Quality statement 6: Psychological interventions

Quality statement

Women referred for psychological interventions in pregnancy or the postnatal period start treatment within 6 weeks of referral.

Rationale

It is important that women with a mental health problem in pregnancy or the postnatal period receive prompt treatment to manage their condition and prevent their symptoms worsening. More urgent intervention may be needed at these times (and women with acute mental health problems will need to be seen as quickly as possible) because of the potential effect of the untreated mental health problem on the baby and on the woman's physical health and care, and her ability to function and care for her family.

Quality measures

Structure

Evidence of local arrangements to ensure psychological interventions can be started within 6 weeks of referral for women with a mental health problem in pregnancy or who have a mental health problem in the postnatal period.

Data source: Local data collection.

Process[1]

a) Proportion of women referred for psychological interventions in pregnancy or within 12 months of giving birth who are assessed for treatment within 2 weeks of referral.

Numerator – number of women in the denominator who are assessed for treatment within 2 weeks of referral.

Denominator – the number of women referred for psychological interventions in pregnancy or within 12 months of giving birth.

Data source: Local data collection.

b) Proportion of women assessed as appropriate for psychological interventions in pregnancy or within 12 months of giving birth who start psychological interventions within 4 weeks of assessment.

Numerator – number of women in the denominator who start psychological interventions within 4 weeks of assessment.

Denominator – number of women assessed as appropriate for psychological interventions in pregnancy or within 12 months of giving birth.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (general mental health services, primary care psychological therapy services and specialist secondary care mental health services) have service capacity to ensure that women who are referred for psychological interventions in pregnancy or the postnatal period are assessed within 2 weeks of referral and treatment is started within 6 weeks of referral.

Healthcare professionals (mental health professionals) assess women who are referred for psychological interventions in pregnancy or the postnatal period within 2 weeks of referral and start treatment within 6 weeks of referral.

Commissioners (clinical commissioning groups) commission psychological interventions and specify that assessment of women referred for psychological interventions in pregnancy or the postnatal period should take place within 2 weeks of referral and treatment should start within 6 weeks of referral.

What the quality statement means for patients, service users and carers

Women with a mental health problem who are pregnant or have had a baby in the past year and who have been referred by their healthcare professional for psychological therapy start their therapy within 6 weeks of being referred, so they can receive the treatment they need as soon as possible.

Source guidance

Definitions of terms used in this quality statement

Psychological interventions

Psychological interventions should be tailored to the (sometimes highly specialist) needs of women in pregnancy and the postnatal period, and to support the baby's development, attachment and mental health. All healthcare professionals providing assessment and interventions for mental health problems in pregnancy and the postnatal period should understand the variations in their presentation and course at these times, how these variations affect treatment, and the context in which they are assessed and treated (for example, maternity services, health visiting and mental health services).

[Antenatal and postnatal mental health (NICE guideline CG192)]

Equality and diversity considerations

When tailoring psychological interventions to women's individual needs, health professionals need to ensure that assessments and interventions are culturally competent and that women are able to understand and communicate effectively. An independent interpreter should be provided if needed.



[1] Process measures have been included to reflect that the 6 weeks to treatment set out in the quality statement comprises 2 weeks to assessment and 4 weeks to treatment, as recommended in NICE's guideline on antenatal and postnatal mental health, recommendation 1.7.3.