older psychiatryA new hub of resources to support GPs to deliver the best possible care to patients with perinatal mental health conditions has been launched by the Royal College of GPs (RCGP).

Perinatal mental health, a clinical priority for the RCGP since 2014, affects up to 2 in every 10 women during pregnancy and the first year of their baby’s life, but many do not seek medical help or deal with it alone.

GPs are concerned that women could be missing out on the help and support they need before and after giving birth, as they are reluctant to discuss issues such as anxiety or postnatal depression for fear of being stigmatised or even having their babies taken away.

The impact of undetected or untreated maternal mental health problems on the child can be significant, particularly if they occur during pregnancy and the first year of the child's life. In extreme cases, perinatal mental health issues can lead to maternal suicide and the consequences can be devastating for entire generations of families.

In response, the RCGP has launched the free-to-access perinatal mental health toolkit for family doctors and other healthcare professionals, as a go-to collation of resources that could support them to deliver the care their patients with perinatal mental health issues need. 

There is a variety of resources to offer patients from information leaflets, links to supporting charities and social media peer support groups among many others. Health professionals may face additional challenges in seeking help for perinatal mental health problems and there a specific section of the toolkit to address this need.

One resource is a tool developed by the RCGP designed to make the National Institute for Health and Care Excellence (NICE) guidelines on antenatal and postnatal mental health more accessible and focused for GPs. It is presented in the form of 10 questions to help GPs identify the crucial, but often hidden, signs of perinatal mental health issues in their patients as early as possible to enable them to discuss support and treatment with the woman.

The tool is based on and designed to be used alongside NICE guidelines, and has been approved by NICE. It also aims to reduce variation in the care of women with perinatal mental health problems, many of whom face a 'postcode lottery' in trying to access specialist referral and follow-up services.

Dr Judy Shakespeare, clinical champion for perinatal mental health at the RCGP, said: “While our attitudes to mental health issues seem to be improving as a society, a terrible stigma still surrounds mothers with mental health problems, not least from the women themselves who think they are being judged as 'bad' mothers or are frightened that their child will be taken away if they open up about how they are feeling.

"We hope that this toolkit will prove a useful for GPs, especially in broaching what can be difficult conversations around mental health.

“In the wider scheme of things there is a real economic case for investing in specialist perinatal services, which across the country are patchy at best.”

Dr Carrie Ladd, RCGP clinical fellow for perinatal mental health, and lead on the toolkit, said: "I know from talking to GPs and patients in my practice, and via support groups on social media, that there is a real need for more to be done around perinatal mental health. There are lots of resources of varying quality out there, but they are scattered all over the place - this toolkit brings the best altogether, in an easily accessible format.

“It has been developed in consultation with women who have had perinatal mental health problems, and we hope it will give them the confidence to approach health professionals, and be better informed about their choices and what they should expect.

"We also recognise that GPs are under immense workload pressures at the moment – and the standard 10-minute consultation is increasingly inadequate to properly deal with complex issues associated with perinatal mental health. 

"We hope this collection of resources will enable GPs and other members of the primary care team to access information quickly and within the consultation so helping them offer the best possible care to their patients at this important time in their lives"

Dr Stephanie DeGiorgio, who has experienced perinatal mental health issues, said: "Mothers suffering with postnatal depression find it very hard to approach their GP. When I had it the first time, I was worried I was being silly and everyone found motherhood as hard as I did. I needed an understanding response when I finally disclosed how I felt. Even the smallest dismissive comment will put a mother off from opening up. It took me a long time. 

“Knowing that these resources are available for GPs and healthcare professionals – and patients themselves – could make all the difference to a nervous mother who is worried that her children might be taken away or who hasn't been able to ask for help anywhere else. 

“Amongst other things, I hope it will help GPs feel more confident to ask about mental health during the postnatal check and to recognise perinatal mental health problems in mothers who are often trying hard to cover up their feelings.”