Caring for new mothers with mental health difficulties means supporting loved ones too

A team of researchers and clinicians led by the University of Leeds in collaboration with the University of Surrey, King’s College London, South London and Maudsley NHS Foundation Trust and the University of Huddersfield, have developed a new good practice guide which recommends that caring for mothers in need of specialist mental health services means also finding ways to involve and support the people most important to them.

The good practice guide outlines key principles and ideas for involving and supporting partners and other family members – and why this is vital. This includes:

• Acknowledging the mental health and wider support needs of fathers, other co-parents or partners.
• Considering the needs of other children
• Being aware of cultural differences
• Appreciating how diverse families can be.

The team recognised that providing support to fathers is key – but services must also acknowledge that families and support networks can look very different, from same-gender parents to multigenerational households, single parents or more than two main caregivers.

The guide encourages perinatal mental health services to follow three underpinning principles:

1. Think Family
   
   Services should consider the needs of the whole family, how family members can be included in the mother’s care and how they can be supported as individuals.
2. The Perinatal Frame of Mind
   
   Thinking about the needs of multiple family members, being aware of the father, other co-parent or partner’s mental health and how this affects the mother and baby. Thinking about how the pregnancy is affecting the partner and other family members’ health and wellbeing, and how the absence of a partner or lack of support from the family may affect the mother, baby and mother-baby relationship.
3. Stay Curious
   
   Thinking inclusively about how families are formed and being open-minded about who may be important to the mother.

Funded by the NHS England, the team worked with families, NHS services and community organisations to explore how services can involve and support those closest to new mothers with moderate to severe mental health difficulties because this is key to enabling the whole family to thrive.

Dr Zoe Darwin, who led the project for the University of Leeds’s School of Healthcare, said:

"When a mother experiences a mental health difficulty during pregnancy or after their baby’s birth, the whole family can be affected. It can be a very stressful time for everyone concerned. In the guide, we offer a series of ideas for how specialist perinatal mental health services can involve and support partners and other family members.

"By drawing on recent research, expert opinion, and practice examples from individual services, we hope to encourage change at a national level in how we care for families. Ultimately, we hope this will improve mental health and relationship outcomes for all family members."

Dr Jane Iles, Clinical Psychologist and Senior Teaching Fellow at the University of Surrey, said:

"The long lasting and wide-reaching impact of mental health difficulties of new mothers and parents has not always been recognised, and therefore many mental health difficulties experienced by families in the perinatal period have gone untreated. This can lead to further problems, not only for the new mother but for her wider family. It is important that such difficulties are acknowledged and acted upon by health care professionals.

"This guidance provides many tips and ideas to help them do this, and to provide women and their families with a positive experience of care, with services joined up around them."

Dr Darwin, Associate Professor in Health Research at the University of Huddersfield, said:

"Working in this way is also important for addressing inequalities. Around 1 in 10 fathers experience mental health difficulties during pregnancy or after a baby’s birth and currently their needs are largely undetected and unmet. In addition, minority groups face increased vulnerability to perinatal mental health disorders and barriers to accessing services. 

"Consultation with stakeholders highlighted the importance of inclusivity, for example, in relation to Black and Minority Ethnic parents, LGBTQ+ parents, and to lone parents."

It was commissioned by NHS England and Improvement to help professionals understand how to support and involve partners and other family members of mothers accessing specialist services, in line with the NHS Long Term Plan, its strategy for the next 10 years.