Dr Jonathan Evans, Director of the Improving Perinatal Mental Health Health Integration Team (IMPROVE HIT), gives an update on progress in 2018-19.
The specialist perinatal mental health service, which the IMPRovE HIT supported to obtain funding, has secured its second wave of funding and is now up to full complement of staff. The University of Bristol’s evaluation of the service is still ongoing because of staff changes, but we expect initial findings in December 2019. So far, the evaluation has focused on service staff and evaluating the service set-up and process, as well as on mechanisms to support self-evaluation into the specialist team. The second part of the evaluation will now focus on service users and their experience of the service. Dr Hannah Family has been appointed to finish this work and will be starting in June.
We have begun to look at the pathways in place for women experiencing less severe mental health problems, with a focus on depression and anxiety. Colleagues at Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group are working on this and we hope to have identified our areas to target in the coming months.
Our work to increase women’s engagement with Children’s Centres has been successful, with a system up and running to register all women during their pregnancy. We are looking to assess the impact of this on perinatal mental health. Dr Rebecca Pearson, who leads the universal prevention work stream, is collaborating with Sally Jaeckle, lead for children services at Bristol City Council, on this work.
We have had a productive year in terms of obtaining research funding for HIT-related projects. Dr Iryna Culpin is leading a three-year project to study the role of fathers in the context of postnatal depression which will investigate how dads contribute to the wellbeing of family life and their role in parenting when their partner has postnatal depression. IMPROVE HIT was instrumental in formulating research questions and the design of the study, through facilitating close engagement and strong partnership with community services and charities that support families through perinatal depression, and, most importantly mothers and fathers who articulated a strong need for help and support during this challenging time. The HIT is also a tried-and-tested mechanism for rapid dissemination of research findings and the study will continue collaborating with IMPROVE to engage with policymakers and perinatal health practitioners through workshops and collaborative interdisciplinary meetings.
Rebecca is leading a project on mental health intergeneration transmission, which has been awarded funding from the European Research Council of €1.3 million and Dr Jonathan Evans has been awarded funding of £250,000 from the NIHR to compare psychological treatments for prenatal depression. Other members of the HIT are assisting research into the use of antidepressants in pregnancy by acting as a patient advisory group.
We have recently expanded our focus to look at service provision for those who do not have a child, whether through perinatal death or having had the child taken into care. We will be holding a workshop on each issue later in the year to bring together local expertise, identify teaching and training provision, and hear from those with lived experience, so that we can improve the support and services available for those in need.
A work stream is developing to improve services available for women who are at risk of losing their child through care proceedings. This is a collaboration between Ruth Jackson of Bluebell, Dr Lydia French from the University of Bristol, Stephen Wildblood QC, Family Court judge, and other representatives of legal and social services and non-statutory services.
We have continued our work with local charities Bluebell, Mothers for Mothers and Rockabye and we continue to seek other collaborations with those with lived experience of perinatal mental health problems.