Perinatal Community Mental Health Team

A Perinatal Psychiatrist is medical doctor who specialises in the diagnosis and management of mental health disorders in women in the perinatal period.

As part of their role they will:

• Provide advice for women with mental health difficulties who are considering trying to conceive. This will include discussing risks of illness and treatment during the perinatal period and providing a plan of care.
• Assess women who are referred to the service and are currently struggling or at high risk of relapse in their mental illness providing a formulation of the difficulties and offer a diagnostic opinion.
• Discuss, advise and prescribe treatment options including medication, psychological intervention and other modalities.
• Support and offer supervision to the other professionals within the team. 

The Mental Health Nurses in our team use their nursing skills with specialist knowledge of the emotional and mental health difficulties women can experience while pregnant or in the postpartum period.

We work alongside you, your family, and the different support services involved in your care. This is to help you with your emotional adjustment to pregnancy and motherhood support the parent-infant bond and ensure you understand your mental health needs and what can help you to feel more empowered and more hopeful in improving your mental health.

As nurses, we are often the staff member who will assess you once you have been referred by your GP, health visitor, midwife or other staff member. This is usually a face to face appointment where we talk through your pregnancy or experience post-birth. We give you an opportunity to tell us about your life as a whole. This helps us gain an understanding of everything which impacts your mental health, and gives us an opportunity to talk with you about what would help support you in the future.

We also have one to one appointments, either in the home or in a clinic. During these appointments we can use a number of different methods to improve your mental health depending on what is right for you. This can include among other things:

• Cognitive Behavioural Therapy
• Compassion Focussed Therapy
• Acceptance and Commitment Therapy
• Distress Tolerance

We also attend team meetings and appointments with other members of the team, or partner services for the family, to ensure your family is getting the right support. We often support on your behalf to help you make your voice heard.

Additionally, we also work on the duty line, open during office hours, where you can speak to someone in short notice when you are experiencing distress between appointments.

Occupational Therapy considers everything we want, need, and are expected to do on a day to day basis, and focuses on the things which matter most to you. We call these occupations.

We understand that welcoming a new baby into the family changes how we spend our time, our roles and our responsibilities and this can be difficult to adjust to for any family but particularly when you are struggling with your mental health.

An occupational therapy assessment will consider how both your health and the demands of a new baby impacts the things you do, but also how what you do impacts your health and well-being.

We will support you to think about your goals, both as a parent and in other areas of your life which are important to you.

We work in a practical way with you, your baby and significant others to identify and overcomes barriers to you reaching your goals, identifying and building on the strengths and resources you already have.

We work with women where there is a social barrier to their recovery.  This could be to do with isolation, accommodation or any other social event.

We work closely with the wider MDT to support your mental health needs and offer short term interventions where appropriate.

We use our knowledge of local resources and try to connect you with services in your local community to support you in your recovery.

We will help you navigate social systems – such as housing and benefit claims which can be confusing.

We can support in accessing a Carer’s assessment to ensure your whole family receives the support it needs to help you to your recovery.

We can support you in resolving family conflict.

Clinical psychologists work with people with a wide range of psychological difficulties. This can include, but is not limited to, difficulties with anxiety, low mood, phobias, trauma, and relationships.

A clinical psychologist will spend time talking with you about your current difficulties, where they may have originated from, what keeps them going, what worsens them, and what helps. This is known as a psychological formulation.

Clinical psychologists are trained in a wide range of interventions. Your individualised treatment plan may include aspects from one or more of the following therapeutic approaches:

• Cognitive Behavioural Therapy (CBT)
• Acceptance and Commitment Therapy (ACT)
• Compassion Focussed Therapy (CFT)
• Systemic Therapy (working with you and your family)
• Trauma based interventions

Regardless of the type of therapy, sessions will focus on building on your existing strengths and coping strategies.

You may also be asked to complete tasks between sessions to maximise the benefits gained from therapy.

We offer group and 1:1 therapy using our specific mode of therapy to support you in developing understanding of your experience so that you are able to make sense of it and minimise any harmful impact on your life.

Any Therapist will spend time with you initially to get to understand how you view your experiences and then come to an agreement about how a treatment plan might look.

Sometimes, people decide that therapy is not for them, and that’s ok. The assessment part can in itself be useful and you can revisit the therapy at a later date.

There are many different types of therapy but at the centre of each therapy we offer is your agreement to be part of this process.

In the team at present we have:

• Art Therapists – we use creative therapy to help you engage with what you are experiencing in a non-threatening way. Art therapists/art psychotherapists use art as a medium to address emotional issues which may be confusing and distressing.
• CBT Therapist – we use the model of Cognitive Behavioural Therapy to help understand some aspects of your life that you consider problematic and look at ways to understand them so you can make changes

All the staff in the Perinatal Psychiatric Service work to support parents and babies as part of their roles However; the Mother Infant Therapist is available specifically to offer support to mothers in their relationship with their baby.

Each family is different, and there may be many reasons why a mother might feel she needs help in understanding or developing her relationship with her baby. The Mother Infant Therapist will work with mother / parents to try and learn what the difficulties. This helps them to decide with you the best approach. Some of the interventions available are:

• Video Interaction Guidance is a therapeutic method, which aims to improve communication and relationships between parents and their children. Participants are supported by a VIG Practitioner to view and discuss short edited clips of personal interaction with their children. Participants become much more aware of their own skills in effective communication through viewing themselves and reflecting on what they observe. The Clinician aims to empower participants in the process of change by exploring perceptions, building on their strengths and challenging assumptions. Relationships, interactions and behaviour can improve as participants change their communication style.

• Observation appointments are offered to encourage parents to notice infants communications and initiatives, build their responsiveness and encourage reveie, playfulness and “mind mindedness”.

• Interventions around Reflective Functioning aimed at helping mothers develop a personal story (narrative) about their pregnancies and their babies.

• Interventions around Emotional Regulation and Distress Tolerance to develop skills in recognising and managing emotional states, promoting and supporting the development of emotional regulation in baby and building resilience and self care.

We are nursery nurses specially trained in mental health, We can support by providing a safe space for;

• listening and reassurance, supporting you with the challenges and anxieties as a new mum
• exploring your expectations of parenting and advice on how babies communicate
• providing advice on child development and tips on feeding, weaning, positive play and how to communicate and understand your baby
• support you in developing a positive bond with your new baby through play and baby massage.

Peer support workers are people who have personally experienced mental health challenges themselves or as a carer. They are employed by the Trust to use their experiences to support others on their recovery journey.  

How a peer support worker may help you:

• By establishing a supportive and respectful relationship with you that is based on shared understanding.
• Helping you identify your recovery goals.
• Sharing ideas with you, about ways of achieving recovery goals, by drawing on their own personal experiences and a range of coping, self-help and self-management techniques.
• Assist you in creating your own treatment and recovery plan
• Supporting with self-awareness, self-belief, self-advocacy and hopefulness.
• Signposting you to various resources, opportunities and activities within the trust and the community.
• Accompanying you to appointments, meetings and activities
• Helping overcome fears within a relationship of empathy and trust.