When do you refer to secondary care services? « PATH

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.

RCPsych Perinatal specialist community mental health team service specification template 2018