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Specialist Perinatal Mental Health Services

It is just as important to be aware of and have treatment for mental health problems as it is for physical health problems in pregnancy. In Ireland, the aim for each maternity hospital/unit is to have access to perinatal mental health services to support women with mental health problems in pregnancy. They will also offer advice to women with mental health problems who may be planning a pregnancy. It is possible to ask your GP, midwife, mental health midwife, public health nurse or psychiatrist if they can refer you to a perinatal mental health service.

As many as 1 in 5 women have mental health problems in pregnancy or after birth. It can happen to anyone. Depression and anxiety are the most common mental health problems in pregnancy. These affect about 10 to 15 out of every 100 pregnant women. Just like at other times in life, you can have many different types of mental illness and the severity can vary. 

The National Programme for Specialist Perinatal Mental Health Services has developed a poster 10 things to know about Perinatal Mental Health.

Patient Information Leaflets

App for Healthcare Staff   

Image of Perinatal Mental Health app

The Healthcare staff Specialist Perinatal Healthcare App is designed to provide the latest information to assist frontline staff in their roles, providing information and services to women seeking information, advice and support for mental health problems in pregnancy and the first year post-partum. Information on the development of new services developed since the Specialist Perinatal Mental Health Model of Care launch.

The app is regularly updated with new content, weekly MCQ questions and information on news and event related to perinatal mental health services. Available at: https://PMH.healthcarestaff.app

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. The HSE’s National Specialist Perinatal Mental Health Services Model of Care describes the specialist (secondary and tertiary care) component of an overall perinatal mental health service. Helpful infographic on the estimated number of women affected by Perinatal Mental Health difficulties

Background to new services available

The Specialist Perinatal Mental Health: Model of Care for Ireland was launched on 30th November 2017. The HSE’s then 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 completed this work on behalf of the then Mental Health Division in the HSE. Download the Specialist Perinatal Mental Health: Model of Care for Ireland.

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.

Focus of the National Model of Care

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 ensures women with milder mental health problems will be both identified and receive appropriate help from skilled staff within maternity services through the development of the role of the mental health midwife nationally. This also plays a central role in educating and training all involved in the delivering of services to women during the antenatal and postnatal periods.

Service Provision

There are 19 maternity services in Ireland. In each hospital group, the maternity service with the highest number of deliveries is the designated hub. In the smaller maternity services, mental health midwives are being employed to work with liaison mental health teams. Access to the service is through your GP or through the booking clinic and the mental health midwife in both hub and spoke sites.

The contact details for Specialist Perinatal Mental Health Service in hub hospitals are:

  • National Maternity Hospital
  • Rotunda Hospital
  • Coombe Women & Infants University Maternity Hospital
  • University Maternity Hospital Limerick
  • Cork University Maternity Hospital
  • Galway University Hospital

Each hub within a hospital group should have a specialist perinatal mental health service. It’s staffing is multidisciplinary and led by a consultant psychiatrist in perinatal psychiatry. In the remaining maternity units (13) referred to as "spokes", the liaison psychiatry team continues to provide the input to the maternity service with the addition of a mental health midwife. This team will be linked to the hub specialist perinatal mental health teams for advice, regular meetings, training, education and clinical opinions.

There are 19 maternity services in Ireland. In each hospital group, the maternity service with the highest number of deliveries is the designated hub. In the smaller maternity services, mental health midwives are being employed to work with liaison mental health teams. Access to the service is through your GP or through the booking clinic and the mental health midwife in both hub and spoke sites. See a full map of Hubs and Spokes in the Specialist Perinatal Mental Health Network.

Hubs Spoke

Goals 2020

  • Continue to implement the National Model of Care in the six hub sites identified
  • Support the recruitment of Staff for both 6 hub and 13 spoke sites
  • Develop online supports for women seeking information on mental health in pregnancy
  • Support frontline staff working to support women with mental health problems in pregnancy through online training and supports e.g. https://PMH.healthcarestaff.app
  • Continue to collect and analyse core clinical outcome datasets from hub and spoke sites
  • Continue to work closely with the National Women & Infants Health Programme
  • Continue to work to establish links with other key clinical areas such as Directors of Midwifery and Public Health nursing and other key partners
  • Continue to work to establish the first Mother & Baby Unit in Ireland

Related links

National Standards for Antenatal Education in Ireland

Service Standards for Mother and Baby Units, 6th Ed., (March, 2018)

Contact

Dr. Margo Wrigley, National Clinical Lead, National Programme for Specialist Perinatal Mental Health Services, Clinical Design & Innovation, HSE.

Ms. Fiona O'Riordan, Programme Manager, National Programme for Specialist Perinatal Mental health Services, Clinical Design & Innovation, HSE. spec.perinatalmhs@hse.ie

View all members of the Specialist Perinatal Mental Health Working Group