Perinatal and parent infant mental health

Greater Manchester aims to give all families the best possible start, by focusing on supporting families in the perinatal period up until their child’s 2^nd birthday. We will support the emotional and mental well-being of all parents, the infant, their relationship, and the family.

Scientific studies show the importance of the earliest period of an infant’s life, the first 1001 critical days. We used to think babies’ brains grew and developed because of physical maturation and genetic inheritance; we now know that brain development depends principally on healthy interactions between a baby and his/her parents.

We also know that about 20% of women experience mental health problems during this time, making this a relatively common experience. A wide range of mental health conditions can occur, most commonly depression and anxiety. A significant percentage of partners can also experience mental health problems.

We’re developing a pioneering perinatal and parent-infant mental health whole system approach. Services include Specialist Perinatal Community Mental Health; Parent-Infant Mental Health; Adult Talking Therapies with a perinatal and parent infant focus; Volunteer Perinatal and PIMH peer support.

Why this matters

Up to one in five women will experience a mental health problem in pregnancy, or the first year after birth, with up to three to five per cent experiencing a serious psychiatric disorder. As part of the NHS Long Term Plan, the NHS has committed to continued investment in perinatal mental health care for mothers and their partners who need specialist support during and following pregnancy. Up to 18% of fathers experience anxiety and depression in the perinatal period and, where parents are struggling, the impact on infant mental health is significant.

Some women, with pre-existing mental illness may benefit from pre-conception advice, or a woman may need extra support in the antenatal period if she starts to feel anxious and depressed during her pregnancy. If professionals spot the early signs of a perinatal ill-health issue, she can be fully assessed, to ensure any red flags are not missed.

Perinatal mental health issues can be brought on by many things, such as a traumatic pregnancy and childbirth, previous loss, history of mental illness or lack of support, and it can sometimes go under the radar because of feelings of shame, embarrassment and fear of the consequences. There is support for all parents from GPs, health visitors and midwives who are specially trained to spot the early signs that extra help is needed. They can then provide or refer to the perinatal mental health community team, a parent infant mental health specialist or even a psychiatrist.

With the right care at the right time, pregnant women and parents have the best chance of staying well during pregnancy, and afterwards.

Research has shown that our earliest relationship with our main caregivers (typically a parent) can have a profound effect on how we develop physically, emotionally, cognitively and socially. This early emotional wellbeing is a key factor in determining resilience, mental health and to what extent individuals will make the most of life’s opportunities, including education, and how they will manage later relationships with partners and their own children.

We all hope our relationship with our baby or young child is filled with joy and is strong. However, lots of things can affect how you feel about your baby and yourself. Having a baby or young child can be difficult at the best of times. Sometimes, it can feel hard to cope with a baby’s feeding, sleeping or crying. Sometimes problems like depression in pregnancy, or after birth, a traumatic birth, mental health problems, events from the past or present, can affect how you feel about your baby, and you may feel worried about some of the feelings you have. All these problems can affect anyone. Parent Infant services are here to help parents and their relationship with their baby.

Our aims

We’re aiming to be a leading region through our delivery of the vision to promote the emotional wellbeing and mental health of pregnant women, parents and all the 37,000 babies born in Greater Manchester every year and their families. We are doing this through building high quality specialist perinatal and parent infant services that work closely with partners, including midwives, health visitors and GPs, to develop their knowledge and skills in promoting wellbeing for all and in the early identification and support for parents and infants with emotional and mental health needs. The four key parts to the Greater Manchester model work together to make this happen:

The Greater Manchester specialist perinatal community mental health teams– specialist service for pregnant women and new mothers who experience significant mental health problems.
Locality parent infant mental health teams– specialist staff who work with mothers and/or their partners and infants
Parent-infant focused Talking Therapies (previously known as IAPT psychological therapy services)– building knowledge and skills into the full IAPT in every locality to support swift and easy access into therapy for all parents in pregnancy and first two years after birth
Perinatal and Parent Infant focused Peer to peer support – Peer support is support that is offered from others that have been through similar experiences and it has many benefits in helping those with mild/moderate mental health needs, such as anxiety and depression, and in helping parents with their relationship with their baby.

As well as offering direct support to parents, the services work together to raise awareness of the importance of the perinatal mental health, parental mental health and parent infant relationships by offering training, support and consultation to staff working across health and social care, as well as community and voluntary services. This will help create a shared language and understanding of perinatal and parent infant mental health across the region.

What’s next

Development of integrated services in localities where services are well developed
Inclusion of data from all perinatal specialists to capture all activity
Increased access to specialist perinatal mental health support in Greater Manchester, in the community or in-patient mother and baby units, allowing at least an additional 1,680 (4.5%) women each year to receive evidence-based treatment, closer to home, when they need it
Business case developed to expand the offer to reach 7.1% of women in 2023/2024 and work towards increasing access to 10% over the next few years