiry into Maternal and
Child Health (CEMACH) reports why Mothers
Die? and ‘Saving Mothers Lives’.
 All Babies Count (NSPCC).
 Working together to safeguard children.
 Munro report.
 Francis report.

The challenges for CMFT
 Between 2012-2013 CMFT maternity services
delivery rate was 8,452 .
 Perinatal mental illnesses affect at least 10% of
pregnant Women.
 Identifying the most at risk.
 Commissioning.
 Increasing number of referrals to the perinatal
mental health service 2012-2013.
Ethnic Origin Mental Health Referrals
(incl Dual Diagnosis) – Total = 505
350
332
300
Referrals
250
200
150
100
31
50
42
8
7
2
3
4
20
4
16
23
10
3
0
te
hi
W
B
h
is
ri t
te
hi
W
s
Iri
h
k
ac
Bl
sh
iti
Br
k
ac
Bl
ric
Af
an
k
ac
Bl
C
n
ea
ri b
r
a
C
se
ne
hi
hi
es
d
le
ng
a
B
i
an
st
i
k
Pa
Ethnic Origin
an
di
In
ed
ix
M
R
e
ac
n
ea
op
r
Eu
O
an
si
A
er
th
O
er
th
U
w
no
nk
n
Making a difference
Identify gaps within services.
 Perinatal mental health guideline and clear
pathways.
 Training and development of staff.
 Creating the right culture.
 Working collaboratively with others.
 Resources.
 Audit to assess client satisfaction.

The Woman's journey
 Identification
of risk.
 Make every contact count.
Early intervention, equality of access and a
‘whole family approach’.
 Referral to specialised perinatal mental health
services.
 Specialist Midwife for mental health to
champion Women.
 Care planning

Women's comments
I was worried that my
medication would harm my
baby.
I valued the consultant
psychiatrists knowledge and
reassured that I could
breastfeed.
I suffered puerperal
psychosis after giving
birth last time. I am
terrified it will happen
again.’
‘I am so grateful of the
support. I feel reassured’
‘I found it hard to tell anyone how I
was feeling for fear of being judged
or not believed’. Its good to talk to
someone who understands’.
’I felt like a horrible
person and an
inadequate Mother. Just
talking about the
depression helped a lot’.
Thank you for listening