Informing Perinatal Mental Health Services
HEALTH PROFESSIONALS
Getting it right first time
It is important that health professionals take responsibility for each woman they see to help facilitate women’s journey along the care pathway.
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Dismissing or normalising women’s symptoms.
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Focussing only on infant.
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Not recognising help seeking.
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Appearing too busy.
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Tick box delivery.
Dismissing or normalising women’s symptoms
Health professionals being dismissive or normalising women’s symptoms is a barrier.
"I did ask for support, but I didn’t really get any. And the health visitor’s response — ‘Well you seem like you’re doing all right’”.
Evidence level: High
Parts of the care pathway affected: Contact with health professionals, Decision to disclose, Referral, Access to treatment, Women’s experience of treatment.
Key literature:
Not recognising help seeking
Health professionals not recognising help seeking or symptoms of perinatal mental illness can be a barrier.
"I purposely circled the things ’cos I’m struggling, the health visitor didn’t get back to me, which I’m really disappointed about.”
Evidence level: Moderate
Parts of the care pathway affected: Contact with health professionals, Assessment. Referral.
Key literature:
Focussing only on infant
Health professionals only focussing on the infant may be a barrier.
"… somebody [is] not just checking on the baby but actually sitting down with you asking, ‘how are you doing?’ ‘What can I do to help you?’ ".
Evidence level: Low
Parts of the care pathway affected: Contact with health professionals, Decision to disclose, Provision of optimal treatment.
Key literature:
Appearing too busy
Appearing to busy can be a barrier, whereas making time to address perinatal mental health symptoms is a facilitator.
"The health visitor said something like: ‘You know, in this community we have to look after a thousand and something babies.’ And that instilled in me the feeling, like: ‘Oh, they are very busy these people, and I don’t have to be bothering them all the time’”.
Evidence level: Moderate
Parts of the care pathway affected: Contact with health professionals, Assessment, Decision to disclose, Access to treatment, Provision of optimal treatment, Women’s experience of treatment
Key literature:
Delivery of assessment
Behaviours shown by health professionals during assessment can either be a barrier (i.e. carrying out assessment in a tick-box way) or a facilitator (i.e. taking a personalised approach).
"I sometimes feel that they're [assessment tools] a little bit silly so I usually sort of introduce the questions, ‘we're interested in sort of how they're feeling emotionally or how they feel about the pregnancy …’ and we just go through them. But I try to sometimes re-phrase them a little bit because, depending on who I'm talking to basically, if I'm seeing a 16 year old girl who's scared out of her wits, I've got to be careful how I ask that sort of question because it's important to find out".
Evidence level: Moderate
Parts of the care pathway affected: Assessment, Decision to disclose.
Key literature:
Recommendations
We recommend service managers employ an adequate number of workers to ensure health professionals have enough time to address women’s needs.
We recommend service managers implement perinatal mental health good practice guides. This guide provides information on symptoms of perinatal mental illness, communication skills when discussing perinatal mental illness, what to do if a woman discloses perinatal mental illness and case studies of good practice.
We recommend health professionals participate in continuing professional development activities related to perinatal mental health including taking part in high quality training.