Leeds Perinatal Mental Health Service referral guidelines

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Referral criteria for the out-patient and community service

The Leeds Perinatal Mental Health Service provides assessment and management of women who
experience, or are at high risk of developing, significant mental health difficulties during pregnancy and up to one year following delivery.

Appropriate referrals include:

  • Pregnant women with a history of:
    • bipolar affective disorder
    • schizoaffective disorder
    • schizophrenia
    • previous post-partum psychosis
    • severe depression (depression needing in-patient or specialist treatment).

Postpartum relapse rates for the above can be greater than 50%. A referral should be made prior to the third trimester in order for assessment and a management plan to be put in place. In complex cases, where a high level of support is needed we may need to co-work with the local community team.

Where the patient has had previous contact with their local community team (particularly if recent or
prolonged), a reassessment by that team, followed by consultation with, or referral to, the Perinatal Team may be most appropriate.

  • Any woman with suspected postpartum psychosis

In cases of suspected postpartum psychosis urgent assessment is required. If the perinatal service is
unable to respond urgently, referral to the Crisis Resolution Home Treatment Team is needed. This may be followed by admission to the Mother and Baby Unit if appropriate.

  • New onset of significant mental health difficulties in pregnancy or postpartum, where these are
    related to the pregnancy and cannot be managed in primary care.
  • Referral is recommended if a woman has a family history of bipolar disorder or postpartum
    psychosis.
  • Women at high risk of postnatal illness who require preconception counselling

Note: We are happy to discuss potential referrals and give advice on whether our, or other services would be appropriate. There is a duty worker available each working day 9-5.

Who can refer?

The community service is available to women registered with a leeds GP. We accept referrals from health professionals within Leeds including GPs, obstetricians, health visitors, midwives, and mental health teams.

Referral criteria for mother and baby in-patient treatment

The Mother and Baby Unit is able to admit women in late pregnancy and women and their babies in the first postnatal year who meet the following criteria:

  • Women with new episodes of serious mental illness during late pregnancy and the first postnatal
    year, including:

    • Women with puerperal psychosis, bipolar affective disorder, serious affective disorder and/or other psychoses.
    • Women with severe depressive illness.
    • Women with other severe and/or complex mental illnesses.
    • Women with severe anxiety based disorders.
    • Women with a personal history of serious mental illness who are at risk of an early postpartum relapse.
  • Mothers under the age of 18 if significant perinatal mental illness dominates their presentation and they are likely to be the baby’s principal carer.

In these circumstances the admission should be managed in collaboration with Child and Adolescent Mental Health Services (CAMHS) and Children and Young People’s Social Care.

Referrals to the mother and baby unit

Women registered with a Leeds GP can be referred by any health professional. Where the referral details are incomplete, we may undertake a community assessment, or request further assessment by the GP, local community mental health or crisis assessment team.

Women from the wider Yorkshire and Humber region, who are not registered with a Leeds GP can be referred following assessment by their local crisis team or community mental health team.

How to refer

Urgent referrals and requests for in-patient admission must be discussed with a member of the team by calling 0113 8555505 during office hours or 0113 8555509 at other times. We are also happy to discuss routine referrals.

Download our referral form and  to the service on 0113 8555506.

Where women are under the care of a mental health team, referrals must be accompanied by an up to date risk assessment, care plan and summary of past history. Referrals from within the Trust can be made via CareDirector. These should include the details requested on the referral form above. We aim to respond to routine referrals for treatment within two weeks. We are unable to accept self-referrals.

Exclusion criteria for admission to the mother and baby unit

  • Women with a diagnosis of personality disorder, learning disability, eating disorder or who are
    known substance misusers unless they are also suffering from, or there is, a suspected or potential serious/complex mental illness.
  • If there is prior or current evidence of serious violence/aggressive behaviour that might pose a risk of harm/injury to her own and/or other babies on the unit.
  • For the sole purpose of a mother and baby parenting assessment.
  • If there is evidence that when well, a mother is unlikely to provide an acceptable standard of
    parenting in the community without reasonably available support (based upon the quality and length of her best level of functioning in the past three years).
  • Where Children and Young People’s Social Care are involved, they must be in agreement with the joint admission of mother and baby.