The Specialist Perinatal Mental Health: Model of Care for Ireland was launched on 30th November, 2017. The HSE Mental Health Division (MHD), in recognition of the importance of Perinatal Mental Health included in its 2016 Service Plan the development of a model of care for specialist perinatal mental health services. A national Working Group chaired by Dr Margo Wrigley (the then National Clinical Advisor and Clinical Programmes Group Lead Mental Health), completed this work on behalf of the Mental Health Division.
This Model of Care supports the seven actions on mental health to be implemented by the HSE’s National Women & Infants Health Programme outlined in Ireland’s first National Maternity Strategy and launched by the Minister for Health in January 2016. The Maternity Strategy maps out the future for maternity and neonatal care from 2016 to 2026, to ensure that it will be safe, standardised, of high-quality and offer a better experience and more choice to women and their families.
What is Perinatal Mental Health?
Perinatal mental health disorders are those which complicate pregnancy (antenatal) and the first postnatal year. They include both new onset and a relapse or reoccurrence of pre-existing disorders. Their unique aspect is their potential to affect the relationship between mother, child and family unit with consequent later development of significant emotional and behavioural difficulties in the child. This Model of Care considers the specialist (secondary and tertiary care) component of an overall perinatal mental health service.
Focus of the National Working Group
The Working Group’s task was to design a specialist model of care. The terms of reference encompassed both the strategy for and operation of a specialist perinatal mental health service for Ireland taking into account:
- The interests of women, infants and their families
- Relevant national and international research and evidence based practice and standards
- Relevant national and international policy documents and reports.
Whilst the focus of this specialist service will be women with moderate to severe mental illness, it will play a central role in educating and training all involved in the delivering of services to women during the antenatal and postnatal periods. This will ensure women with milder mental health problems will be both identified and receive appropriate help from skilled staff at primary care level in the community and within maternity services.
In each hospital group, the maternity service with the highest number of deliveries is the designated hub. The hub hospitals are:
- RCSI Hospital Group (HG) – Rotunda Hospital
- Ireland East HG – National Maternity Hospital
- Dublin Midlands HG – Coombe Women & Infants University Maternity Hospital
- University of Limerick HG – University Maternity Hospital Limerick
- South/Southwest HG – Cork University Maternity Hospital
- Saolta HG – Galway University Hospital
Each hub within a hospital group should have a specialist perinatal mental health service. It’s staffing will be multidisciplinary and led by a consultant psychiatrist in perinatal psychiatry. In the remaining maternity units (13) referred to as "spokes", the liaison psychiatry team will continue to provide the input to the maternity service. This team will be linked to the hub specialist perinatal mental health teams for advice, regular meetings, training and education.
- Implement the National Model of Care in the six hub sites identified
- Support the recruitment of Staff for hub and spoke sites
- Support training of HSE staff in various roles in implementing the Model of Care
- Capture a core clinical outcome dataset
- Continue to work closely with the National Women & Infants Health Programme
- Establish links with other key clinical programmes.