Many women who develop a perinatal mental health problem will experience depression or anxiety disorders; approximately 9.5-14.5K women across London will experience mild-moderate depressive illness and anxiety in the perinatal period every year in London [source: PHE Fingertips].

Psychological interventions (either alone or in conjunction with pharmacological treatment) are extremely effective for treating depression and anxiety disorders, and many women prefer them to taking medication [source: NICE Perinatal MH Care Pathway].

Improving Access to Psychological Therapies (IAPT) services can successfully treat many women experiencing depression and anxiety disorders during the perinatal period. Many IAPT teams have developed perinatal services; examples are below:

1. Working closely with antenatal, perinatal and health visiting services, for example:

• Liaise regularly with MH Trust Perinatal leads to review referrals.
• Work closely with MH Trust perinatal teams, and their patient groups (if present), to explore what IAPT can offer patients. In Greenwich a PWP spends 2dpw with IAPT service and 3dpw with the Trust perinatal team.
• Attend Health Visitor (HV) meetings to develop relationships with Health Visitors.
• Develop step 3 connections with Children’s centres, health visitors and with ante-natal teams. Delivering workshop in these centres and attending their meetings.
• Creating a shortened IAPT referral form for midwives and health visitors, to reduce their paperwork.

2. Outreach to new parents via facilities they usually access, for example:

• Attend HV baby weigh-in clinics and midwife antenatal classes – deliver talks and presentations to raise awareness amongst parents of the IAPT offer available to them.
• Deliver MH workshops in children’s centres (and Sure Start centres), for new parents. Sometimes creche facilities can be provided at these settings.
• Project called ‘Mumzone’ – providing information to new mums about holistic care available to them – physical health, mental health and wellbeing.
• Information provided to mums in the new parent packs given to parents when they leave hospital after giving birth.

3. Adapting content to meet needs of local parents, for example:

• Online mindfulness and baby groups for new parents – positive responses so far, and as patients can be at home it reduces concerns re: childcare provision during sessions.
• Updating the referral criteria to be for anyone with a child under 2 (rather than under 1).
• Virtual mindfulness and baby group sessions for new parents in partnership with the Perinatal team. Encourage babies to participate in the sessions with the parents (10 max).
• Pre-recorded perinatal webinars that parents can access at a time convenient to them.
• Creating sessions for particular groups (fathers, new mums).
• Sessions for fathers with children under 12 months with the Anna Freud centre – called ‘Mind the Gap’.
• Rolling group for new mums – over 6 weeks with a different topic each week, co-produced with mums (e.g. role transition and adjustment, low mood, personal effectiveness, worry, shame and guilt, compassion). [Case study: County Durham Talking Changes Perinatal – include link]

Further resources

NICE and NHSEI Perinatal Mental Health Pathway guidance

Royal College of Psychiatry: Additional resources and guidance re: developing perinatal mental health pathways.

PHE Fingertips data on perinatal mental health, to estimate demand for your borough.

Video produced collaboratively by West London NHS Trust Perinatal Mental Health services, West London NHS Trust IAPT services and service users.

Research paper that was published in 2020 to highlight and evaluate the excellent service being done in Hounslow IAPT to provide treatment groups for women in the perinatal period.

An information sheet for pregnant women and new parents about support that psychological therapy services (IAPT) can offer.

Case studies

Case study: County Durham Talking Changes Perinatal Service 

Case study: Torbay depression and anxiety service