Introduction of Specialist Perinatal Mental Health Service in NHS Lanarkshire Dr Aman Durrani;Consultant Psychiatrist Helen Sloan;Senior Charge Nurse

0.4 WTE Consultant Psychiatrist 1.0 WTE Senior Charge Nurse 0.6 WTE Charge Nurse 0.5 WTE Admin Support Perinatal Mental Health Service

Context Childbearing is a critical time in the life of a mother, her baby and her family. Undetected or untreated maternal mental illness can lead to long term adverse outcomes for the whole family, including the father. Some children have been shown to have long term psychological, social and educational difficulties as they age.

Background Lack of specialist community perinatal mental health service in Lanarkshire Lack of specialist PMH liaison service for Maternity inpatients Variation in clinical practice across Lanarkshire in caring for mothers No formalised pathways for communication between agencies Limited awareness and training of PMH

The Benefits of Early Intervention Perinatal and infant mental health services are aimed at giving every child the best start in life by promoting the wellbeing of parents and their babies across the perinatal period, in addition to the early identification and treatment of problems that complicate pregnancy and the post-partum year.

A Lanarkshire-wide specialist perinatal mental health service focusing on four key areas Maternity inpatient liaison service Specialist maternity mental health liaison clinic Training and education for colleagues Promote and support good practice and review local pathways of care Aim of the Project

Key Partners Mental health services Maternity services Public Health Primary Care Social work Service users

Prior to the Pilot Project NHSL Perinatal mental health (PMH) special interest group Perinatal mental health ‘link’ nurses in some localities Mothers managed by generic community mental health teams Good inter-agency working in some localities

Aim: AP SD A P S D AP SD D S P A DATA FEEDBACK TO FRONTLINE STAFF: Compliance w PVC check D S P A Cycle 1 Developed a Referral criteria and pathway Cycle 3 Accepted referrals and identified gaps in system Cycle 5 Identified ‘launch date’ for the service’. Cycle4 : Delayed further referrals until support systems were secure Cycle 2 Refined robust pathway for referrals from Inpatient services Process Change: Consulting with key partners, internal audit, mapping patient journey Measures: Reviewing feedback from key partners, Reviewing performance at MDT and Business meetings Ensuring there is an clear referral criteria and pathway. The Referral system is accessible to all staff

Challenges Recruitment Raising awareness Ensuring Service is accessible and beneficial for staff and patients Internal processes, protocols and procedures Admin and IT systems Managing expectations

Number of referrals

How will we know if we’ve made an improvement ? Referrer satisfaction survey Patient satisfaction questionnaire Training impact analysis Repeat Original Staff Survey Admission details

Next Steps Complete pilot project and evaluate impact Discuss with key partners regarding implementation of Service Establish system for ensuring evidence-based best practice across Lanarkshire Securing Permanent Funding NHSL Perinatal Mental Health Conference 12 March 2015

Perinatal Mental Health Conference Making a difference by raising awareness and promoting good practice in Perinatal Mental Health throughout Lanarkshire Thursday 12 th March 2015 Venue: ‘101Park St’, Kildonan St, Coatbridge ML5 3LS ~ Book now ~ Contact: FREE event for all staff working in Lanarkshire ~ Lunch & refreshments provided Highlights of programme Impact of untreated perinatal mental health problems on women, families and society The new NICE Perinatal guidelines CG192 Using technology to deliver perinatal services Prescribing in childbearing Latest educational and e-learning resources Psychological therapies Dr Alain Gregoire, Winchester Mother and Baby Unit Nigel Curtis, Hampshire Perinatal Mental Health Service Dr Roch Cantwell, West of Scotland Mother and Baby Unit Elaine Clark, West of Scotland Mother and Baby Unit Eleanor Forrest, Glasgow Caledonian University …further speakers and topics to be confirmed

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