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Shining a spotlight on perinatal mental illness

Shining a spotlight on perinatal mental illness – Cornwall and Isles of Scilly support Maternal Mental Health Matters Awareness Week. 
This year’s Maternal Mental Health Matters Awareness Week (30 April – 6 May) shines a spotlight on the help available for women who develop a mental illness during pregnancy or within a year after giving birth. In Cornwall and the Isles of Scilly, Kernow Clinical Commissioning Group commission a specialist perinatal service delivered by Cornwall Partnership Foundation Trust, and Post Natal Depression Support Groups, delivered by Outlook South West, to offer more timely and appropriate support closer to women closer to home. 
More than 1 in 10 women develop a mental illness during pregnancy or within the first year after having a baby. Perinatal mental illnesses, which include depression, anxiety or psychosis, are caused by a combination of biological, psychological, and social factors, and can be mild, moderate or severe. Research shows that 7 in 10 women will hide or underplay the severity of their perinatal mental illness. If untreated, these illnesses can have a devastating impact on the women affected and their families.
This is the second annual UK Maternal Mental Health Matters Awareness Week to be organised by the Perinatal Mental Health Partnership to help raise awareness of perinatal mental health problems and provide information on how and where mums and families can get support. 
The theme of this year’s week is ‘Support For All’, with a focus on advocating for all families affected by perinatal mental Illness to access the information and help they require to enable recovery. The campaign is using the #maternalmhmatters hashtag and is focusing on a series of themed days. These include; “What is Perinatal Mental Health” (Monday, 30 April); “Support from Health Care Professionals” (Tuesday, 1 May); ‘The Village”, focusing on working together to remove barriers to services so everyone can access them (Wednesday, 2 May – which is also World Mental Health Day); “Dads” (Thursday, 5 May) and the creation of a “Positivity Pot” focusing on recovery (Friday, 4 May). 
Last year NHS England pledged to increase access to specialist perinatal mental health support in all areas of England by 2021 and launched a phased, five-year transformation programme, backed by £365m in funding, to improve access to and experience of care, early diagnosis and intervention. Consequently, two joint bids have been submitted to NHS England to further enhance the local perinatal mental health service and increase workforce training and awareness in perinatal mental health, and we are waiting for a decision on both bids.
After successfully bidding for funding from NHS England in 2016 to expand existing specialist perinatal mental health service, last year saw the recruitment of a range of professionals from a range of different disciplines. These included a psychologist, nursery nurses, mental health nurses, occupational therapist and a social worker. Following the expansion of the team the service was officially relaunched on 4 December 2017 and is now taking direct referrals. The team received 527 referrals between April 2017 and March 2018, generating just over 6,000 patient contacts. 
The service also delivers specialist perinatal and infant mental health training across Cornwall and works in partnership with the Angela Harrison Charitable trust who provide training opportunities for specialist perinatal mental health training from national experts such as Alain Gregoire. The team are now providing therapeutic interventions in pregnancy and postnatally to treat significant mental health problems and enhance the attachment between mum and baby. 
The specialist perinatal service has worked with volunteers who have experienced perinatal mental illnesses to set up new craft based peer support groups called ‘Untangled’ and these groups are supported by the perinatal mental health team. There are currently two Untangled groups – one in St Austell and one in St Blazey – who are supporting 17 families, but following the success of these groups, a third group is due to open in St Austell next week. Plans are also being developed to set up new peer support groups in other parts of Cornwall.  Further information about the groups is available from Cara on 07917 008778. 
One of the volunteers is mum of four Samantha Collins who experienced severe postnatal depression following the births of her second and third children. Samantha was extremely anxious when she discovered she was pregnant with her fourth child and says the support she received from the perinatal mental health team and members of the Untangled support group changed her life.
“I was terrified I would become ill again and people would call me a bad Mum. But my support worker sat me down and said that if I did become ill, they would look after me so I could look after my baby. 
“New mums and dads are often too scared to admit that parenting can be very hard but the support I received from the perinatal mental health team and members of Untangled have given me the courage to be honest and ask for help when I need it.  I now feel safe and secure in looking after my baby and want to make sure that other people do not have to go through what I did.“
NHS England are very interested in this peer support group model and are hosting a webinar for the peer supporters to present their work to the regional perinatal and infant mental health steering group on 8 May.
Another group which support mums in Cornwall is run by Outlook South West. The “Finding Yourself Again” group supports mums, with children aged 0-3, in the transition to motherhood. The five week course, overseen by a psychologist, helps women develop individual ways of coping more easily with the demands of a young family, reducing depression, stress and anxiety. 
One young mum, who was referred to the group by her GP two years ago when her child was 18 months old, recently reflected on her experiences saying “…when I felt unable to feel any love to my beautiful son I knew I had to do something about it. (In the group) we were able to talk about all the difficulties we had been experiencing. It felt okay and comfortable talking about how much I desperately needed a break from my child, how much I wanted to run away and never return. It’s okay to feel like that sometimes. The course changed my life. I learnt about coping methods, I learnt how to just take time for myself, how important it is to be able to share my feelings with others, and best of all I learnt to be myself again! And ultimately that's what the course is about! You!’
Mums attending recently praised the group as “very, very helpful in learning to understand about, and discuss why I had been feeling the way I have” and “as a “lifeline”.
Women, not all first time mums, can refer themselves to Outlook South West, or be referred by a GP, midwife, health visitor, or may be already seeing the specialist perinatal mental health team.
The specialist perinatal team has also worked with the perinatal teams in Devon and Somerset to coordinate the use of the new interim Mother and Baby Unit (MBU) in Exeter to provide specialist support for new mums with serious mental health needs from across the three counties. Opened on 20 April, Wonford House provides a temporary four bed unit for vulnerable women and their babies while a permanent eight bed unit is being built. 
This is a major milestone for Cornwall’s perinatal services as the new unit means that mums needing specialist help can now be supported alongside their babies in the south west, rather than having to travel to an MBU in another part of the country or separated from their baby and admitted to an adult psychiatric ward.
“We know that becoming a mum is a hugely emotional experience and we want to make sure that women who are experiencing mental health issues have access to the expert help and support they need close to home so they don’t have to suffer alone “ said Mandy Raywood, Specialist Perinatal Team Leader, for Cornwall Partnership NHS Foundation Trust.  
The wide range of services has also been welcomed by Dr Paul Cook, who is lead clinician for mental health services for KCCG.  “The positive developments in our specialist perinatal mental health services during the past twelve months mean we are much better placed to ensure that vulnerable women and their families in Cornwall and the Isles of Scilly can access targeted, specialised support at one of the most important periods of their lives. “ he said. 
“Anyone who is feeling concerned about their mental health, or that of a loved one, should talk to their GP, midwife or health visitor, who will be able to help”.