Accessing Our Perinatal Services

    (expand submenu)

    Accessing Our Perinatal Services

    Specialist Perinatal Community Mental Health Team, Lancashire and South Cumbria.

    Referral Guidance

    Tel: 01254 612731

    email: SpecialistPerinatal.CMHT@Lancashirecare.nhs.uk

    • Referrals are accepted from health professionals involved in the care of women during pregnancy and within 12 months of delivery where the woman has complex or severe mental disorder or is at high risk of serious postpartum mental illness.
    • Referrals are also accepted for women contemplating a pregnancy who have a diagnosis of psychotic disorder or previous postpartum psychosis.
    • If the person has a mental health care co-ordinator, the referrer should discuss their concerns with them, the care co-ordinator will then refer to the SPCMHT for advice and support if required.
    • Women with primary addiction problems should be referred to their local Community substance misuse team in the first instance.
    • Women under 16 years of age should be referred to CAMHS in the first instance.
    • Note: sudden changes in mental state in late pregnancy or the early postpartum period should always be taken seriously. Please see Bluelight 82
    • Women who have a learning disability where complex or severe mental health problems are also present.
    • If there is an emergency and the woman is unable to keep herself safe for the 4hr response or if the SPCMHT is not able to respond within 4hrs, then other emergency pathways should be considered. For example crisis team response, or phoning an ambulance to take the woman to A&E (only if they have a medical emergency or the woman cannot keep themselves safe) in all cases ring the SPCMHT for advice.

    Red Flags

    New thoughts or acts of violent self-harm

    New and persistent expressions of incompetency as a mother or estrangement from the infant

    Recent significant change in mental state or emergence of new symptoms

    The most recent confidential enquiry in to maternal deaths has identified that almost a quarter of women who died between 6 weeks and one year after pregnancy died of mental health related causes. One in seven of the women died by suicide. Analysis of the deaths identified the following ‘red flag’ signs for severe maternal illness that require urgent senior psychiatric assessment:

    Pre-pregnancy – Pre-conception advice

    Pre-existing bipolar disorder

    • Refer to SPCMHT

    Pre-existing schizophrenia

    • Refer to SPCMHT

    Previous postpartum psychosis

    • Refer to SPCMHT

    Pregnancy

    Pre-existing bipolar disorder

    • Refer to SPCMHT

    Pre-existing schizophrenia or other psychosis

    • Refer to SPCMHT

    Previous postpartum psychosis

    • Refer to SPCMHT

    Current suicidality, psychosis, severe depressive, severe anxiety or severe obsessive-compulsive symptoms, eating disorder

    • Refer to SPCMHT

    Previous inpatient mental health care

    • Contact SPCMHT for advice

    Mild to moderate depression or anxiety

    • Refer to GP/IAPT/Primary Care Mental Health Team, (or equivalent i.e. START) ,  unless (i.e., refer to SPCMHT  if)
    • 10 relative with bipolar disorder or postpartum psychosis
    • Significant change in mental state in late pregnancy

    Family history of severe perinatal illness in first degree relative

    • In absence of personal illness, ensure close monitoring by maternity and primary care. Refer if any change in mental state in late pregnancy.

    Postpartum

    Psychosis, severe depressive, severe anxiety or severe obsessive-compulsive symptoms, eating disorder.

    Current suicidality?

    • Refer to SPCMHT

     

    • Contact SPCMHT for advice

    Mild to moderate depression or anxiety

    • Refer to GP/IAPT/Primary Care Mental Health Team (or equivalent i.e. START),      

             unless (i.e., refer to SPCMHT if)

    • 10 relative with bipolar disorder or postpartum psychosis
    • significant change in mental state in early postpartum
    • Significant interference with mother-infant relationship

    Family history of severe perinatal illness in first degree relative

    • In absence of personal illness, ensure close monitoring by maternity and primary  

             care. Refer if any change in mental state in early postpartum.