Service Detail

• To provide specialist medical, nursing, psychological and social care over the four community pathways
• To respond in a timely manner to emergency requests for assessment and advice
• Monitor the mental health of patients who have been assessed as being at risk of developing a serious mental illness in the perinatal period, and assist in the development of proactive management plans
• Provide psychological assessment and therapy for mental health problems occurring during the perinatal period. This potentially covers the whole range of adult mental health disorders including depression (including post-natal depression), anxiety disorders such as tokophobia, panic disorder, generalised anxiety, obsessive-compulsive disorder, or post-traumatic stress (including birth trauma), psychosis (including post-partum psychosis) and personality disorder. Consistent with NICE guidelines, the majority of treatment is from a cognitive behavioural perspective, although other theoretical orientations are also drawn upon
• Pre-birth perinatal mental health plans should be developed with the pregnant women, partner and professionals involved in her care at 28 to 32 weeks’ gestation
• To achieve the earliest resolution of the maternal mental illness whilst promoting the care and developing relationship with the infant
• To assess and proactively manage high risk women with a prior history of serious mental illness to prevent avoidable recurrences in pregnancy and the postpartum period
• Provide appropriate information to women, their partners and families
• Monitor, support and provide care for mothers discharged from mother and baby units
• A perinatal psychiatric liaison consultation service to primary care, maternity, mental health and other involved services. The main function of this service is to advise and assist in the identification, assessment and treatment/management of pregnant and postpartum women with a current or previous serious mental illness and to promote early planning, intervention and treatment

Mother and Baby Unit (MBU)

• Wherever possible, to ensure that women who are presenting with severe mental illness in the last trimester of pregnancy or during their first year post birth who are unable to be safely and appropriately cared for in the community are admitted to a MBU in order for them to receive care and treatment while they are with their baby
• Wherever possible, mothers referred to the MBU will be cared for with their baby
• Mothers admitted to the MBU will be assessed at the point of admission and will then receive on-going assessment and review. Care will be planned collaboratively with the mother, members of her family as appropriate (with the mother’s consent) and members of the multi-disciplinary team. Care plans will be reviewed regularly and updated as required
• A thorough risk assessment is undertaken of all mothers admitted to the MBU in order to plan care that will address any risks identified, this may include a mother being placed on enhanced nursing observations for periods of time
• Babies who accompany their mothers to the MBU are considered as guests. As well as observations for mental state, a mother will also be assessed regarding the level of support and supervision that she requires with baby care and will be placed on the most appropriate baby care level of observation
• All mothers admitted to the MBU will be allocated a primary nurse, an associate nurse and a nursery nurse on admission
• Nursery nurses and member of the wider multidisciplinary team will support mothers to develop parenting skills as assessed to be necessary
• All mothers admitted to the MBU will be offered a psychological assessment and an occupational therapy assessment within the first week of admission or at the earliest opportunity that the mother’s mental state allows
• All mothers admitted to the ward will have access to a therapeutic timetable which will include group and individual sessions
• The MBU will ensure that communication is maintained with the mother’s community professionals in order to plan their on-going care collaboratively. Community professionals will be invited to attend the weekly ward round as appropriate including CPA meetings.
• If a mother is not previously known to mental health services prior to admission or does not have a care co-ordinator a referral will be made at the point of admission to ensure that collaborative planning for after care can begin as soon as possible

MBU environment

The MBU has 13 bedrooms. Bedrooms are not en-suite however there are several toilets, shower rooms and a bathroom for use by the mothers and older babies. 

The MBU has a communal nursery area, a communal dining area, a sleep room which is able to accommodate eight babies, a baby change area / bathroom, a milk kitchen for the preparation of baby’s feeds and a laundry room. The MBU also has an enclosed grassed garden area and a separate couryard garden. In order for visitors to access the MBU, their identity will be checked by staff on duty.