When do you refer to secondary care services?

Refer to a mental health service if the woman is pregnant and has had:


  • New episodes of serious mental illness during pregnancy and the first postnatal year including:

  • Postpartum psychosis, bipolar affective disorder, serious affective disorder and/or other psychoses

  • Severe depressive illness

  • Severe anxiety-based disorders e.g. OCD and panic disorder

  • Severe and/or complex mental illnesses including obsessive compulsive disorder

  • An eating disorder, such as anorexia or bulimia

  • Pre-existing serious mental illness in pregnancy – Specialised perinatal community mental health teams will either advise on management and treatment to community mental health teams or take over the care of the woman temporarily or co-work with the psychiatric team, according to individual need and choice

  • Women who have had the above illnesses have a high risk of becoming unwell following birth. These women can be referred to a perinatal mental health service, if available, or to a community mental health team

  • Before conception or during early pregnancy, women who are well but at high risk of developing a serious postpartum illness, including a history of serious mental illness e.g. schizoaffective disorder, bipolar affective disorder or severe depressive illness (postnatally or at other times)

  • Women with a family history of serious mental illness

  • Mothers under the age of 18 if significant perinatal mental illness dominates their presentation and they are likely to be the baby’s principal carer. In these circumstances the assessment, treatment and management of a young mother should be undertaken in collaboration with CAMHS and social services

  • Mothers with significant mental health problems and mild learning disability who are likely to be the baby’s principal carer

Women who have had the above illnesses have a high risk of becoming unwell following birth. These women can be referred to a perinatal mental health service, if available, or to a community mental health team.

The list of specialist perinatal community teams in England can be found on the Web Beds site.

Watch this video about building better perinatal mental health services from London Clinical Networks.

References


RCPsych Perinatal specialist community mental health team service specification template 2018

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