Community perinatal mental health teams reduce risk of mental health relapse after delivery: study

New research has found that women with a history of serious mental illness are at lower risk of relapse after giving birth in areas where they have access to a community perinatal mental health team (CPMHT).

The research, published in Lancet psychiatryis the first of its kind to evaluate the effectiveness of CPMHT and suggests that women with access to specialist support have a reduced risk of acute relapse after birth, but also highlights the importance of the need for mental health services to work more closely with maternity services.

CPMHTs were rolled out in England from 2016 as part of a unique national initiative to improve access to specialists for women with perinatal mental health problems and overall mental health outcomes.

Women with a history of serious mental illness, such as bipolar disorder and severe depression, are at significantly increased risk of relapse in the first months after birth, and CPMHTs aim to improve access to preventative care during pregnancy in addition to treating new episodes of mental illness. during pregnancy and after birth. However, little research has been conducted to explore the effectiveness of this CPMHT care.

This study identified 70,323 women who had given birth to a single baby and who had been in contact with a secondary mental health care service in the ten years immediately preceding their pregnancy. Researchers followed this group to determine how many of them experienced acute relapses in their mental health after birth, defined as either being admitted to a psychiatric hospital or managed by a crisis resolution team.

Researchers from the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London, in partnership with the University of Exeter and the London School of Hygiene & Tropical Medicine, found that access to care is increasing. was considerably improved: 24.2% of women had access to care during pregnancy in areas where a CPMHT was available, compared to 17.9% in areas where no CPMHT was available. Additionally, acute relapse after delivery was noted in 1,117 (3.6%) of 31,276 women for whom CPMHT was available and in 1,745 (4.5%) of 39,047 women when it was not available. There wasn’t any.

Professor Heather O’Mahen, Professor of Perinatal Clinical Psychology at the University of Exeter and one of the co-senior authors of the study, said: “Pregnant and postnatal women can face many barriers in mental health care. real difference in their ability to access the necessary treatment.

Professor Louise Howard, Emeritus Professor of Women’s Mental Health and one of the lead authors of the King’s IoPPN study, added: “The period after birth may be a time of increased risk for women with serious mental illness, such as those with bipolar disorder or a mental health disorder. history of severe depression. It is very encouraging that the presence of a community perinatal mental health team in an area is associated with a significant reduction in relapse rates after birth – a time when mothers want and need to be healthy and healthy. home with their infants. “.

Conversely, researchers found that women living in areas with CPMHT were at increased risk of stillbirth, neonatal death, and giving birth to babies who were small for their gestational age.

Professor Dharmintra Pasupathy, co-author and professor of maternal-fetal medicine at the University of Sydney, observed: “There is no simple interpretation we can give to these associations, but it may be that one More intensive psychiatric support available in a region may have a negative effect. affect the midwifery and midwifery support that women with severe mental illness receive during pregnancy and childbirth. This is something we urgently need to study further, as the full facts are unclear.

Dr Ipek Gurol-Urganci, lead author and Associate Professor of Health Services Research at the London School of Hygiene and Tropical Medicine, remarked: “The results of this study highlight the value of the data that the NHS collects regularly about the care he provides. Without this national data, it would not have been possible to assess the role of CPMHT, a unique approach to providing support to women with serious mental illness during pregnancy and after birth.