Perinatal Mental Health Toolkit for GPs

rcgp-logo.ashxLast Friday the RCGP launched their new Perinatal Mental Health Toolkit – I was invited to attend and was so disappointed that I couldn’t make it! But I am really excited to see this new development and very much hope that it makes a difference in the lives of Mums (and Dads) who suffer from PMH issues.

In my open Letter, a few months ago, to the Health Minister for NI, I highlighted these issues:

“It has also been suggested, when Health Professionals are visiting the home after the birth, enough time is not always given to discussing a mother’s mental and emotional state, never mind actively looking for the signs. Many mothers have reported they were only asked these questions as, what they have termed, an “add-on”; they were rushed in giving answers and their concerns were not followed up. Some felt “no time” at all was given to this issue. I have also heard from a selection of mums who felt the support was so lacking that it was further damaging to the their state of well-being.

Many women have complained that when they approached a Health Professional for help, with how they were feeling, they got nowhere. On too many occasions, mums are dismissed as simply having the “baby blues”, when in fact it is something much deeper. This means there is a time lag in receiving appropriate treatment, which is not acceptable. Perhaps the question to be asked is  – do we need re-education about PMH and how problems present themselves?

Concern has also been noted, by mums experiencing problems, that the next step is not always known, when a diagnosis is finally given. Many mums have been left for months, on waiting lists, for a service that was never going to meet their needs. Many have had to take to finding support and services for themselves, which is far from ideal. There are of course others, who, in not knowing where to turn, are left in misery, hoping that someone will hear them and help them. This is not good enough – we need a clearer pathway, known by all, towards help, support and resources.”

A number of mums have noted that medication alone is not the answer and yet felt that was all they were offered. These mums have suggested they would have also benefited from counselling, CBT and peer support groups. But again, on many occasions, had to seek this out for themselves.  Unfortunately, it can be location which determines how much support there is available. Some mums live in areas where there are accessible resources, others feel very isolated and alone as there are limited support outlets.

You can read the full Letter here – Open Letter to the Department of Health NI


I am really excited about this new resource, as hope that it can help GPs and HCPs to further and better help those in need. You can read all about the new Toolkit below…

GPs lead the way in supporting patients with perinatal mental health conditions

Screen Shot 2016-07-26 at 19.55.15“A ‘one-stop’ hub of resources to support GPs to deliver the best possible care to patients with perinatal mental health conditions has been launched today by the Royal College of GPs.

Perinatal Mental Health, a clinical priority for the RCGP since 2014, affects up to two in every 10 women during pregnancy and the first year of their baby’s life – but many do not seek medical help or deal with it alone.

GPs are concerned that women could be missing out on the help and support they need, both before and after giving birth, as they are reluctant to discuss issues such as anxiety or postnatal depression for fear of being stigmatised or even having their babies taken away.
The impact of undetected or untreated maternal mental health problems on the child can be significant, particularly if they occur during pregnancy and the first year of the child’s life.
In extreme cases, perinatal mental health issues can lead to maternal suicide and the consequences can be devastating for entire generations of families.

In response the RCGP has launched the free-access perinatal mental health toolkit for family doctors and other healthcare professionals, as a go-to collation of resources that could support them to deliver the care their patients with perinatal mental health need.
There is a variety of resources to offer patients from information leaflets, links to supporting charities and social media peer support groups amongst many others. Health professionals may face additional challenges in seeking help for perinatal mental health problems and there a specific section of the Toolkit to address this need.

One resource is a tool developed by the RCGP designed to make the NICE guidelines on antenatal and postnatal mental health more accessible and focussed for GPs. It is presented in the form of ten questions to help GPs identify the crucial, but often hidden, signs of perinatal mental health issues in their patients as early as possible to enable them to discuss support and treatment with the woman.

Screen Shot 2016-07-26 at 20.04.42The tool is based on and designed to be used alongside NICE guidelines, and has been approved by NICE. It also aims to reduce variation in the care of women with perinatal mental health problems, many of whom face a ‘postcode lottery’ in trying to access specialist referral and follow-up services.

Dr Judy Shakespeare, Clinical Champion for Perinatal Mental Health at the RCGP, said:

“While our attitudes to mental health issues seem to be improving as a society, a terrible stigma still surrounds mothers with mental health problems, not least from the women themselves who think they are being judged as ‘bad’ mothers or are frightened that their child will be taken away if they open up about how they are feeling. We hope that this toolkit will prove a useful for GPs, especially in broaching what can be difficult conversations around mental health. In the wider scheme of things there is a real economic case for investing in specialist perinatal services, which across the country are patchy at best.”

Dr Carrie Ladd, RCGP Clinical Fellow for Perinatal Mental Health, and lead on the PMH toolkit, said:

“I know from talking to GPs and patients in my practice, and via support groups on social media, that there is a real need for more to be done around perinatal mental health. There are lots of resources of varying quality out there, but they are scattered all over the place – this toolkit brings the best altogether, in an easily accessible format. It has been developed in consultation with women who have had perinatal mental health problems, and we hope it will give them the confidence to approach health professionals, and be better informed about their choices and what they should expect. We also recognise that GPs are under immense workload pressures at the moment – and the standard ten minute consultation is increasingly inadequate to properly deal with complex issues associated with perinatal mental health.  We hope this collection of resources will enable GPs and other members of the primary care team to access information quickly and within the consultation so helping them offer the best possible care to their patients at this important time in their lives”

Dr Stephanie DeGiorgio, said:

“Mothers suffering with postnatal depression find it very hard to approach their GP. When I had it the first time, I was worried I was being silly and everyone found motherhood as hard as I did. I needed an understanding response when I finally disclosed how I felt. Even the smallest dismissive comment will put a mother off from opening up. It took me a long time. Knowing that these resources are available for GPs and healthcare professionals – and patients themselves – could make all the difference to a nervous mother who is worried that her children might be taken away or who hasn’t been able to ask for help anywhere else.  Amongst other things, I hope it will help GPs feel more confident to ask about mental health during the postnatal check and to recognise perinatal mental health problems in mothers who are often trying hard to cover up their feelings.”

The Toolkit is available for all to see here –