Tags: perinatal mental health

Understanding mental health and wellbeing during the transition to parenthood: LGBTQI+ parents

Marking Pride 2024, we are delighted to publish our brand-new iHV Good Practice Points resource Understanding mental health and wellbeing during the transition to parenthood: LGBTQI+ parents, written by research experts, Zoe Darwin and Mari Greenfield.

Any parent can experience perinatal mental health difficulties, regardless of their gender or whether they carried their baby. Mental health difficulties can have significant short and long-term impacts for parents, their babies, and the wider family. These impacts are not inevitable or irreversible, and health visitors are well placed to promote mental health and offer timely support.

LGBTQI+ people are a growing group accessing perinatal services, but research into the experiences and needs of LGBTQI+ parents is lacking. Rates of mental health difficulties in LGBTQI+ parents are unknown but may be higher for birthing lesbian, gay and bi women, and birthing trans and non-binary people, than for cisgender heterosexual birthing women.

As registrants under the Nursing and Midwifery Code, health visitors must prioritise all people and ensure they:

  • Treat people as individuals and uphold their dignity
  • Avoid making assumptions and recognise diversity and individual choice
  • Listen to people and respond to their preferences and concerns

This resource provides health visitors with an overview of key aspects relating to perinatal mental health and wellbeing in LGBTQI+ parents, including vulnerability factors, barriers to accessing support, and good practice tips for working with LGBTQI+ parents.

“We hope that this resource will help to develop health visitors’ knowledge and confidence for working with LGBTQI+ families, helping to improve care experiences and outcomes. This includes through supporting thinking about some of the distinct considerations within the LGBTQI+ community, including with birthing and non-birthing parents.” – Zoë Darwin, co-author.

 

Click here to access Understanding mental health and wellbeing during the transition to parenthood: LGBTQI+ parents

Want to learn more about how to improve your practice to support LGBTQI+ parents? Click here to take a look at our LGBTQI+ and Perinatal Mental Health training programme

 

Please note that GPPs are available to iHV members.

If you’re not a member, please join us to get access to all of our resources.

The iHV is a self-funding charity – we can only be successful in our mission to strengthen health visiting practice if the health visiting profession and its supporters join us on our journey. We rely on our membership to develop new resources for our members.

So do join us now!

button small_200

New resource to Support High-Quality Perinatal Mental Health Care

iHV and the Maternal Mental Health Alliance (MMHA) are proud to share a new resource and accompanying evidence to support high-quality Perinatal Mental Health (PMH) Care.

The Institute has worked closely with the MMHA for many years to bring about positive change for the mental health and wellbeing of families and there have been huge strides made, but there is still some way to go:

  • At least 1 in 5 women experience a PMH problem, making mental illness the most common serious health problem that a woman might experience in the perinatal period.
  • Suicide is still the leading cause of death for women when looking across the perinatal period.
  • The 2022 MBRRACE report again highlighted gaps in mortality rates between women from deprived and affluent areas, women of different ages, and women from different ethnic groups.
  • Evidence continues to show that people, who identify as LGBTQI+, experience prejudice and discrimination generally and within healthcare services which can lead to worse physical and mental health in the perinatal period.

This latest project brought us together to think about how we can support developing PMH systems across all four nations. The changing landscape of how care is accessed and delivered offers an opportunity for systems to come together to support inclusive high quality family mental health care and this is what led to the latest collaboration between the iHV and MMHA.  It has led to the iHV undertaking an evidence review, which we feel will be incredibly useful for families, practitioners and services.

The Evidence Review, conducted by the iHV, is is a comprehensive desktop review that brings together key publications, policy guidance, toolkits, research, and reports of families’ and practitioners’ lived experiences. The focus of the review is “what does high-quality perinatal mental health care look like?” for women, birthing people and their families. Key themes and principles emerging from the evidence review are captured in the related resource:

Supporting High-Quality Perinatal Mental Health Care is the new resource drawn from the Evidence Review. It provides a strengths-based action template to enable and inform high-quality care for families impacted by PMH problems – enabling individuals to come together and plan “what good looks like” for them, as practitioners, services, professions, organisations, pathways, networks, and systems. This new resource highlights:

  1. Why improving PMH care is crucial
  2. What good care looks like to both practitioners and families with lived experience
  3. 10 principles of best practice
Read MMHA's news story on the launch of these resources

Karen Middleton, Head of Campaigns and Policy, MMHA, says:

“The iHV’s literature review has been incredibly helpful to understand the wealth of information out there on maternal mental health and what action is still needed to ensure high-quality care is available to all who need it. During the review, several recurring themes quickly emerged as well as clear opportunities for learning across the system, as highlighted in the final resource.

“In recent years, there has been a welcome increase in the understanding of the impact of maternal mental health problems. However, many still face huge barriers to accessing essential care. I hope this work will encourage local systems to have collaborative conversations and help them continue to develop services that provide high-quality maternal mental health support for women and birthing people, babies, and families across the UK.”

 Melita Graham, Head of Mental Health, iHV, says:

“Family mental health and wellbeing is complex and, whilst individuals, different professions and services can, and do, make a huge difference – we know that by joining the junctions and pulling together we can achieve so much more. Working closely with the Alliance I have seen the power of collective effort and the positive differences this has made. This latest project aims to support all parts of the PMH system to come together, to think together and to act together – we know that when people with a common interest come together, great things can happen!

“The Institute is committed to promoting family mental health and wellbeing, addressing inequalities and driving change. Alongside the MMHA and other partners, we won’t stop until every family, has access to high quality mental health care in the perinatal period. We very much hope that these new resources will enable high quality perinatal mental care irrespective of where a family may live in the UK.”

Download Supporting High-Quality Perinatal Mental Health Care Resource

Download Evidence Review - Supporting High-Quality Perinatal Mental Health Care: What does good look like?

Health visiting on BBC Radio 4’s World at One today!

Alison Morton, Executive Director iHV, joined Jonny Dymond on BBC Radio 4’s World at One today to discuss the surge in new mothers and pregnant women seeking help for mental health problems in the lockdown.

The piece on perinatal mental health and health visiting begins with a mum, Amy, sharing her PMH concerns as a new mother and how it impacted her life during the pandemic – this starts at 32:18 into the programme. Alison joins at 35:53 to talk about the health visiting service and the role that health visitors play in providing support to new mothers. Jonny asked if the figures on perinatal mental illness that Radio 4 World at One have become aware of reflect what health visitors are seeing. Alison shared that before the pandemic 20-25% of women and some men had perinatal mental health needs and that the pandemic has made the situation much worse, with rates reportedly doubling. Alison speaks about the vital role that health visitors play supporting families and the difference that getting support early can make.

Alison also shares the challenges that the health visiting service in England faces. In particular, she shares how the needs of women and babies have been largely overlooked in the pandemic response and the impact that this has had on families. With widespread recognition that many women do not find it easy to speak out about how they are feeling, and against a backdrop of 31% cuts to the health visiting workforce since 2015, Alison highlights how these cuts reduce the amount of time that HVs can spend with families. She commented that health visitors come into  the profession wanting to support babies and families – to give babies the best start in life! When challenged about whether families have been let down, Alison agrees that the sector has been under enormous pressure, but defended the profession by saying, “I can tell you categorically that  health visitors did the very best job they could under immensely challenging circumstances!”

Listen to BBC Radio 4 World at One - 30 July 2021

  • Recording available for 29 days only from 30 July
  • PMH piece starts at 32:18
  • Alison Morton starts at 35:53
  • Piece ends 39:19

 

#MakeAllCareCount Campaign

The iHV is delighted to see the #MakeAllCareCount Campaign launched today by the Maternal Mental Health Alliance (MMHA).

Melita Walker, Mental Health Lead at iHV, said:

 “As long-standing active members of the Alliance it has been brilliant to work alongside the fantastic MMHA team and wider Alliance members to help shape the call for a truly integrated system of perinatal mental health care. Family mental health is complex, mental health needs are an enormous public health challenge. The Pandemic has increased the mental health risks for new parents and the already-stretched services supporting their mental health during the perinatal period, so the new focus of the MMHA campaign is needed now, more than ever”.

The #MakeAllCareCount Campaign is calling for:

All women and families across the UK to have equitable access to comprehensive, high-quality perinatal mental health (PMH) care, including and beyond specialist PMH services.

This includes:

  • A confident, well-equipped workforce delivering excellent, safe PMH care and support.
  • Care for all women, including those impacted by inequalities
  • Specialist PMH that meet national standards and act as a catalyst for change within the wider system of care.

Graphic of interlocking wheel with words for MMHA campaign

Find out more about the #MakeAllCareCount Campaign

The new phase of the MMHA’s work to drive change for women and families affected by PMH problems looks at the wider system, including and beyond specialist services, and how to support maternal mental health at every opportunity.

Whilst everyone who comes into contact with women before, during or after pregnancy has the opportunity to provide mental health support, ‘Make all care count’ highlights and defines the essential services that can dramatically affect the lives of women with, or at risk of, poor maternal mental health. Each essential service in each of the sections of the interlocking wheel above can be explored.

Defining essential perinatal mental health care: health visiting

The campaign recognises the critical role that health visitors have as part of an integrated system of care in achieving good family mental health and wellbeing.

What is the role of health visiting in providing essential perinatal mental health care?

“The campaign is a great opportunity for health visitors (and our partners) to make it clear and be recognised for what we can achieve – if we are in the right numbers with the right competence and capacity.

By making certain that all care is women and family-centred, that there is a competent and confident workforce, by working together and by recognising, liberating and strengthening the unique contribution of each individual/service -we are much more able to ensure that all families across the UK have equitable access to comprehensive, high quality PMH care.”

Do join the call for ALL women and families across the UK to have equitable access to essential, high-quality perinatal mental health care and do tag us in @iHealthVisiting @MMHAlliance  #MakeAllCareCount  #EveryonesBusiness

 

New content added to Perinatal Mental Health e-learning programme

Health Education England e-Learning for Healthcare (HEE e-LfH) has been working with the Institute of Health Visiting, the National Workforce Skills Development Unit at The Tavistock and Portman NHS Foundation Trust, maternity and general practice leads and HEE’s Mental Health team to add new content to the Perinatal Mental Health e-learning programme.

The Perinatal Mental Health programme is designed to help educate and develop the workforce’s confidence and competence in caring for people with perinatal mental health problems. The planned updates to the existing e-learning programme are particularly timely, aiming to support key health and care colleagues working with pregnant mothers and new parents, during the additional challenges posed by the COVID-19 pandemic.

Two of the six new e-learning modules were developed by the Institute of Health Visiting, in partnership with HEE, and look at:

  • Perinatal Mental Health: Health Visitor Assessment
  • Perinatal Mental Health: Health Visitor Interventions

Melita Walker, Mental Health Lead iHV, commented:

“Here at the iHV, we really do believe that there is no health without mental health! And so, we are absolutely delighted to be launching these modules during Mental Health Awareness Week.

“Perinatal Mental Health (PMH) is, to coin a phrase, “ everyone’s business” and perhaps now, more than ever, it is even more vital that all those who work alongside families understand the importance of perinatal mental health: What it is, why it matters and what they can do to support good family mental health and wellbeing.

“It has been a truly collaborative effort, in getting these modules ready to launch during Mental Health Awareness Week and we would like to thank all our partners in making this happen – including Sylvia Woolley, Catherine Lowenhoff, Judy Shakespeare, Toni Turner, colleagues at Health Education England and the National Workforce Skills Development Unit at The Tavistock and Portman NHS Foundation Trust.”

The new content covers six sessions to complement the existing e-learning programme. Each of the six e-learning modules last around 20-30 minutes.

The following sessions are now available:

  • Introduction to Perinatal Mental Health 1
  • Introduction to Perinatal Mental Health 2
  • Perinatal Mental Health in the Antenatal Period
  • Perinatal Mental Health in the Postnatal Period
  • Perinatal Mental Health: Health Visitor Assessment
  • Perinatal Mental Health: Health Visitor Interventions

For more information about the Perinatal Mental Health e-learning programme, including details of how to access, please visit the link below:

Go to HEE eLfH Perinatal Mental Health e-learning programme

The link to this e-learning programme is also on the iHV e-learning resource page:

Go to iHV e-learning resource page

Let’s hear it for Family Perinatal Mental Health

At the start of the UK Maternal Mental Health Awareness Week (4-10 May 2020) with the theme of ‘Supporting mums during difficult times’, a blog by Melita Walker, Mental Health Lead at the Institute of Health Visiting , to highlight the essential work of health visitors in supporting mums’ and families’ mental health needs – and a call to join us in recognising and appreciating all Mental Health Practitioners as key frontline workers at 8pm this Thursday #ClapForMentalHealthHeroes @ClapforCarers @ClapForKeyworkers.

iHV clapping our Mental Health Workers

This Thursday at 8pm, like the previous Thursdays, the Institute of Health Visiting will be joining the national wave of appreciation for our courageous frontline workers. However, this week as part of Maternal Mental Health Week, we particularly want to recognise and honour the determined efforts of the iHV Perinatal and Infant Mental Health Champions and all those who have been working tirelessly alongside them throughout this pandemic, to prioritise and ensure that the mental health needs of families are effectively and proactively responded to during this pandemic.

The perinatal period, whilst often being one of great joy, is also an increased time of risk and vulnerability. Latest UK research suggests that:

  • 1 in 4 women are affected by perinatal mental health disorders
  • Maternal suicide is the leading cause of death when looked at over the perinatal period
  • Approximately 10% fathers experience perinatal mental illness (PMI) but 25-50% of fathers will experience perinatal anxiety or depression when the mother also has a PMI

The impact on the foetus or the infant/child who has a parent experiencing mental illness is not inevitably negative, but they are at increased risk for a range of poorer outcomes and it is essential that we make sure their voice is heard and that we are proactive and act to support families at the earliest opportunity.

At the moment, parents are having to negotiate the usual associated changes that becoming a parent involves (physiological, psychological, environmental, social and emotional changes) alongside reduced family, friend and service support and other increased worries, stress and impact caused by the COVID-19 pandemic.

“How it feels to be 29 weeks pregnant amid COVID-19, a thread…Truly I have no idea how I am supposed to feel. At first, I was really calm and over the last few days everything has changed. I am scared, I am anxious”.

As the country faces its biggest challenge in recent memory, the primary focus has been to stop the spread of the coronavirus and treat infected patients. This has required a rapid increase in staff required for frontline duties and, understandably, this is a priority. Attention is now turning to the secondary impacts of the pandemic, including the mental health and wellbeing of our children and their families. They too are at immediate risk and they cannot wait for support.

As this pandemic is global in its reach, learning from previous pandemics and other countries’ current experiences of the secondary impact of COVID-19 suggest that the pandemic is likely to have more adverse effects for vulnerable parents and children, with domestic violence and abuse, safeguarding and mental health needs of vulnerable populations likely to increase as the crisis continues. It is therefore imperative that the national response to COVID-19 incorporates both the immediate focus to treat people who are infected with the coronavirus, as well as children and families at risk from the secondary impact of the pandemic. We ignore, at our peril, the impact of not seeing perinatal and infant mental health (PIMH) practitioners as frontline workers in the fight against COVID-19.

The iHV has trained 2095 multi-agency PIMH Champions and we are hearing the voices from professionals across the range of PIMH systems and services and from parents with needs across the mental health spectrum of care. Parents are telling us that they are anxious – we know for some that the current situation is triggering new episodes of illness and for others exacerbating illness already there, and we are hearing that parents feel unsure about reaching out for support.

Eve Canavan BEM, Coordinator- UK maternal mental health awareness week, Perinatal Mental Health Partnership, commented:

“The Perinatal Mental Health Partnership have received feedback from mums and families of the uncertainty surrounding what support is available from health care professionals at this unusual time,  with a clear message coming through that those who require support are unsure if they can contact their GP, midwife, health visitor or local mental health services. This means some women may not be currently accessing support they need. The stigma surrounding mental health and the perception that services are so overstretched and unsafe means that many mums are struggling but do not feel they have the right to ask for the help that they need. We are delighted to be working with the iHV and other key stakeholders during Maternal Mental Health week to get the message out that family mental health is a priority and that services to support families are very much open for business”. 

We are hearing from professionals whose concerns include, worry about:

  • hidden and unmet need
  • risk of suicide
  • the immediate safety of women and their unborn babies/infants/children
  • the potential impact of untreated mental health problems/illness on the unborn baby, developing infant and older children
  • the impact of the current stress that families are experiencing on the couple relationship/ couple conflict and domestic violence and abuse.

“Its really important to consider the impact of changes in working practices and redeployment of staff who play a vital role in in assessment, monitoring and onward referral for mums mental health. Some perinatal mental health conditions develop rapidly and without warning and families need urgent help”.

We are hearing that some PIMH practitioners have been redeployed while at the same time we are hearing that parents and their children need them now, and more than ever. We are also hearing of practitioners and services that continue to see the vital importance of prioritising mental health and from parents who say that they are a lifeline.

“I am pleased to say XXX health visiting service is increasing. 34 staff are being redeployed back in from various services within the trust. Health Visiting in XXX is considered critical to life service at the moment”.

“Now reassuring pregnant and postnatal mums, some of whom are fearful of attending hospital for maternity care. Please continue to keep antenatal appointments, scans and sharing worries and concerns with your midwife, it is safe to do so. If something doesn’t feel right, call you midwife”.

“Met my HV over the phone today- so knowledgeable, professional and kind!! Thankful for such a simple adjustment to practice that is reassuring for newbie mums”.

What can we do to support perinatal and infant mental health at this time?

The iHV will do all we can to support our PIMH Champions and colleagues working across the PIMH spectrum. We will continue to collaborate nationally, to support all families locally.

We have developed a comprehensive compendium of resources for professionals and families:

We are regularly updating these pages, so please keep checking back for the latest!

Let’s hear it for Family Perinatal Mental Health – this Thursday!

Maternal Mental Health , with its theme of “how to support mums through difficult times”, is a great opportunity to raise the importance of family mental health and to let families know what support is out there. It was brilliant to have the profile of perinatal mental health raised by the Duchess of Cambridge over weekend, and it has been wonderful to work alongside so many individuals, organisations, professionals, parents and alliances to highlight the need for supporting family mental health.

We look forward to sharing more of the fantastic examples of the responses and efforts from our frontline mental health practitioners to support family mental health during Maternal Mental Health week. Mental health practitioners are frontline now, and crucially, will be needed on the frontline (dealing with the psychological aftermath of COVID-19), long after any vaccine has brought the coronairus under control.

We do hope you will join us in recognising and appreciating all Mental Health Practitioners as key frontline workers at 8pm this Thursday #ClapForMentalHealthHeroes @ClapforCarers  @ClapForKeyworkers

Melita Walker, Mental Health Lead at the Institute of Health Visiting

New publication – iHV COVID-19 professional advice: Family Perinatal Mental Health

We are delighted to publish the latest addition to our new series of iHV COVID-19 professional advice – Family Perinatal Mental Health.

 

 

Developed in partnership with Public Health England by the professional team at the Institute of Health Visiting, the series of documents support the safe and effective delivery of health visiting practice during the global pandemic.

 

 

 

Download iHV COVID-19 Professional advice: Family Perinatal Mental Health

The new iHV COVID-19 professional advice: Family Perinatal Mental Health joins our suite of documents Delivering the Health Visitor Healthy Child Programme during the COVID-19 pandemic – Professional advice to support best practice which includes:

Please note: As the COVID-19 situation is rapidly changing, the information in these resources may change. Please keep checking the Government and NHS websites for details.

Also, don’t forget our COVID-19 webpages for health visitors and parents – see details below:

COVID-19 webpages
  • For Health Visitors– These new professional advice documents can be found on our COVID-19 (coronavirus) guidance for health visitors webpage – https://iHV.org.uk/COVID-19
  • For parents and families– The iHV is dedicated to supporting the health and wellbeing of all families and we are putting together links and resources from trusted organisations and websites to support parents and families during the COVID-19 pandemic – please see our Parenting through Coronavirus (COVID-19) webpage – https://iHV.org.uk/ParentingCOVID19

We have waivered our usual restrictions on resources for members and the COVID-19 sections of our website are “free access” to all to support the national response to this pandemic.

 

PANDAS Helpline Statement

PANDAS FOUNDATION Pre and Postnatal Depression Advice and Support – committed to continuous support for all parents from conception through to birth and beyond. They aim to ensure that the NHS are supported by us through their perinatal mental health charity.

PANDAS FOUNDATION are committed to supporting every parent and their network for their continued well being during and beyond the Coronavirus.

PANDAS want to support the NHS and release some of the burden and backlog from a mental health patient perspective.

  • A reminder that they are operating their helpline FREE from all UK landlines and mobile phones. Available Monday – Sunday 9am-8pm – 0808 1961 776.
  • They also offer their free email support service with a response within 72 hours [email protected].

Whilst respecting the government advice in relation to support groups, they have made the decision to pause the face to face groups. These will re-commence once they have been advised that its safe to do so.

Whilst they cannot give medical advice, they are here, business as usual with eager and supportive trained volunteers ready to offer hope and empathy. Please do use their services when considering your mental health to ease the stress from the NHS as much as possible.

PANDAS Foundation are anticipating an increase in calls and support offered for support services. Whilst their services remain free, they are reliant on donations to keep going. If you would like to donate please contact [email protected] for interesting (house-bound) ideas and suggestions for fundraising, with your child’s input.

iHV proud to support launch of Perinatal Peer Support Principles

As an active member of the Maternal Mental Health Alliance (MMHA), the iHV is proud to have supported the new perinatal peer support principles – launched  on 3 December.

Launch of Perinatal Peer Support Principles at Peerfest on 3 December 2019

The Perinatal Peer Support Principles are a set of five values designed to give peer supporters the confidence to create and deliver peer support that meets the needs of women and families affected by mental health problems during pregnancy or the postnatal period.

The principles were co-designed by Mind, the McPin Foundation, and a team of lived experience facilitators, with support from the MMHA. They provide guidance to help ensure that peer support is safe, inclusive, and helpful, and that it meets the unique needs of mothers and babies.

Laura Wood, a mum with lived experience and  one of three lived experience facilitators on this project, said:

“I hope that these principles will make safe, welcoming, nurturing peer support accessible to more mums who need it. I believe that they will, as lived experience has been at the heart of the project. Because the principles were co-created with women and families who have lived through perinatal mental health difficulties, they are shaped around their needs, not what others imagine those needs to be.”

You can access the principles, and a more detailed report, via the Maternal Mental Health Alliance website.

Read Laura's blog on what they did to develop the principles

To subscribe to the newsletter and/or enquire about hosting a workshop or event with the perinatal peer support principles, please email [email protected]

Inspiring day at PIMH Relationships Matters! Conference #iHVPIMH19

What an amazing day we had at iHV’s annual PIMH conference – Perinatal and Infant Mental Health: Relationships Matters! – #iHVPIMH19

Held on 10 September in London, the second annual iHV PIMH conference was in collaboration with the Maternal Mental Health Alliance.  The conference created time to prioritise and place relationships at the heart of perinatal and infant mental health care. We shared, discussed and reflected together on the latest evidence, research and experiences of PIMH care in the context of relationships being fundamental to good parental and infant mental health.

Sold out several weeks ago, we had a full house of 200. “Inspiring, very interesting, thought provoking, insightful, really enjoyable, fantastic, hopeful, excellent” – just some of the feedback that we’ve received.

A big thank you to all our speakers, presenters and exhibitors for helping to make the day.

Go to conference programme

Photos of the conference

We have made a short video of some of the photos taken during the conference:

Tweets from #iHVPIMH19

For those of you who could not either join us yesterday or could not follow the #iHVPIMH19 hashtag on Twitter, we’ve collected and made a little “Wakelet” collection of the day’s tweets so you can follow some of what was shared. Please see below.