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Commissioning antenatal and postnatal mental health services

Mental disorder during pregnancy and the postnatal period can have serious short- and long-term consequences for the health and wellbeing of a woman, her baby and other family members. The detection of women at risk of developing a mental disorder and the identification of those with a current mental disorder, followed by prompt intervention at all levels of healthcare provision, can help to minimise maternal morbidity and limit adverse effects on the baby and other family members.

In an average primary care trust (PCT) with a population of 300,000, the number of women experiencing mental disorder and requiring referral for psychological therapies will be approximately 300 per year (80 per 1000 deliveries). Around 140 women per year (40 per 1000 deliveries) will require referral to a specialist perinatal mental health service and of these about 15 will require admission to a mother and baby unit. Figure 1 illustrates the likely severity of mental disorders experienced by women during pregnancy and the postnatal period and the likely service demand.

The provision of antenatal and postnatal mental health services varies considerably across England because of local factors, including the organisation of existing mental health services, the demographic profile of the population and geographical issues.

NICE clinical guideline CG45 on antenatal and postnatal mental health makes recommendations on how the components of services may be adapted to meet local needs and deliver integrated care. This can be achieved by developing managed clinical perinatal networks. Specialist mental health commissioners and providers should ensure that there are properly developed links between specialist perinatal mental health services, social services and primary care services, with commissioning agreements in place to support service reconfiguration and redevelopment.

The philosophy of care set out in the National service framework for mental health: modern standards and service models should underpin the commissioning of all mental health services, whether specialised or non-specialised.

Benefits

The potential benefits of robustly commissioning effective antenatal and postnatal mental health services include:

Key clinical issues

Key clinical issues in providing effective antenatal and postnatal mental health services are:

  • identifying women with common mental disorders and/or who are at risk of developing a serious mental disorder
  • enabling patient choice by providing up-to-date information about the risks and benefits of treatment before conception, when pregnant and during the postnatal period
  • providing timely and appropriate care and treatment for women with common mental disorders
  • providing support, advice, information and training to maternity, psychiatric and primary care services through managed perinatal networks
  • providing a quality assured service.

National priorities

National priorities and initiatives relevant to commissioning antenatal and postnatal mental health services include:

Although many or all of these priorities may be relevant to the services nationally, your local service redesign may address only one or two of them.

This page was last updated: 02 March 2012

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.