‘Perinatal’ means the period covering pregnancy and up to roughly a year after giving birth. Around one in five women will experience a perinatal mental health problem. This might be a new mental health problem, or it might be one which a woman has experienced before but which has 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. Find out more about peer support.
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 those of clinical mental health care, including things like feeling heard and understood or dealing better with being unwell (rather than focusing solely on becoming well).
Mind have been involved in developing a set of 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, who led consultation events and focus groups to co-design the principles. Throughout 2018, they gathered families, health professionals, and peer support providers to explore together how to make maternal mental health peer support as safe, nurturing, and inclusive as possible. The result was five principles with explanatory notes and prompts for reflection as to how these can be met in different scenarios.
The perinatal peer support principles are designed to give peer supporters the confidence to create and deliver peer support that meets the needs of women and families affected by mental health problems during pregnancy or the postnatal period. Adherence to them should ensure that peer support during this important time is:
The first of the perinatal peer support principles concerns balancing robust safeguarding structures with a friendly and welcoming environment that has human relationships at its centre. These are essentially two sides of the same coin: physical and emotional safety, being safe and feeling safe.
Principle two stipulates the need for every service to take proactive steps to increase accessibility for the specific group of women it is aiming to support. It discusses various potential barriers that need to be considered, and stresses that different peer support projects and services should work together collaboratively as the full range of peer support choices on offer will increase accessibility of peer support to individual mothers.
3. Principle three describes how good perinatal peer support builds upon what makes it unique and distinct from clinical support. It should be holistic and flexible, adapting to the needs of individual families, and peer workers and mothers should decide together what outcomes they would like to achieve. In order for peer support within perinatal services to flourish, peer workers need positive relationships with clinicians in which both approaches are equally valued and respected.
Principle four explains how 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 within 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, as well as the service in which it takes place, and treated as equal partners throughout that process.
Principle five explores the ways in which peer workers can benefit from their involvement in peer support. Peer workers are not ‘providers’ of support in the same way that clinicians are and should be able to benefit from peer relationships, although they may not benefit in the same way as the mothers they are supporting. Some benefits peer workers might experience are increased confidence, a sense of purpose, and feeling helpful. Perinatal mental health services must recognise that offering peer support has an impact on peer workers’ own mental health and wellbeing, and take steps to ensure that the impact is a positive one. These steps must include providing adequate training and supervision.
Remote perinatal peer support refers to peer support taking place online, via video calls, email, telephone, etc. The CoViD-19 pandemic has made this necessary for more peer support services and projects, and many are now using online digital platforms such as Zoom.
We will be using the principles to develop online resources to help people participate in perinatal peer support remotely. We designed a survey to identify gaps in this area and had a great response from people and groups who currently facilitate perinatal peer support, telling us what would be useful to them. Our next steps are to speak to some of them in more depth and to conduct shared learning sessions so that people can benefit from each others’ experiences and expertise.
If you would like further information or would like to contribute, then please get in touch we would be happy to hear from you!
The NHS Long Term Plan builds on the commitment of the Five Year Forward View on Mental Health to improve perinatal mental health services in England. The NHS aims to ensure that by 2023/24 that 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 are an important part of the workforce.
Three mothers who have experienced a perinatal mental health problem in the past have co-produced a ‘thought piece’ about peer support within NHS perinatal mental health services, supported by staff from Mind and commissioned by Health Education England. Informed by the perinatal peer support principles, they engaged in a series of discussions with peer workers and clinical staff within these services to understand how to ensure that peer support within these services is as beneficial as possible for everyone involved.
The thought piece develops the guidance offered by the perinatal peer support principles for this specific context and offers insights and recommendations to help make sure that mothers using these services have access to positive peer support.