Achieving the 5 Year Forward View in Perinatal Mental Health Services
Chaired by Elaine Hanzak Survivor of Postnatal Illness and Perinatal Mental Health Advocate Speaker, this conference will provide you with practical information and inspiration to take back to your organisation and utilise in implementing and improving perinatal mental health care in line with the 5 Year Forward View.
Speakers and presentations:
5YFW Perinatal Mental Health Update
Dr Trudi Seneviratne Chair of the Faculty for Perinatal Mental Health Royal College of Psychiatrists Clinical Lead for South London and Maudsley NHS Foundation Trust
• progress to date
• funding wave 1 successes, wave 2 progress
• how we are leading to the 2020/21 goals
Dr Seneviratne comments:
- "It is important to secure very early attachment relationships – this will help prevent serious MH issues later in life
- An additional 8000 are expected to be assessed in perinatal MH services in 2018/2019
- ¼ of women are dying between 6 weeks-1 year after pregnancy due to suicide"
Dr Seneviratne's Biography
Dr Gertrude( Trudi) Seneviratne, MBBS, FRCPsych, Consultant in General Adult and Perinatal Psychiatry. She qualified as medical practitioner in 1992 from St Bartholomew’s Medical School, subsequent training in psychiatry at St Bartholomew’s, City and Hackney Mental Health Trust, followed by South London and Maudsley NHS Foundation Trust (SLaM) and a researcher with Professor Channi Kumar at the Institute of Psychiatry. She has been a perinatal psychiatrist for 20 years at SLAM working across the entire care pathway across liaison, specialist community perinatal services, the Parenting Assessment Service and the acute inpatient service at the Mother and Baby Unit at the Bethlem Royal Hospital
As Consultant Psychiatrist since 2002, Lead Clinician Perinatal Psychiatry, in SLaM 2007-2017, now Associate Clinical Director, has supported the development of Perinatal Mental Health Services, locally and nationally, through Royal College Psychiatry CCQI accreditation processes. Since 2008, She have been involved in developing national standards for perinatal services and accredited numerous services across the UK.
With colleagues, has published/disseminated numerous research over years. An important recent was outcome data from the MBU which demonstrated excellent outcomes for parents/babies. She has been an active educator over the years. A recent example is the innovative Multi-professional Simulation Training Package in Perinatal Mental Health.
She has held numerous national roles (1) member and Vice Chair of the national Clinical Reference Group- Perinatal Mental Health Services, NHS England, that write the service specifications / CQUINS. a member of the ‘All Party Political Group (APPG) 1001 Critical Days Campaign’ and have given several talks at Parliament to influence policy and service investment. In 2016, she was elected Chair of The Perinatal Faculty, Royal College Psychiatrists, a four year post.
Taking a prevention lens to the challenges of becoming a parent
Dr Camilla Rosan Programme Lead for Families, Children and Young People Mental Health Foundation Member Expert Reference Group Perinatal Competency Framework With Freya Corfield Psychologist
• the transition to parenthood
• a model for prevention
• who is at risk and getting in early?
• the evidence base for preventing perinatal depression and examples of good practice
Dr Camilla Rosan and Freya Corfield comment:
• "1 in 7 mothers are affected by perinatal depression
• 1 in 20 fathers are affected by perinatal depression
• Peple who have had previous MH difficulties are 50% more likely to develop postnatal depression/anxiety
• 20% of families will break down in the 1st year of a child’s life. This increases to 50% in low income families
• 30% of domestic violence starts, or gets worse, during pregnancy"
• 90% of all domestic violence occurs when the child is in the same room
Pre conference abstract
Depression in pregnancy and the postnatal period is a significant public health concern; affecting up to 20% of new mothers and 10% of new fathers. For the majority of men and women, perinatal depression includes symptoms of dysphoria, emotional lability, insomnia, confusion, guilt, and suicidal ideation. Following birth, there is a common period of emotional adjustment and lability lasting a few weeks, usually referred to as baby blues, however postnatal depression is more severe and enduring.
Despite some of these challenges that expectant and new parents experience, the perinatal period represents a time when parents report being highly motivated and responsive to making positive changes in their lives. They often describe an interest in exploring relationships, considering how they themselves were parented and how they want to be as parents; expressing a desire to be a good parent and to ensure that their baby leads a better life than they themselves may have experienced. This together with the high incidence of professional contact makes pregnancy an opportune prevention opportunity for professionals to engage with parents.
To understand more about how to prevent perinatal depression, we need to understand what modifiable risk factors we might want to target. Perinatal depression is likely to have multifactorial aetiology, with meta-analytic and review findings consistently highlighting the importance of psychosocial variables, such as stressful life events, anxiety, couple relationship difficulties and conflict and low levels of partner support.
In the most recent Cochrane review of 28 trials of preventative interventions of perinatal depression, no strong evidence was found for perinatal education classes, postpartum lay-based home visits, early postpartum follow-up, continuity of care models, in-hospital psychological debriefing, and cognitive behavioural therapy. They did however find some evidence in favour of professionally-based home visits such as intensive nursing home visits and flexible postpartum care provided by midwives, postpartum peer-based telephone support, and interpersonal psychotherapy. They also concluded that interventions targeting an indicated, at-risk group of mothers may be more beneficial and feasible than those delivered universally.
Although several preventative perinatal and early childhood interventions have been developed, the majority of these do not have clear, targeted risk mechanisms and are designed predominantly for mothers alone. It has been highlighted that more preventative programmes need to be developed that are couple relationship-focused and encourage the active involvement of both partners
Dr Rosan's Biography
Camilla works at the Mental Health Foundation leading a national portfolio of prevention programmes related to families, parenting, infants, children and young people. Camilla is a perinatal clinical psychologist and couple therapist by background and across her clinical career has held a range of therapeutic roles in the NHS, local authority and other third sector organisations.
Camilla completed an undergraduate degree in psychology and neuroscience at Sussex University. After working for a number of years in the social care field related to parenting and child protection, she was later awarded a quality improvement leaders fellowship with NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC). After training as a clinical psychologist at Oxford University and completing her doctoral thesis on co-parenting approaches in the early years at Imperial College London, she moved into the third sector to lead national service development work related to perinatal and infant mental health. Camilla retains an honorary clinical academic post at Imperial College London in the Centre for Psychiatry and has published extensively in peer-review journals, therapy manuals, book chapters, policy reports and national guidelines. She has a specialist research interest in developing the field of couples work from pre-conception across the transition to parenthood and beyond and is involved in several research trials to develop the evidence-base in this area. Camilla teaches and supervises clinical psychology trainees and sits on many government level expert advisory groups for perinatal and infant mental health.
Freya Corfield's Biography
Freya is a third year Trainee Clinical Psychologist at Royal Holloway, University of London. She is currently on placement at the Mental Health Foundation under the Supervision of Dr Camilla Rosan. As part of her studies, she is undertaking research into cognitive assessment in multiple sclerosis (MS). She has previously carried out placements in physical health, including adult neurorehabilitation and paediatric diabetes. She has provided liaison assistance to fellow clinical psychology trainees involving the co-ordination of outreach presentations to schools and peer support for management of electronic records of clinical activity.
With a clinical and research background in eating disorders, Freya completed her PHD at the Institute of Psychiatry, King's College London in the department of psychological medicine and has had several papers published. Freya has also supported HIV and AIDS education at the Centre of Awareness, NGO in Accra, Ghana. She looks after her mental health by playing hockey and netball and attending music festivals.
Building Great Britons - 1001 critical days
Robin Balbernie Clinical Director PIP UK Past Professional Lead for child psychotherapy and a Consultant Child and Adolescent Psychotherapist Gloucestershire CAMHS
• how the Parent Infant Partnership are working to improve services
• current projects and innovations
• moving forward to improving practice
Robin comments: "1001 Critical Days – to improve the life chances of children
It is the quality of early care giving that counts
Internal and external stress factors makes mothers vulnerable to be able to hold the baby in mind. Early intervention is needed to break this cycle
Nurturing early relationships set the foundation for life"
Robin Balbernie's Biography
Robin Balbernie is clinical director of PIP UK, a charity dedicated to help establish infant mental health teams across the country. Previously he was consultant child psychotherapist in Gloucestershire. He also worked with Children’s Centres as clinical lead of the team providing an infant mental health service, known locally and nationally as ‘Secure Start’. He was involved with the Intensive Baby Care Unit at Gloucester Royal Hospital and ran supervision groups for Health Visitors for over 25 years. His interest in working with adopted children led him to the field of Infant Mental Health and early preventative intervention; and this became his speciality following a Winston Churchill Memorial Trust Travelling Fellowship to look at related projects in America. He is an advisor to the Association of Infant Mental Health and the WAVE Trust and was a member of the Young Minds’ Policy and Strategy Advisory Group.
Future conferences of interest:
The Maternity Transformation Programme: Learning from the early adopters and pioneers
Monday 5 February
De Vere West One Conference Centre
Transforming Mental Health Services for Children & Young Adults
Masterclass: Assessment, Diagnosis, Treatment & Management of Eating Disorders
Preventing Suicide in Young People & Children
Depression in adults: treatment and management
15 January 2018