Perinatal Service

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Please note: The Leeds Perinatal Mental Health Service is moving

We are making some changes to our Perinatal Mental Health Service. From Thursday 9 April, our Mother and Baby inpatient unit (MBU) is temporarily relocating from its current base at The Mount, to Parkside Lodge in Armley.

This decision has been made in response to the Coronavirus pandemic as we are making changes to the clinical environment at The Mount to prepare for this. In addition, the Leeds Perinatal Community Mental Health Service and Outreach teams will also temporarily relocate their base from The Mount to ensure a good continuity of service.

The service’s full address will now be:

Parkside Lodge
16 Stanningley Road
Armley
Leeds
LS12 2HE – link to Google Maps

Our contact numbers will remain the same. They are
Mother & Baby Unit: 0113 85 55509
Outreach Team: 0113 85 55505
Leeds Community Perinatal Team: 0113 855 5505

About the service

The Leeds Perinatal Mental Health Service provides specialist support to women experiencing significant mental health difficulties during pregnancy and the first year following a child’s birth.

The word “perinatal” refers to the period during pregnancy and extending to a year after childbirth.

The service also provides inpatient care at the Yorkshire and Humber Mother and Baby Unit and through an Outreach Service (more on this below) that offers three care options to women and mental health professionals across the Yorkshire and Humber region.

You’re not alone!

Perinatal mental health difficulties are very common and for many women. In this short video mums from Leeds share their stories around how they felt during and after pregnancy, and how important it is to talk to someone.

If you are a new parent in Leeds you can find out what support there is via the Mindwell Leeds website.

If you are worried about your mental health or the mental health of a woman you know during pregnancy, or in the first year following the birth of a child, then please get in touch with us (see the Contact Us section below).

Who is our service for?

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.

*What is 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.

Find out more about us and what we do

How can I access the Leeds Community Perinatal Service?

You can be referred to the team by a health professional including your GP, midwife, health visitor, obstetrician, psychiatrist or the 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 Annexe building where we are based. 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 talking therapies

You can also find out more by listening to the following interview with Clinical Engagement, Access & Inclusion Co-ordinator Balvinder Dosanjh and Dr Saif Bangash 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.

Leeds & York Partnership Foundation NHS Trust · Balvinder Dosanjh and Saif Bangash on the importance of Perinatal Mental Health

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.’

Or visit our website and read the How we use information about you section.

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.

Outreach Service

This service offers three care options to women and mental health professionals across Yorkshire and the Humber:

A pre-conception counselling clinic to help women before they become pregnant
Advice to mental health professionals on management of complex perinatal presentations
Follow-up of women across the region discharged from the inpatient Mother and Baby Unit in Leeds.

Referrals will be accepted from secondary mental health care services, although telephone enquiries will be taken from other health care professionals. The referral documentation can be found below.

The Yorkshire and Humber Mother and Baby Unit

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’s 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 an occupational therapist and infant mental health specialists.

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

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. There is a lounge with television, DVD player and music system. 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 nursery 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 11:30am 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?

Smoking is not allowed within the hospital building. There is a smoking shelter within the courtyard. 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.

Preconception counselling

We provide preconception 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.

Preconception counselling takes place at the Perinatal Mental Health Service at The Mount. In most cases a single 90 minute appointment is sufficient, sometimes a follow up appointment is arranged to discuss things further.

The preconception 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 preconception counselling by your GP or Community Mental Health Team.

What should good perinatal mental health care look like?

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.

How to refer to our services

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. We’re happy to take telephone enquiries from other professionals who are working with families.

There are more specific criteria for referrals to our mother and baby inpatient unit (see below).

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.