Not all mothers with mental health problems require different or additional treatment. Those providing care and support should speak directly with expectant mothers about their mental health and wellbeing, what they think might help and what they would like to happen.
Agencies across the board, including employers, should consider the Healthy Working Lives Awards Scheme (external link), which includes activity on creating mentally healthy workplaces, and also taking the 'see me' Scotland Pledge (external link).
Quick links:
- Service managers and commissioners
- Midwives, GPs, Practice Nurses
- Voluntary sector and education workers and managers
- Employers
- Interventions for mental health in pregnancy
Service managers and commissioners
Valuable, evidence-based points of reference for professionals can be found in SIGN Guideline 127: Management of Perinatal mood disorders (external link) and NICE Guideline CG45: Antenatal and Postnatal mental health: clinical management and service guidance (external link).
In addition, ensure that:
- staff are trained in mental health issues to a level consistent with their role
- services are accessible and relevant to vulnerable families and consistent with related policy commitments
- relevant information resources are available - consult the NHS Scotland Publications Database (external link)
- clear routes of referral between services and agencies are established
Midwives, GPs, Practice Nurses
At the earliest opportunity, those involved in providing antenatal care should ask mothers about their mental health status. This can be done in the context of the Scottish Women Held Maternity Record (external link) which supports active enquiry by the midwife and referral where appropriate.
The SIGN Guideline 127 (external link) and NICE Guideline CG45 (external link) provides valuable, evidence-based points of reference for professionals, and also contains detailed information on treatment options.
Professionals should also be aware of good sources of local support and how to access them on behalf of their patients. The booklet 'Mood disorders during pregnancy and after the birth of your baby' (external link) produced by SIGN and NHS Healthcare Improvement Scotland aims to make women and their families aware of the treatment and care they should expect to receive if they have a mood disorder during pregnancy and after the birth of their child. It also aims to help women, their partners and their families to manage their condition by understanding the latest research evidence.
Use of self-help options to deal with stress should be encouraged where appropriate – see Steps for Stress (external link).
Relevant information resources on any specific problems should also be made available in suitable formats - consult the NHS Scotland Publications Database (external link).
Voluntary sector and education workers and managers
Voluntary sector agencies and workers can:
- encourage early contact with a GP or midwife
- provide information on specialist local services
- provide accessible information on mental health issues generally - consult the NHS Scotland Publications Database (external link)
- encourage uptake of self help options - see Steps for Stress (external link)
- provide direct support to individuals or their family
- establish good, inter-agency links with specialist service providers and other sources of support
Employers
Employers can help by providing information on mental health and wellbeing and addressing the stigma and misunderstanding that exists around mental illness.
Consider the Healthy Working Lives Award Scheme (external link) and the 'see me' Scotland Pledge (external link).
Employers must also respect their responsibilities towards pregnant employees - see the Healthy Working Lives pages on maternity and parenting.
Interventions for mental health in pregnancy
The following clinical guidelines for England are a useful reference point for high quality peer reviewed evidence and associated guidance for professionals:
- NICE Guideline CG45: Antenatal and Postnatal mental health: clinical management and service guidance (external link).
- Nice Guideline CG110: Pregnancy and complex social factors
- Guidance for self help on stress is outlined in Steps for Stress (external link). This resource is also available in booklet form.
- For self-help Cognitive Behavioural Therapy, see Living Life to the Full (external link)
- The booklet 'Mood disorders during pregnancy and after the birth of your baby' (external link) produced by SIGN and NHS Healthcare Improvement Scotland aims to make women and their families aware of the treatment and care they should expect to receive if they have a mood disorder during pregnancy and after the birth of their child. It also aims to help women, their partners and their families to manage their condition by understanding the latest research evidence.
