Referral

Maternal Mental Health

The Maternal Mental Health clinics work with women who have experienced perinatal loss or trauma within the context of moderate/severe/complex mental health difficulties.

The service is an extension of the existing Perinatal Mental Health services in Devon provided Devon Partnership NHS Trust (DPT) and Livewell Southwest.

Scope

Women who are experiencing moderate/severe/complex mental health difficulties (or difficulties which are at a level that mean day to day life and/or the new parenting relationship/decisions around fertility are significantly affected) and which are directly linked to the following:

  • Trauma occurring in the neonatal/maternal/perinatal context (e.g., those experiencing PTSD following traumatic birth or PTSD as a result of NICU experience). There is no limit set on time since the trauma.
  • Loss occurring in the neonatal/maternal/perinatal context. This may include those who have experienced loss of a baby through intra-uterine death, neonatal death, still birth, early miscarriage, recurrent miscarriage, or termination of pregnancy for any reason. There is no limit set on time since the loss.
  • Experiencing the temporary removal or period of separation from their baby due to Local Authority planning, but who are now parenting their baby.
  • The removal of a previous baby due to Local Authority planning, but have the opportunity to parent their current unborn child.
  • A severe fear of childbirth (Tokophobia) which either predates pregnancy (primary Tokophobia), or a fear which has developed after a traumatic or distressing delivery (secondary Tokophobia).
  • A severe fear of foetal medicine following a previous loss or trauma (foetal medicine is the branch of medicine that provides care for the unborn baby and mother, including assessment of foetal growth and wellbeing, and diagnosis and management of foetal disorders or abnormalities).

Out of Scope

  • Mental health problems not considered moderate/severe/complex
  • Those who already have an open referral to a Community Mental Health Team (CMHT) or Perinatal Mental Health Team (PMHT).
  • Mental health problems not primarily related to perinatal loss or trauma.
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Risk issues to consider:

  • Recent significant change in mental state or emergence of new symptoms.
  • New thoughts or acts of violent self-harm or suicidality.
  • Domestic abuse.
  • New and persistent expressions of incompetency as a mother or estrangement from the baby/infant.
  • Thoughts of harm towards the baby/infant.
  • Disengagement from health services or personal support networks.

DEVON:

If a woman’s mental health presentation does not meet the above criteria, consider a referral to the local Community Perinatal Mental Health Team, Community Adult Mental Health Service or TALKWORKS (Improved Access to Psychological Therapy Service).TALKWORKS have clinicians who specialise in perinatal work, and they can prioritise women in the perinatal period.

PLYMOUTH:

If a woman’s mental health presentation does not meet the above criteria, consider a referral to the local Community Perinatal Mental Health Team, Community Adult Mental Health Service Plymouth Options.

Referral Instructions

Devon Partnership Trust:

Referrals are reviewed on a weekly basis and we will inform you and the client of the outcome as soon as possible.

We can accept referrals via the Community Perinatal Mental Health Service as well as from Midwives, Health Visitors and GPs.

Livewell Southwest:

Please email a SBAR referral letter to Livewell Southwest: livewell.perinatalmht@nhs.net.

All Perinatal referrals are triaged together and will be transitioned to the appropriate pathway, where known please specify if you are requesting the Maternal Mental Health Service

Supporting Information

Livewell Perinatal Mental Health Team

Devon Partnership NHS Trust

Patient Information

DPT - Pregnant women and new mothers

Royal College of Psychiatrists printable perinatal mental health leaflets

Tommys - Pregnancy Hub

Sands

Virtual support groups are accessible via Eventbrite

Pathway Group

This guideline has been signed off on behalf of Devon Partnership NHS Trust, Livewell South West and NHS Devon.

Publication date: January 2022