Quality standard
Quality statement 7 (developmental): Specialist multidisciplinary perinatal mental health services
Quality statement 7 (developmental): Specialist multidisciplinary perinatal mental health services
Developmental quality statements set out an emergent area of cutting‑edge service delivery or technology currently found in a minority of providers and indicating outstanding performance. They will need specific, significant changes to be put in place, such as redesign of services or new equipment.
Developmental quality statement
Specialist multidisciplinary perinatal community services and inpatient psychiatric mother and baby units are available to support women with a mental health problem in pregnancy or the postnatal period.
Rationale
Access to specialist multidisciplinary perinatal community services and inpatient psychiatric mother and baby units can help to ensure that the most appropriate assessment, monitoring and treatment is provided. Access currently varies considerably, because services are not available in all localities.
In particular, women with severe mental health problems need specialist perinatal support to ensure that their condition is monitored appropriately, and that they can access the most suitable treatment. This is because severe mental health problems can be associated with significant impairment in social and personal functioning, which might affect the woman's ability to care for herself and her child. Psychiatric causes of maternal death, particularly suicide, continue to be a significant cause of maternal mortality in the UK.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
a) Evidence of local arrangements to provide specialist multidisciplinary perinatal community services.
b) Evidence of local arrangements to ensure that women needing inpatient care for a mental health problem within 12Â months of childbirth can be admitted to an inpatient psychiatric mother and baby unit.
c) Evidence of referral arrangements for women with a severe mental health problem to be referred to specialist multidisciplinary perinatal community services and inpatient psychiatric mother and baby units.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example care protocols.
What the quality statement means for different audiences
Service providers (mental health trusts and specialist tertiary services) provide specialist multidisciplinary perinatal community services and inpatient psychiatric mother and baby units for women with a mental health problem in pregnancy or the postnatal period.
Healthcare professionals (GPs, midwives, health visitors and mental health professionals) support women with a mental health problem in pregnancy or the postnatal period through specialist multidisciplinary perinatal community services and inpatient psychiatric mother and baby units. They are aware of local referral pathways and use them to refer women with a mental health problem in pregnancy or the postnatal period.
Commissioners commission specialist multidisciplinary perinatal community mental health services and inpatient psychiatric mother and baby units for women with a mental health problem in pregnancy or the postnatal period. NICE has produced a costing report for NICE's guideline on antenatal and postnatal mental health that can support commissioners to consider the cost impact of commissioning specialist perinatal mental health services.
Commissioners of primary and secondary care services (NHS England and clinical commissioning groups) should check that providers refer women with a mental health problem in pregnancy or the postnatal period to specialist multidisciplinary perinatal community mental health services and inpatient psychiatric mother and baby units when appropriate.
Women who have a mental health problem during pregnancy or in the year after having a baby receive support from services that are specially designed for women with a mental health problem during these times. These services can give them the care and support they need.
Source guidance
Antenatal and postnatal mental health. NICE guideline CG192 (2014, updated 2020), recommendations 1.5.10, 1.10.1 and 1.10.3
Definitions of terms used in this quality statement
Specialist multidisciplinary perinatal mental health service
A specialist multidisciplinary perinatal mental health service that provides direct services, consultation and advice to maternity services, other mental health services and community services, and is available in all localities. [NICE's guideline on antenatal and postnatal mental health, recommendation 1.10.3]