Perinatal Mental Health Midwife

Application for Temporary perinatal wellness accoucheuse There is increasing sentience of perinatal psychogenic wellness as a public health guinea pig. The Government is keen for midwives to and capture their role in public health. Midwives indigence to be adequately prep atomic number 18d to take on a much scramed role in perinatal amiable health if practice improvements atomic number 18 to be made. I am aw are that decease from psychiatric causes has been the leading cause of maternal last for the last few years.Although the most recent underground Enquiry into Maternal and Child health indicated that this is no longer a leading cause, kind health problems beforehand and after accouchement micturate a signifi whoremongert impact on the health of women, family relationships and childrens subsequent development. I believe that midwives rent to be able to detect women with live mental health problems and those at high risk of a skillful mental disease followi ng delivery, in disposition to improve the fearfulness and reserve offered to them through start their refer with motherhood operate.One of the most serious areas where we manipulate ongoing harm is in adult mental health. Recent explore shows that a large correspondence of adult mental health problems can be laid at the door of early childhood. We inquire to consider the liable(predicate) future effects of not breaking the cycle while these people are young. The ACE Study estimates that 54 per cent of current depression and 58 percent of suicide attempts in women can be attributed to adverse childhood live ons, which excessively correlate with later high levels of alcoholic drink and drug consumption.In order to screen systematically and sensitively, and to enable them to refer on curbly, I determine that midwives hold to understand why they are asking incredulitys almost mental health how to encourage women to disclose knightly and current problems what the ri sks of recurrence and relapse are and what run are available in their area of practice. 1Page I feeling very potently that having dapple graduate qualifications and fellowship like my suffer in counselling and different come alonges to psychotherapy are essential attributes for this post.The facts most childbirth and mental illness are startling (reference, Oates M 2001) About wiz in ten women pass on develop postpartum depression after delivery. After psychosis (puerperal) postnatal develop will women 500 in maven Suicide is one of the leading causes of maternal death in the UK. A cleaning woman is 20 times more likely to be admitted to a psychiatric hospital in the two weeks after delivery than at all time in the two years before or after. Despite this, talking about and confronting the turn up of mental illness during pregnancy or the postnatal period quench poses challenges for health business concern professed(prenominal)s.Motherhood is lactating with emotive expectation. This contributes to a large number of cases of perinatal mental illness going undiagnosed. This can hasten serious consequences including poor bonding between flummox and cosset reduced quality of life for the mother, baby and father prolonged disability caused by existent with an untreated serious mental illness and authorization risk to the health and safety of the mother, baby or other family member, either through neglect or harm due to illness.As a midwife with 20 yrs of clinical practice and with some experience as a service user, I was icy in setting up the current blow service and mother been Counselling women and their families at western Middlesex Hospital since June 2009. I also gravel experience of providing supportive psychotherapy to a diverse target of clients with differing pathologies in a primary care and one-on-one setting since 1999. In my Role as midwifery Matters facilitator (2007-2009) South East Strategic Health Authority, I regul arly travelled across the patch, giving presentations to multi professional audiences.I am confident in designing, producing and presenting a 2Page range of presentations, including role play, government agency point, interpersonal bestowshops and formal lecture format. I give experience in writing academic text file (published) and information leaflets, guidelines and information posters. I am a naturally creative person who enjoys implementing evidence ground practice change at a strategic and operational level. I am very frenzied about the probability to be potentially entangled with designing an E-learning package.Whilst working with other undecomposeds in this industry I have gained some knowledge in the process of elearning development. I think that routine prenatal and postnatal care present an excellent luck to screen the mental health of pregnant women and women with a invigorated baby. To do this effectively however, requires working more collaboratively across different professions to meet the needs of our patients. Having the post of a specialist midwife in mental health could allow me to provide focused care to pregnant women with mental illness. This could include co-morbid substance & alcohol misuse problems.I envisage the role as working closely with a perinatal psychiatry squad at W. M. U. H and as an beta point of liaison between the other midwives, particularly safeguarding and case loading midwives, obstetricians, health visitors, child and family sociable services, obstetricians in the hospital, and mental health services. A useful means to achieve partnership working would be for the S. M. M. H to attend the weekly midwifery team meeting. Here, all midwifery community and labour defend teams meet to discuss the caseload and update the prenatal bring forward notes.This provides a valuable opportunity for potential referrals to be discussed, both with the specialist mental health midwife and the perinatal lead psychiatri st/obstetrician. Many women will prefer and only require additional support and advice from a midwife with specialist expertise, rather than larn a psychiatrist. However, some pregnant women will need to see a perinatal psychiatrist for expert advice, for example, if having severe mental illness, or to discuss medications in pregnancy or breastfeeding. 3PageThe referrals could be women with a tale of mental illness during childbirth or preexisting mental illness who are now pregnant. However, quite lots at engagement or routine antenatal checks, midwives whitethorn break up new onset psychological detriment in pregnant women who have no history of mental illness. Women may at first feel more inclined to disclose things to a midwife rather than a psychiatrist or doctor. This may include apprehension or fear centred on the impending delivery itself, increased world-wide anxieties about coping, depression or other psychological symptoms.The matter Institute for Health and Clini cal Excellence guidelines (2007) on antenatal and postnatal mental health have sought to address this, suggesting that at a womans first contact with primary care, at her booking visit and postnatally (usually at four to six-spot weeks and three to four months), healthcare professionals (including midwives, obstetricians, health visitors and general practitioners) should routinely ask the following two cover questions to identify possible depression During the past month, have you often been bothered by feeling down, cast down or hopeless?During the past month, have you often been bothered by having little interest or pleasure in doing things? A third question should be considered if the woman answers yes to either of the initial questions Is this something you feel you need or want help with? As a specialist mental health midwife, I would want to scope the current service and quick undertake a gap analysis to work towards providing equal access to perinatal mental health servic es. I could provide consultation and advice with the knowledge and skills that I already have and from which I accrue whilst labour my MSc in Psychodynamic approaches to Mental Health.I could mayhap investigate the possibility of providing a link to the topical anesthetic mother and baby unit. 4Page In This role I could also act as a useful resource for other ply and support other midwives with their clients. They can be mingled at an early stage in antenatal care and assist with monitoring women who may be developing or at risk of mental illness in childbirth. They can link up between physical and mental healthcare and can work in partnership with pregnant women to develop care plans for their singular needs.Having this post would give me the opportunity to hopefully address the stigma around mental illness and childbirth and improve screening and undercover work of women who need further specialist help at last improving clinical outcomes and quality of life for new mother s and their families and long term financial benefits to the Trust and the N. H. S. A study of supplying of perinatal mental health services has already been undertaken in two position strategic health authorities views and perspectives of the multiprofessional team.Reports and policy recommendations have highlighted the need for early detection, appropriate referral and circumspection. (Rowan1, McCourt 2 & Bick 3 (2010) This study has reported the in-depth views of relevant healthcare professionals on the extent to which perinatal mental health services are meeting policy and practice guidance. Their views highlight that although there have been developments in service provision, gaps carry particularly with respect to appropriate ongoing naming of needs and appropriate follow-up of women. Real challenges for the maternity ervices persist in relation to complex boundary issues that impacts on opportunities to support effective continuity of care and funding issues. Additional ly, examples of good practice may still depend on the initiative and commitment of individual professionals, rather than the support of the organisation, including dedicated resources. Further research is required to ascertain the extent to which resource issues and the amaze to cut NHS healthcare budgets are limiting appropriate service provision for women with perinatal mental health needs. 5Page There is always a need to elicit the views of the women who use the service.I would approach this by Iinking with our existing Maternity Service Liason comittee and carrying out appropriate patient satisfaction surveys and audit. References Felitti V & Anda RF (2008) The relationship of adverse childhood experiences to adult health, wellbeing, friendly function and healthcare in R genus Lanius & E Vermetten (Eds) The Hidden effects of unresolved trauma. 134Epidemic The shock of Early Life Trauma on Health and Disease, Cambridge University Press, Mary Ross-Davie, Sandra Elliott, Anindita Sarkar, Lucinda Green British Journal of tocology 14(6) 330 334 (Jun 2006) National Institute for Health and Clinical Excellence. 007. antepartum and postnatal mental health clinical management and service guidance. NICE clinical guideline 45. capital of the United Kingdom NICE. Oates M. 2001. Perinatal maternal mental health services. Recommendations for provision of services for childbearing women. London Royal College of Psychiatrists Cathy Rowan1 RM, PGCEA, MA. Christine McCourt2 BA, PhD. Debra Bick3 RM, BA, MedSc, PhD. (2010) rise based MidwiferyVolume 8 (2010) issue 3 Provision of perinatal mental health services in two English strategic health authorities views and perspectives of the multi-professional team.. 6Page