1. Perinatal Mental Health HIT IMPROVE (Improving Mental Health Perinatally through Research and Education) Implementing evidence; generating evidence

2. Importance Prevalence – Depression approximately 10% at anyone time (antenatal and postnatal). 6% severe depression perinatal, anxiety disorders similar rates. Also severe mental illness eg schizophrenia, bipolar. High relapse rate postnatally. Impact – antenatal (fetal programming and maternal programming) and postnatal environment in the early years. Cost - Perinatal depression, anxiety and psychosis carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK

5. Aim of the Improve HIT Overall aim – raise the quality of perinatal mental health care in order to improve outcome for mother, father and child

6. Achievements so far Bringing together clinicians and managers across a range of organisations and disciplines. Forming into work streams. Raising awareness of the importance developing the case for a perinatal mental health team. Early indication that there is a greater use of appropriate referral for psychological treatment during pregnancy.

7. The Antenatal Care Pathway Teaching and training Business Case for a Perinatal Mental Health Team Universal prevention Patient and public involvement Research Audit Fathers Team Business

8. Perinatal mental health - Care Pathway

9. Audit figures (NBT and UHB) NBT 2013-14 there were 6201 births 618 (10%) screen positive to depression case finding questions. Only 186 (3%) requesting help. (Previous year NBT 11.7% and 2.7% respectively) UHB 2013-14 there were 5499 births 379 (6.9%) positive on depression case finding questions 117 (2.1%) requesting help.

10. Research Grants – Fathers intervention (in submission) – Fellowship - epidemiology of maternal risk factors (targeting) – Novel intervention Approach training (piloting) – Medication advice decision aid intervention – External links Acorn trial, Netmums trial, paediatrics SSRI withdrawal, Swedish data on psychotropic risks and neurodevelopmental disorders.

11. Festival of perinatal mental health