What is perinatal or maternal mental health?
‘Perinatal’ means the period covering pregnancy and up to roughly a year after giving birth. Around 1 in 5 women will experience a perinatal mental health problem.
This might be a new mental health problem. Or it might be a problem a woman has experienced before, and it's continued or come back during the perinatal period. Some people use the term ‘maternal’ to describe mental health problems that affect mothers specifically.
Peer support is when people use their own experiences to help each other.
Perinatal peer support can complement the work of specialist mental health services by offering a more holistic approach which goes beyond mental health.
It works flexibly to adapt to the needs of the mum and her family. Its outcomes can be different to clinical mental health care, including things like feeling heard and understood, or dealing better with being unwell (rather than focusing solely on becoming well).
Perinatal peer support principles
Mind has helped develop 5 peer support principles which consider the unique needs of mothers and babies. The project was facilitated by mothers with lived experience of perinatal mental health problems.
Throughout 2018, the mums gathered families, health professionals, and peer support providers together. They explored how to make maternal mental health peer support as safe, nurturing, and inclusive as possible.
The result was 5 principles, with explanatory notes and prompts for reflection.
The principles are designed to give peer supporters the confidence to deliver peer support that meets the needs of women and families affected by mental health problems during pregnancy or postnatal period.
The first of the perinatal peer support principles is about balancing robust safeguarding with a friendly and welcoming environment that has human relationships at its centre.
This means having physical and emotional safety, as well as being safe and feeling safe.
Every service must take steps to increase accessibility for the group of women it's aiming to support. Peer support services should consider the potential barriers mothers face.
Different peer support projects and services should work together. Having a bigger range of peer support choices on offer makes it easier for mothers to access peer support. As there's more likely to be something to suit their needs.
Good perinatal peer support is unique and different from clinical support. It should be holistic and flexible, adapting to the needs of individual families. Peer workers and mothers should decide together what outcomes they would like to achieve.
In order for peer support in perinatal services to flourish, peer workers need positive relationships with clinicians. Both approaches should be equally valued and respected.
Perinatal peer support should involve people with relevant lived experience in its design and delivery. This means that peer workers and mothers affected by perinatal mental health difficulties should lead decisions about how peer support happens in the service.
This includes involvement at project management level and, wherever possible, mothers with lived experience should be skilled up to take on management positions.
If this is not possible, they should be involved in the co-production and co-design of peer support work. And treated as equal partners throughout that process.
Peer workers should benefit from being involved in peer support. Peer workers are not ‘providers’ of support in the same way that clinicians are. They should be able to benefit from peer relationships, although they may not benefit in the same way as the mothers they're supporting.
Benefits peer workers might experience include:
- Increased confidence
- A sense of purpose
- Feeling helpful.
Perinatal mental health services must recognise that peer support has an impact on peer workers' own mental health and wellbeing.
Services should therefore take steps to make sure the impact is positive. They must offer training and supervision to peer workers.
Perinatal peer support in NHS services
The NHS Long Term Plan commits to improving perinatal mental health services in England.
The NHS aims to ensure that by 2023 to 2024, at least 66,000 families will have access to perinatal mental health care and support in the community.
Since the launch of the perinatal peer support principles in December 2019, peer support in NHS perinatal mental health services has continued to expand and develop.
Peer workers and peer support volunteers are increasingly being recruited to work in these services and they're an important part of the workforce.
Illustration by Carys Tait | Carys-ink.com