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Perinatal and Infant Mental Health Glos Care Pathway Overview

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Initial Routine Screening Pathway

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Initial Routine Screening Assessment

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Risk Indicators for Referral to Mental Health Services
  • Recent significant changes in mental state or emergence of new symptoms
  • New thoughts or acts of violent self-harm
  • New and persistent expressions of incompetency as a mother or estrangement from the infant

 

Perinatal risk indicators (Antenatal and postnatally period)

  • Women with a history of bipolar disorder, schizophrenia, severe depression, other psychotic disorder, or previous inpatient/crisis care should be referred to the perinatal team; this group is at increased risk of severe postpartum episodes
  • Antenatal presentation can be a predictor for post-natal episode of mental ill health; discuss all antenatal referrals with perinatal team.
  • High risk period is 1- 10 days post-natal but the threshold should be lower for women up to 10 weeks postnatally.
  • Women who are presenting with uncharacteristic symptoms and marked changes to normal functioning. This can include symptoms of confusion and general perplexity or unusual or overvalued ideas (ideas that seem out of context or extreme)
  • If partner, family, friends report significant change in presentation and acting out of character.
  • Older professional women with depression who appear to be functioning at high level.
Mental Health Referral Guidance

Recent reviews of serious incidents have identified potential system and process changes which could improve the quality and responsiveness of care for people who require secondary care mental health services.

It would be helpful if GPs could please share any information in relation to substance misuse with GHC, particularly when a patient is injecting, as this aids clinical risk assessment and management. It is also really helpful if referrals into mental health services contain an appropriate risk assessment.

In all instances when a patient dies unexpectedly, especially if the cause of death is suspected suicide, GPs should inform GHC as soon as possible. This will allow GHC to quickly put in place support for those bereaved and minimise the risk of appointment letters etc. being sent to the deceased.

Contact: gordonbenson@nhs.net (Assistant Director of Governance & Compliance, GHC)

Woman Presenting as Acutely Unwell

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Woman in the Community Requires Referral to MH Service

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Woman with Previous Mental Health History Considering Pregnancy

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Woman Receiving Treatment Whilst in Mental Health Care Becomes Pregnant

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Infant Mental Health Antenatal Referral Pathway

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Infant Mental Health Postnatal Referral Pathway

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Infant Mental Health Team Pathway

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