Perinatal Mental Health Service

Perinatal mental health difficulties are very common and for many women it is possible for these to be managed by their GP, Health Visitor or through local counselling services.

Our team will look after women with more complex difficulties or when the above services have not resolved their difficulties.

You may benefit from seeing our team if:

• You have a history of serious mental health difficulties and are planning a pregnancy or are pregnant
• You have a family history of serious mental health difficulties such as bipolar disorder or postpartum psychosis*. These conditions may increase your risk of becoming unwell during pregnancy or postnatally.
• Your GP or obstetric team feel that you are currently experiencing mental health difficulties which would benefit from specialist intervention.

How can I access the Leeds Community Perinatal Service?

You can be referred to the service by a health professional including your GP, midwife, health visitor, obstetrician, psychiatrist or community mental health team.

Sorry but we cannot accept self-referrals.

How long will I wait to be seen?

We aim to see referrals within 48 hours if urgent or within 14 days if it’s less urgent.

We see mums for assessments during office hours, Monday to Friday.

What can I expect?

A mental health professional will complete an initial assessment with you which will usually take place at The Mount Hospital. It will last approximately 90 minutes.

A home visit can be arranged should you have difficulty attending your appointment here.

These appointments are an opportunity for you to discuss any current difficulties and for us to gain some background information in order to come to a joint understanding of what may help you recover.

If it is felt that our team is not the most appropriate for you, we will discuss other useful services that may be able to help you.

Who and what can I bring with me?

You may wish to bring your partner, relative or friend with you. We would encourage you to bring your baby to your appointments. It is often not appropriate to discuss difficult issues around older children and alternative childcare arrangements should be made for them.

If you are pregnant please bring your hand-held maternity notes.

What happens next?

If it is decided that what we offer is right for you, you will be allocated to a member of our team who will work with you to agree a care plan to meet your needs.

We offer a variety of support options including:

• a complete assessment including liaison with other professionals to inform future care planning and support.
• preconception counselling
• care planning and co-ordination in the perinatal period
• specialist advice on risks and benefits of medication in pregnancy and breastfeeding
• nursery nurse sessions including baby massage and sensory play
• video-interaction guidance – a mother infant intervention to improve attachment and communication
• group work
• family work
• peer support
• partner support
• young carers’ support, and
• psychological therapies such as cognitive behaviour therapy

You can also find out more by listening to the following interviews with Clinical Engagement, Access and Inclusion Co-ordinator Balvinder Dosanjh and Dr Madhu Kewalramani from our Perinatal Mental Health Service as they discuss the support that the Perinatal Service provides and the signs and symptoms of perinatal mental health issues you can look out for.

 

Will everything I say be kept confidential?

You can expect the details of any assessment and treatment plan to remain confidential between you, the team and other involved professionals.

If you would like to know more about confidentiality and the information kept about you, please see the leaflet ‘Your Personal Information. How we use it and keep it confidential.’

Consent to treatment

It is important that you understand any risks, benefits and alternatives before you agree to treatment.

If you feel unsure about giving your consent please ask a member of staff for further information.

You can download a patient information leaflet in English:

 

Perinatal A5 Leaflet – English

You can download leaflets translated into community languages here:

Perinatal A5 Leaflet – Bengali
Perinatal A5 Leaflet – Hindi
Perinatal A5 Leaflet – Somali
Perinatal Patient leaflet – Arabic
Perinatal Patient leaflet – Punjabi Indian
Perinatal Patient leaflet – Punjabi Pakistani
Perinatal Patient leaflet – Urdu

If you need a leaflet in any other format please contact a member of our team (see contact us section for details) or speak to your caseworker.

This short film is the information leaflet about the perinatal mental health service in British Sign Language, with subtitles:

Download our Mother and Baby Unit Leaflet.

The Yorkshire and Humber Mother and Baby Unit provides an inpatient environment where mothers experiencing severe mental health difficulties can receive treatment and support while continuing to care for their baby (for professional referral details see ‘How to refer to our services’ section below).

It is a small, safe friendly unit with specialist staff who help mums to recover from difficulties and return home with appropriate support.

Find out more about us in this short video which shows what to expect if you’re referred to the unit and introduces some of the ward staff:

Most women experiencing mental health difficulties will be able to remain at home and receive treatment. In some cases when a mother is severely unwell, treatment in hospital may be recommended.

You may benefit from admission if:

• You have a history of a serious psychiatric disorder such as schizophrenia, schizoaffective disorder, bipolar disorder or severe depression and need inpatient care during the perinatal period.
• You experience an episode of postpartum psychosis: This is a rare but serious disorder which can include changes in thinking (delusions) or unusual experiences (hearing or seeing things), confusion, severe anxiety, over-activity and changes in behaviour. It is very treatable but due to its severity admission to hospital is usually necessary.
• You experience an episode of significant depression or anxiety, particularly if this is affecting your bond with your baby.

Louise’s story

Louise is a mum who has received support from the unit.

In this short video she shares her story to help others coming on to the ward.

What support will I receive on the unit?

The unit is staffed by doctors, nurses, nursery nurses, health support workers, with input from our occupational therapist, social worker, psychologist and art therapist.

Your midwife or health visitor will remain involved in your care, visiting you on the unit and attending care planning meetings. If you live a long distance from the unit, a health visitor from the local area will offer temporary input.

Wherever possible, you are encouraged to provide the care your baby needs; you will be supported by the team to do this. It is common for mothers to need a high level of support when first admitted and you may initially have a member of staff with you at all times. This level of support will be reduced as your health improves and you gain confidence in caring for your baby.

What treatment am I likely to receive?

This will depend on the nature of your difficulties. A period of assessment is sometimes required before agreeing on a treatment plan. Possible treatments include:

• Medication
• One to one supportive counselling
• Cognitive behavioural therapy
• Nursery nurse input
• Therapeutic mother-infant activities such as infant massage, play sessions and interventions to promote attachment
• Relaxation/anxiety management
• Groups to help you understand your baby
• Compassion focused therapy
• Creative therapies

You will have a review meeting each week with the team members involved in your care to review progress and plan further interventions. You can invite a family member or friend to attend this with you.

What is the unit like?

The unit has eight single rooms each with a bed, washbasin, cot and wardrobe. Some rooms are en-suite while other rooms have shared bathroom facilities. There is a shared lounge with television,  There is a kitchen area with fridge, microwave and toaster, and laundry facilities are available. Breast-feeding is welcomed throughout the unit, there is also a milk kitchen for preparing bottles; each mother has a cupboard for formula milk and a cold water steriliser. There are quiet areas for visiting, a conservatory and enclosed courtyard. We have a sensory room well equipped with toys for infants.

Will my baby and I be safe on the unit?

The unit is only accessible to designated staff. There is a video-intercom system controlling the entry of patients and visitors. We continually make assessments of patient and infant safety. Rarely, if a risk cannot be safely managed on the Mother and Baby Unit, a mother may temporarily need to be transferred to an alternative unit.

How often can people visit? Can older children visit?

We try to be flexible with visiting times, generally visits are allowed between 11:00am and 9pm. It is important to strike a balance between having sufficient contact with your family and benefitting from time with staff on the unit. Older children are welcome to visit but must be supervised at all times by a responsible adult. If the unit is very busy or visitors are disruptive, they may be asked to leave.

How long will I need to be in hospital?

This will vary depending on your needs but typical admissions are between a few weeks and a few months. As your health improves you will spend increasing amounts of time at home-starting with a few hours initially, building up to spending several days at home before discharge.

Can I smoke on the unit?

There is no smoking allowed anywhere within the hospital grounds. Disposable e-cigarettes may be allowed in bedrooms. If you would like help to stop smoking, this can be provided.

What support will I receive on discharge?

A planning meeting will be arranged prior to discharge to ensure you are well supported and know how to access further help if needed. You may have ongoing input from a community nurse and clinic appointments. You may start to attend local mother and baby groups and have support from your health visitor or local children’s centre.

I am worried people will think I can’t care for my baby, or my baby may be taken away.

We understand that this is a common worry but it is very rare for a baby to be removed from their family. Many women are able to care very well for their baby despite experiencing mental health problems; others will need additional support at times. It is possible to have severe mental health difficulties in the perinatal period and make a full recovery. The wellbeing of all infants is essential and where appropriate we liaise closely with Children and Young People’s Social Care in order to provide support to keep families together and to safeguard children.

How do I access the service?

If you live in Leeds, you can be referred by your Midwife, Health Visitor, GP, Obstetrician or Community Mental Health Team. If you live in the wider Yorkshire and Humber area, you will need to be referred by the local mental health service. Where possible we arrange an assessment appointment on the unit to discuss your needs and familiarise you with the service. In an emergency admission may be arranged without prior assessment in order not to delay treatment.

We provide pre-conception counselling to women at risk of developing significant mental health difficulties during pregnancy or after the birth of their child.

This is recommended if you have experienced serious mental health difficulties such as bipolar disorder, schizophrenia, severe depression or previous postpartum psychosis. Even if you have been well for many months or years it is important to be aware of the possibility of relapse in the perinatal period and to discuss the options should this occur.

If you have a family history of postpartum psychosis or bipolar disorder, it is also advisable to be counselled on the risks of becoming unwell and management options.

If you are planning a pregnancy, you may benefit from meeting with a member of our team to discuss the following:

• your individual risk of becoming unwell in the perinatal period
• whether treatment will be beneficial during pregnancy and after birth
• risks and benefits of different medication during pregnancy and in breastfeeding; this may include meeting with a pharmacist and discussing the most recent information on medication
• What can be done to prevent relapse
• support and monitoring during pregnancy and post delivery
• early warning signs of illness, and
• care available should you become unwell.

Pre-conception counselling takes place at the Perinatal Mental Health Service which is temporarily located at Parkside Lodge. In most cases a single 90 minute appointment is sufficient, sometimes a follow up appointment is arranged to discuss things further.

The pre-conception counselling clinic provides consultation, information and advice, not ongoing care. Referral to our service for treatment may be one of our recommendations should you become pregnant.

You may wish to bring your partner to the appointment to involve them in understanding risks and treatment decisions.

With your consent we usually send a copy of the clinic letter to your GP and other relevant professionals involved in your care. They will then be aware of the recommendations and your wishes regarding treatment when you are trying to conceive or become pregnant. You will be offered a copy of any letters sent.

If you are registered with a Leeds GP practice, you can be referred for pre-conception counselling by your GP or Community Mental Health Team.

The following statements were developed by an NHS Expert Reference Group and adapted by local parent support group NESTLeeds and the Leeds Perinatal Mental Health Implementation Group.

They are based on the perspectives of women who have experience of perinatal mental health care.

They highlight the need to develop perinatal mental health services with the woman at the centre.

If I am worried about my mental health, I will be able to discuss my concerns with someone in a supportive environment.  I know that during pre-pregnancy, pregnancy and post-pregnancy check-ups, I will be routinely asked about my physical and mental health, as well as the health of my baby.

I know that if I need care in hospital for my mental health, I can stay with my baby in a specialist unit and will be able to go there as soon as possible.

I know that if I experience problems with my mental health or I’m in crisis during pregnancy or in the following year, I will be given choice and prompt access to a range of treatments and support, quickly, that is right for me and my family.

I know that if I am planning a pregnancy and have (or have had) a severe mental health problem, I will be able to be seen for preconception advice from a specialist service, so that I have the information and support I need to plan my pregnancy effectively.

The perinatal mental health care pathways have been developed by the National Collaborating Centre for Mental Health.

This followed a process agreed with the National Institute for Health and Care Excellence (NICE), with involvement from an expert reference group including experts by experience, carers, practitioners, academics, commissioners, service managers and representatives from national NHS arm’s-length bodies.

This information is for GPs and other professional health workers.

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.

If you would like to discuss a referral, please call us on 0113 855 5505, Monday to Friday, between 9am and 5pm, and we’ll aim to call you back as soon as we can.

Download our referral form – updated March 2021

Download our referral guidelines

Download our pre-conceptual counselling referral form

Download the Leeds Perinatal Mental Health Pathway document

All completed forms should be emailed securely to: perinataldutydesk.lypft@nhs.net.  We’re happy to take telephone enquiries from other professionals who are working with families.

Mother and Baby Unit beds are funded by NHS England and we can admit from any region in England. Our primary area for admissions is the Yorkshire and Humber region.

For referrals to our Mother and Baby inpatient unit, visit the NHS MBU beds website and complete the online referral form. Please refer to our guidance notes to ensure all necessary information is provided.

Referral enquiries can be made 24 hours a day via 0113 8555519.

 

The service’s full address is:

Our contact numbers :
Mother and Baby Unit: 0113 85 55509/0113 8555519
Outreach Team: 0113 85 55505
Leeds Community Perinatal Team: 0113 855 5505