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 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.
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.
Background to new services available
>The Specialist Perinatal Mental Health: Model of Care for Ireland 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 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.
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.
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.
- 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.