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Parental Mental Health and Wellbeing

The following pathway should not be read as stand-alone and MUST be read in conjunction with Section 3: Pathways.

  • The Parental Mental Health and Wellbeing pathway specifically needs to be considered in conjunction with the Infant Mental Health pathway.
  • The pathway identifies postnatal depression and parents with a history of previous mental health issues that potentially can impact on the child and family.

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Preconception

Preconception

Delivery of Integrated care.

Birth - 6 weeks

At birth or soon after

Death of baby

Health Visiting

Support for existing family.

Midwifery

Appropriate management and support provision to the family.

Discussion of future pregnancies support could be provided by:

  • Paediatrician
  • RM
  • Hospital Chaplin /liaison team
  • GP
  • HV
  • SANDS
  • Children’s Centres
  • Others?

Refer to Adult Mental Health Services, 3rd sector organisations, refer to Mental Health Link worker., Perinatal Mental Health Services. CRUISE for bereavement.

Childrens Centres & EYFS

Support for existing family.

Maternal Mental Health

Additional support for mother and family.

Refer to specialist support/bereavement group.

Primary Care & GP

Ongoing support for mother and family, appropriate referral to mental health services if required.

New Birth Visit (NBV) - Universal Partnership Plus

All services and corresponding rationale as for Universal with additional as detailed in this section for universal partnership plus.

Health Visiting

Refer to Adult Mental Health Services, 3rd sector organisations, refer to Mental Health Link worker., Perinatal Mental Health Services.

CRUISE for bereavement.

Maternal Mental Health

Liaison, information sharing, risk assessment, communicating with partner agencies.

Liaise with CAF/TAC/CP/CIN service providers.

Liaise with Named Nurse Safeguarding re Social Care involvement especially if non-engaging.

Peri-natal Mental Health Services, Health Visiting led. CRUISE for bereavement.

Birth - 8 weeks

Physical care of the mother.

Midwifery

Additional postnatal visits as required to 28 days.

Primary Care & GP

Unwell Mother (physical) - Referral to Consultant - Requires enhanced services.

For what?

Regular appointments / home visits for Treatment, support, appropriate referral and provide parental support.

Birth - 8 weeks

Protection for specific client groups.

Primary Care & GP

1 week - 6/8 weeks

All services and corresponding rationale as for Universal with additional as detailed in this section for universal partnership plus.

Provision of appropriate multidisciplinary care pathways.

Health Visiting

Refer where appropriate to Adult Mental Health Services, 3rd sector organisations, Peri-natal Mental Health Services. CRUISE for bereavement.

Maternal Mental Health

Immediate access to Perinatal Psychiatrist e.g. mental health emergency - Puerperal Psychosis.

Consultation with specialist PIMH service.

May require access to a Mother and Baby Unit.

Detailed discussion regarding attachment and attribution, transition to parenthood, encourage family involvement and support.

Referral to TAC via CAF and involving Social Care if required.

Participate /liaise with CAF/TAC service providers.

Liaise with Named Nurse Safeguarding re Social Care involvement especially if non-engaging.

Primary Care & GP

Refer where appropriate to Adult Mental Health Services, 3rd sector organisations, Peri-natal Mental Health Services, CRUISE for bereavement.

8 weeks to 6 months

Provision of appropriate care pathways.

Primary Care & GP

Unwell Mother (physical) - Referral to Consultant - Requires enhanced services.

For what?

Regular appointments / home visits for Treatment, support, appropriate referral and provide parental support.

All Age Groups

Additional Visits

Health Visiting

Enhanced partnership working, with possible referral to TAC via CAF and involvement of Children’s Social Care Services if required.
Referral of one or both parents to specialist mental health service. Health Visitor team to contribute to care package led by specialist service.

Refer where appropriate to:

  • CBT groups facilitated by Mental Health Team
  • Perinatal mental health services
  • Substance misuse teams
  • Community drug and alcohol team
  • Parent-infant psychotherapy
  • Women’s Aid and delivery into hostel.
  • CRUSE for bereavement
  • Primary Infant Mental Health Services for Video Interactive Guidance (VIG) or locally commissioned attachment therapeutic groups.

Health Visitor led targeted interventions which focus on attachment and attribution, transition to parenthood and the need for family involvement and support.

Birth - 6 months

Early identification and treatment of mental health/wellbeing symptoms.

Health Visiting

Refer to Adult Mental Health Services, 3rd sector organisations, Peri-natal Mental Health Services, CRUISE for bereavement.

Maternal Mental Health

Direct access to mental health services psychology therapy for those with previous mental health history if identified as necessary.
Infant mental health intervention to support mother/ baby relationship.

Assessment of (e.g. CARE Index) and promotion of (e.g. parent-infant psychotherapy) the parent-infant relationship.

Detailed discussion regarding attachment and attribution, development needs of an older infant and encourage family, community involvement and support.

Promotion of attachment through individual and group interventions e.g. Circle of Security Parenting Group / Mellow Parenting.

Referral to TAC via CAF and involving Social Care if required.

Liaise with CAF/TAC service providers.

Liaise with Named Nurse Safeguarding re Social Care involvement especially if non-engaging or parental inability to meet infants emotional needs.

Primary Care & GP

Refer to Adult Mental Health Services, 3rd sector organisations, Peri-natal Mental Health Services, CRUISE for bereavement.

Birth - 1 year

Core Purpose 2, 3

To contribute to the therapeutic service delivery for the mother.

Promote health, wellbeing and positive mental health of parents and baby.

Promote parenting skills.

Promote access for hard to reach families.

Reduce risk of/actual child abuse/neglect practices/competency.

Childrens Centres & EYFS

Groups held in Children’s Centre’s working in partnership with HV, mental health team and other health care professionals, specialist services, voluntary services e.g. Women’s Aid where applicable.

Family Support Worker provision.

Birth - 5 years

Reports: TAF/TAC, CIN, LAC, Safeguarding, child protection.

Emotional health assessment.

Provision of appropriate care management.

Childrens Centres & EYFS

Contribute/participate in the CAF/TAC, CIN service provision.

Primary Care & GP

Contribute to a CAF and form part of the team of relevant professionals/agencies needed to support the mother/family e.g.:

  • Specialist Teen Services - FNP & voluntary organisations.
  • Safeguarding services - social services Mental Health Team
  • DAT
  • LA - housing
  • Children’s Centre/LA parenting teams MARAC
  • SARAC - sexual exploitation

6 months - 5 years

Provision of appropriate multidisciplinary care pathways.

Health Visiting

Referral of one or both parents to specialist mental health/perinatal mental health service. Health Visitor team to contribute to care package led by specialist service.

Maternal Mental Health

Specialist services available for support/advice at universal/universal plus levels.

Joined-up multi-agency working delivering high impact evidence based practice with mental health, children’s services.

CAF - Multi-agency support with a focus on improving mental health and parent/ child relationships.

Consider regional based service comprising universal and specialist services.

Refer where appropriate to:

  • CBT groups facilitated by Mental Health Team
  • Substance misuse teams
  • Community drug and alcohol team
  • Parent-infant psychotherapy
  • Women’s Aid and delivery into hostel

Specific observational training of the mother and child (Hackney Model) for e.g. VIG.

Delivery of more intensive parenting programmes e.g. Mellow parenting.

Primary Care & GP

Referral of one or both parents to specialist mental health/perinatal mental health service.

GP to contribute to care package led by specialist service.

1 - 5 years

1 - 5 years

Core Purpose 2, 3

To contribute to the therapeutic service delivery for the mother.

Promote health, wellbeing and positive mental health of parents and baby.

Promote parenting skills.

Promote access for hard to reach families.

Reduce risk of/actual child abuse/neglect practices/competency.

Childrens Centres & EYFS

Family Support Worker provision.

Groups held in Children’s Centre’s working in partnership with HV, mental health team and other health care professionals, specialist services, voluntary services e.g. Women’s Aid where applicable.

Family Support Worker provision.

Participate /liaise with CAF/TAC service providers.

3 - 5 years

3 - 5 years

Detailed liaison with School Nursing Service.

Health Visiting

As detailed above plus:

Detailed handover regarding the child and family to the School Nursing service; documented in child health record.