Perinatal project resources

Please note that these resources are for your information only and should not be used or duplicated elsewhere. 

This programme ran from 7 September 2021 - 10 December 2021

Day 1 - 7 September 2021 - ADHD – assessment and treatment in the perinatal context and implications for parenting

Speakers: Dr Sally Cubbin and Dr Amanda Elkin

Intended learning objectives:

  • Recognise how ADHD presents in adults, with a particular focus on women
  • Understand how untreated ADHD may affect women in the perinatal period
  • Consider medication treatment options for ADHD in the perinatal period
  • Feel confident in writing a CD prescription

Essential reading:

  • Cubbin, S., Leaver, L., & Parry, A. (2020). Attention deficit hyperactivity disorder in adults: common in primary care, misdiagnosed, and impairing, but highly responsive to treatment. The British journal of general practice: The journal of the Royal College of General Practitioners,70(698), 465–466
  • Choice and Medication leaflet:  A guide to help you choose between the medications to help with symptoms of ADHD in pregnancy and breast-feeding

Recommended reading:

  • Choice and Medication: medication-specific ‘handy factsheets’ on: Methylphenidate, lis-dexamphetamine, atomoxetine, melatonin
  • Cortese, S., Adamo, N., Del Giovane, C., et al. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet. Psychiatry,5(9), 727–738
  • Kooij, J., Bijlenga, D., Salerno, L., (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry: The Journal of the Association of European Psychiatrists,56, 14–34.
  • Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., et al. (2020) Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC psychiatry,20(1), 404

Day 2 - 20 September 2021: Autistic Spectrum Disorders in women

Speakers: Dr Judy Eaton

Intended learning objectives:

  • Identify how Autism can present in women
  • Demonstrate a clear understanding of common comorbidities with Autism and how these can be evaluated
  • Formulate the type of support that may benefit women who have Autism in the perinatal period

Essential reading:

  • Green, R. M., Travers, A. M., Howe, Y. & McDouglas, C. J., (2019).  Women and Autism Spectrum Disorder: Diagnosis and Implications.  Current Psychiatry Reports, 21:22,
  • Went, H. E., (2016).  I didn’t fit the stereotype of autism: A qualitative analysis of women’s experiences relating to diagnosis of an Autism Spectrum Condition and mental health.  Thesis submitted as part fulfilment for the degree of Doctor of Clinical Psychology.  University of Exeter
  • Gould, J., (2017).  Towards understanding the under-recognition of girls and women on the autism spectrum.  Autism, vol 21 (6) 703 –705.Recommended reading

Recommended reading:

  • Women and Girls with Autism Spectrum Disorder: Understanding Life Experiences from Early Childhood to Old Age, by Sarah Hendrick, published by Jessica Kingsley Publishers
  • A Guide to Mental Health Issues in Girls and Young Women on the Autism Spectrum: Diagnosis, Intervention and Family Support, by Judy Eaton, published by Jessica Kingsley Publishers

Day 3 - 28 September 2021- Partners of women with lived experience of perinatal mental illness

Speakers: Dr Sally Wilson and Dr Lucinda Green

Intended learning objectives:

  • Understand the effect of a woman’s perinatal mental illness on her partner
  • Describe approaches to assessment and care for partners who have mental health problems in the perinatal period

Essential reading:

  • Lever Taylor, B., Billings, J., Morant, N., Bick, D., & Johnson, S. (2019). Experiences of how services supporting women with perinatal mental health difficulties work with their families: a qualitative study in England. BMJ Open, 9(7):e030208

Recommended reading:

  • Hanley, J. & Williams, M. (2019) Fathers and perinatal mental health. A Guide for recognition, treatment and management. Routledge
  • Ruffell, B., Smith, D.M. & Wittkowski, AJ. (2019) The Experiences of Male Partners of Women with Postnatal Mental Health Problems: A Systematic Review and Thematic Synthesis. Child Fam Stud.;28:2772–2790

Day 4 - 15 October 2021- Couple and family interventions in the perinatal period

Speakers: Dr Phil Arthrington

Intended learning objectives:

  • Describe the contribution that couple and family interventions can make to perinatal mental health services.
  • Identify key challenges faced by families during the perinatal period and how key systemic concepts can aid in making sense of these difficulties.
  • Discuss some of the main barriers to working with families in the perinatal period and how these may be overcome in your service.

Essential reading:

  • Hunt, C. (2006). When baby brings the blues: Family therapy and postnatal depression. Australian and New Zealand Journal of Family Therapy, 27(4), 214-220

Recommended reading:

  • Arthington, P. (in press). Mighty oaks from little acorns grow: Why beginnings matter. Context, 172, pp.xxxxx. Warrington: AFT
  • Barker, S. (2019). Perinatal mental health and working with families. In N. Evans (Ed),Family Work in Mental Health: A Skills Approach. Keswick: M&K Publishing. pp. 67-82
  • Cluxton-Keller, F., & Bruce, M.L. (2018). Clinical effectiveness of family therapeutic interventions in the prevention and treatment of perinatal depression: A systematic review and meta-analysis. PLoS ONE, 13(6): e0198730

Day 5 - 5 November 2021 - Compassionate Leadership

Speakers: Dr Lucinda Green and Dr Nic Horley

Intended learning objectives:

  • Understand the advantages of compassionate leadership approaches for leaders and teams
  • Understand the theoretical underpinnings of compassion focussed ideas
  • Recognise the importance of self-compassion
  • Be familiar with compassion focussed activities that can be used with their teams

Essential reading:

  • West, M., Eckert, R., Collins, B., &Chowla, R. (2017) Caring to Change. How compassionate leadership can stimulate innovation in health care. The King’s Fund 

Recommended reading:

  • Conversano, C., Ciacchini, R., Orrù, G., Di Giuseppe, M., Gemignani, A., & Poli, A. (2020). Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review. Frontiers in psychology,11, 1683.
  • de Zulueta P. C. (2015). Developing compassionate leadership in health care: an integrative review. Journal of healthcare leadership,8, 1–10.
  • Gilbert, P.l & Basran, J. (2018). Imagining One’s Compassionate Self and Coping with Life Difficulties. EC Psychology and Psychiatry,7, 971-978
  • Heaversedge, J. & Halliwell, E.(2012) The Mindful Manifesto. Hay House UK Ltd
  • Neff, KD,Knox, MC,Long, P,Gregory, K.(2020) Caring for others without losing yourself: An adaptation of the Mindful Self‐Compassion Program for Healthcare Communities. J Clin Psychol. 76,1543–1562
  • NHS England (2014) Building and Strengthening Leadership: Leading with Compassion.

Day 6 - 17th November 2021: Infertility, fertility treatment and psychological implications

Speakers: Suzanne Dark and Dr Lucinda Green

Intended learning objectives:

  • Describe and recognise the psychological consequences of infertility and fertility treatment
  • Understand the role of the counsellor in the infertility clinic and the other care and support available for women having fertility treatment
  • Discuss the risk of mental health problems associated with infertility and fertility treatment

Essential reading:

  • Bhat, A., & Byatt, N. (2016). Infertility and perinatal loss: when the bough breaks.  Current psychiatry reports, 18(3), 31.

Recommended reading:

  • Bronya Hi-Kwan Luk & Alice Yuen Loke(2015)The Impact of Infertility on the Psychological Well-Being, Marital Relationships, Sexual Relationships, and Quality of Life of Couples: A Systematic Review, Journal of Sex & Marital Therapy,41:6,610-625,
  • Doyle, M., & Carballedo, A. (2014). Infertility and mental health. Advances in Psychiatric Treatment,20(5), 297-303.
  • Golombok, S. (2015) Modern families: Parenting and children in new family forms. Cambridge University Press.
  • McCluskey G & Gilbert P. Implications counselling for people considering donor-assisted treatment. Fully updated version. British Infertility Counselling Association: 2015.
  • De Berardis, D., Mazza, M., Marini, S., Del Nibletto, L., Serroni, N., Pino, M. C., Valchera, A., Ortolani, C., Ciarrocchi, F., Martinotti, G., & Di Giannantonio, M. (2014). Psychopathology, emotional aspects and psychological counselling in infertility: a review. La Clinica terapeutica, 165(3), 163–169
  • Ebdrup,N. H., Assens, M., Hougaard, C. O., Pinborg, A., Hageman, I., & Schmidt, L. (2014). Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder: a national cohort study. European journal of obstetrics, gynaecology, and reproductive biology, 177, 115–120
  • Pasch, L. A., Holley, S. R., Bleil, M. E., Shehab, D., Katz, P. P., & Adler, N. E. (2016). Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services?. Fertility and sterility, 106(1), 209–215.e2
  • Patel, A., Sharma, P., & Kumar, P. (2018). Role of Mental Health Practitioner in Infertility Clinics: A Review on Past, Present and Future Directions. Journal of Human Reproductive sciences, 11(3), 219–228
  • Szkodziak, F., Krzyżanowski, J., & Szkodziak, P. (2020). Psychological aspects of infertility. A systematic review. The Journal of international medical research, 48(6), 300060520932403
  • Vikström, J., Josefsson, A., Bladh, M., & Sydsjö, G. (2015). Mental health in women 20-23years after IVF treatment: a Swedish cross-sectional study. BMJ open, 5(10), e009426.

Day 7 - 3 December 2021 - Premenstrual Syndrome and menopause

Speakers: Dr Michael Craig

Intended learning objectives:

  • Discuss the management of Premenstrual Syndrome with women who have co-existing mental health problems.
  • Describe the impact of the menopause on women’s mental health
  • Understand the management of menopause related mood symptoms

Essential reading:

  • Green LJ, O’Brien PMS, Panay N, Craig M on behalf of the Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome(2016) BJOG ; DOI: 10.1111/1471-0528.14260

Recommended reading:

  • Craig, M. C., Sadler, C., & Panay, N. (2019). Diagnosis and management of premenstrual syndrome. Practitioner, 263(1824), 15-19
  • Clow A & Smyth N (2020).Stress and Brain Health: Across the Life Course. International Review of Neurobiology Volume 150,2-246

Day 8 - 10 December 2021 - Infertility, fertility treatment and psychological implications

Speakers: Dr Giles Berrisford

Intended learning objectives:

  • Define potential criteria for women who will be eligible for perinatal mental health services once the NHS Long Term Plan is fully implemented
  • Describe approaches to implementing the NHS Long Term plan in perinatal mental health services

Essential reading:

  • Green LJ, O’Brien PMS, Panay N, Craig M on behalf of the Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome(2016) BJOG ; DOI: 10.1111/1471-0528.14260.

Recommended reading:

  • Craig, M. C., Sadler, C., & Panay, N. (2019). Diagnosis and management of premenstrual syndrome. Practitioner, 263(1824), 15-19.
  • Clow A & Smyth N (2020).Stress and Brain Health: Across the Life Course. International Review of Neurobiology Volume 150,2-246

The full programme for the Masterclass Consultant Top-Up Course  2021 is available online

We hope you enjoyed this course and if you require any of the course materials please email: Perinataltraining2022@rcpsych.ac.uk  

This programme will run from 10 January - 7 June 2022.

Themes

10 January 2022 - Day 1Introductions; PMH service development across the UK and Ireland;  Assessment and communication 
 
28 January 2022 - Day 2 - Lived experience, co-production, partners 
 
7 February 2022 - Day 3 - The infant 
 

28 February 2022 - Day 4 - Risk and Safeguarding: adults and children 

4 March 2022 - Day 5 - Prescribing in the perinatal period 

18 March 2022 - Day 6 - Personality Disorder 

25 April 2022 - Day 7 - Legal and Forensic 

6 May 2022 - Day 8 - Pre-pregnancy Counselling, pre-birth planning; addictions 

16 May 2022 - Day 9 - Eating Disorders; pregnancy loss, infertility and complex pregnancy related issues 

7th June 2022  - Day 10 - Leadership and service development 


The aims of this masterclass programme are to: 

  • enable and support new consultants in perinatal psychiatry in their assessment, understanding and management of complex clinical work 
  • encourage participants to integrate current evidence into clinical practice 
  • develop self-reflection skills 
  • support leadership development 
  • emphasise the importance of the perspectives of women, infants, partners and families throughout the perinatal pathway 
  • improve patient safety 
  • improve the experience of women and families in perinatal mental health services. 
The following key issues are fundamental aspects of perinatal mental health care and will be discussed and considered throughout the programme: 

  • safeguarding children and adults  
  • culture and difference  
  • collaborative working with women, partners and families 
  • women’s own experience of perinatal mental disorders and care 
  • legal issues 

Programme

Learning objectives and reading lists will be provided before each day. 

Each session within the day will have a didactic component and small group work/discussion. 

Facilitators: Dr Liz McDonald, Dr Lucinda Green, Dr Roch Cantwell and Dr Clare Dolman (on Day 2) 

Each day will start at 9.15am and finish at 4.30pm. 

Day 1 - Monday 10 January 2022 - PMH service development across the UK and Ireland;  Assessment and communication 

Speakers: Dr Giles Berrisford, Dr Margo Wrigley Ireland, Dr Jo Noblett Wales and Dr Julie Anderson 

Intended learning objectives:

At the end of day 1 participants will be able to: 

  1. Demonstrate an understanding of how the case for perinatal mental health services expansion has been made across the UK and Ireland. 
  2. Understand the different approaches to development and delivery within different nations. 
  3. Describe the range of factors that can affect a woman’s mental health in the perinatal period and her experience of pregnancy and parenting. 
  4. Summarise, formulate and communicate assessments to enable women, families and professionals to understand the factors which have contributed to her mental health problems, associated risks and/or her risk of developing a perinatal mental illness.  

Essential reading: 

  1. Perinatal Mental Health Services - CR232 (rcpsych.ac.uk) 
  2. NHS England (2016) The Five Year Forward View for Mental Health 
  3. NHS England (2019) The NHS Long Term Plan 
  4. Scotland:   Perinatal and Infant Mental Health Programme Board: delivery plan - September 2021 to September 2022 - gov.scot (www.gov.scot) 
  5. https://www.pmhn.scot.nhs.uk/delivering-effective-services/delivering-effective-services-report/ 
  6. Wales:  together-for-mental-health-delivery-plan-2019-to-2022.pdf (gov.wales) 
  7. Ireland:https://www.hse.ie/eng/services/list/4/mental-health-services/specialist-perinatal-mental-health/specialist-perinatal-mental-health-services-model-of-care-2017.pdf 
  8. Pathways papers 
  9. PMH Partners Ambition FAQs.  PMH Partners Ambition FAQ - National Perinatal Mental Health Workspace - FutureNHS Collaboration Platform 

Recommended reading:

  1. Bauer A, Knapp M, Adelaja B (2016). Best Practice for perinatal mental health care: the economic case. PSSRU. London School of Economics.  
  2. NHS England (2016) Better Births: Improving outcomes of maternity services in England - A Five Year Forward View for maternity care. 
  3. Royal College of Psychiatrists (2018) Framework for Routine Outcome Measurement in Perinatal Psychiatry. College Report CR126. 

Day 2 - Friday 28 January 2022 - Lived experience, co-production, partners 

Speakers: Dr Clare Dolman, Dr Henry Fay, Kathryn Grant, Clotilde Rebecca Abe and Sandra Igwe 

Intended learning objectives: 

At the end of day 2 participants will be able to: 

  1.  Demonstrate an awareness of the barriers to care for women in the perinatal period 
  2. Understand the factors influencing women’s decision-making around pregnancy and childbirth 
  3. Recognise how healthcare professionals can improve the experience of women and families receiving perinatal mental healthcare 
  4. Understand the benefits of involving women and partners in co-producing perinatal mental health services. 
  5. Recognise the effect of a woman’s perinatal mental illness on her partner. 

Essential reading:

  1. Dolman, C., Jones, I., & Howard, L. M. (2013). Pre-conception to parenting: a systematic review and meta-synthesis of the qualitative literature on motherhood for women with severe mental illness. Archives of women's mental health, 16(3), 173–196. 
  2. Lever Taylor, B., Billings, J., Morant, N., Bick, D., & Johnson, S. (2019). Experiences of how services supporting women with perinatal mental health difficulties work with their families: a qualitative study in England. BMJ open, 9(7), e030208. 
  3.  Ruffell, B., Smith, D.M. & Wittkowski, A J. (2019) The Experiences of Male Partners of Women with Postnatal Mental Health Problems: A Systematic Review and Thematic Synthesis. Child Fam Stud.;28: 2772–2790. 
Recommended reading:

  1. Dolman, C., Jones, I. R., & Howard, L. M. (2016). Women with bipolar disorder and pregnancy: factors influencing their decision-making. BJPsych open, 2(5), 294–300. 
  2. Lever Taylor, B., Kandiah, A., Johnson, S., Howard, L. M., & Morant, N. (2020). A qualitative investigation of models of community mental health care for women with perinatal mental health problems. Journal of mental health (Abingdon, England), 1–7. Advance online publication. 
  3. Lever Taylor, B., Mosse, L., & Stanley, N. (2019). Experiences of social work intervention among mothers with perinatal mental health needs. Health & social care in the community, 27(6), 1586–1596. 
  4. Megnin-Viggars O, Symington I, Howard LM, Pilling S. Experience of care for mental health problems in the antenatal or postnatal period for women in the UK: a systematic review and meta-synthesis of qualitative research. Arch Womens Ment Health. 2015;18(6):745‐759.  
  5. Millett, L., Taylor, B. L., Howard, L. M., Bick, D., Stanley, N., & Johnson, S. (2018). Experiences of Improving Access to Psychological Therapy Services for Perinatal Mental Health Difficulties: a Qualitative Study of Women's and Therapists' Views. Behavioural and cognitive psychotherapy, 46(4), 421–436. 
  6. Royal College of Obstetricians and Gynaecologists (2017) Maternal mental health women’s voices. 
  7. Sambrook Smith, M., Lawrence, V., Sadler, E., & Easter, A. (2019). Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK. BMJ open, 9(1), e024803. 
  8. Watson H, Harrop D, Walton E, Young A, Soltani H. A systematic review of ethnic minority women's experiences of perinatal mental health conditions and services in Europe. PLoS One. 2019;14(1):e0210587.  
  9. Stephenson, L.A., Gergel, T., Keene, A.R., Rifkin, L. and Owen, G., 2020. The PACT advance decision-making template: preparing for Mental Health Act reforms with co-production, focus groups and consultation. International journal of law and psychiatry, 71, p.101563. 
  10. PMH Partners Ambition FAQs.  PMH Partners Ambition FAQ - National Perinatal Mental Health Workspace - FutureNHS Collaboration Platform 

Day 3 - Monday February 2022 - The infant

Speakers: Dr Maddalena Miele, Dr Jane Barlow, and Dr Amanda Jones

Intended learning objectives:

At the end of day 3 participants will be able to: 

  1.  Understand the key ways in which perinatal mental health problems can affect the ability of women to interact with their infant  
  2. Demonstrate a basic knowledge of the current clinical approaches to assessing parent-infant relationships 
  3. Describe the basic principles of attachment theory and the neurobiology of parenting 
  4. Outline the determinants of a sensitive parent-infant interaction 
  5. Understand the key ways in which parent-infant interaction during the postnatal period influences the later capacity of the infant for emotion regulation.
  6. Examine some of the key evidence-based methods of working dyadically, with mothers experiencing perinatal mental health problems, to support the interaction with the baby. 

 

Essential reading: 

  1. Laulik, S., Chau, S., Browne, K., & Allam, J. (2013). The link between personality disorder and parenting behaviors: A systematic review.  Aggression and Violent Behavior 18(6), 644–655. 
  2. Royal College of Psychiatrists (2018). Framework for Routine Outcome Measures in Perinatal Psychiatry CR216.  London: RCP.  
  3. Van Ljzendoorn, M.H., Schuengel, C., Bakermans-Kranenburg, M.J.  (1999). Disorganized attachment in early childhood: meta-analysis of precursors, concomitants, and sequelae. Developmental Psychopathology,11(2), 225-49. 

Recommended reading:

  1. Madigan, S., Bakermans-Kranenburg, MJ., Van Ijzendoorn, M.H., Moran, G., Pederson, D.R., & Benoit, D. (2006). Unresolved states of mind, anomalous parental behavior, and disorganized attachment: a review and meta-analysis of a transmission gap. Attachment and Human Development, 8(2), 89–111.  
  2. Music G. Nurturing Natures (2017). Attachment and Children’s Emotional, Sociocultural and Brain Development. 2nd Edition. London: Routledge.    
  3. O'Hara, L., Smith, E.R., Barlow, J., Livingstone, N., Herath, N.I.N.S., Wei, Y., Spreckelsen, T.F., & Macdonald, G. (Forthcoming).  Video feedback for improving parental sensitivity and child attachment.  Cochrane Library.  
  4. P.O. Svanberg , J. Barlow & W. Tigbe (2013) The Parent–Infant Interaction Observation Scale: reliability and validity of a screening tool, Journal of Reproductive and Infant Psychology, 31:1, 5-14. 
  5. Schore, A.N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22, 201-269. 
  6. Stein A, Pearson RM, Goodman SH, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800‐1819.  

Day 4 - Monday 28 February 2022 - Risk and Safeguarding: adults and children 

Speakers: Dr Roch Cantwell, Dr Hind Khalifeh, and Dr Lucinda Green

Intended learning objectives:

At the end of day 4 participants will be able to: 

  1. Describe the epidemiology of self-harm and suicide in the perinatal period. 
  2. Describe the distinctive clinical features of maternal suicide. 
  3. Recognise risk in relation to maternal suicide and apply this to clinical assessment. 
  4. Understand the evidence base regarding the extent and impact of domestic violence / abuse in the perinatal period 
  5. Understand the evidence base regarding interventions for domestic violence/ abuse including for domestic violence/abuse in the perinatal period. 
  6. Demonstrate skills in enquiring about and responding to domestic violence/abuse disclosures by women under the care of perinatal mental health services 
  7. Describe the factors highlighted in child serious case reviews which can affect children’s safety and wellbeing and increase the risk of abuse and neglect. 
  8. Recognise how perinatal mental health services, working effectively in partnership with a range of professionals, can ensure child safeguarding concerns are identified early and that effective care, treatment and support for women and families can reduce the risk of harm to infants and children. 

Essential reading:

  1. Oates M & Cantwell R (2011) Deaths due to psychiatric causes. Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer 2006-2008. British Journal of Obstetrics and Gynaecology, 118 (s1), 132-142.  
  2. Cantwell R, Knight M, Oates M, Shakespeare J on behalf of the MBRRACE-UK mental health chapter writing group (2015) Lessons on maternal mental health. In Knight M, Tuffnel D, Kenyon S, Shakespeare J, Gray R, Kyrinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care – Surveillance of maternal deaths in the UK 2011-13 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-13. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2015: p22-41.  
  3. Cantwell R, Youd E and Knight M on behalf of the MBRRACE-UK mental health chapter-writing group (2018) Messages for mental health. In Knight M, Bunch K, Tuffnell D, Jayakody H, Shakespeare J, Kotnis R, Kenyon S, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2014-16. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2018: p42-60. 
  4. https://www.npeu.ox.ac.uk/mbrrace-uk/reports#mbrrace-uk-saving-lives-improving-mothers-care-lessons-learned-to-inform-maternity-care-from-the-uk-and-ireland-confidential-enquiries-into-maternal-deaths-and-morbidity-2017-19 
  5. Department for Education (2018). Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children. London: HM Government 
  6. Howard, L. M., Oram, S., Galley, H., Trevillion, K., & Feder, G. (2013). Domestic violence and perinatal mental disorders: a systematic review and meta-analysis. PLoS medicine, 10(5), e1001452. 
  7. Hahn, C. K., Gilmore, A. K., Aguayo, R. O., & Rheingold, A. A. (2018). Perinatal Intimate Partner Violence. Obstetrics and gynecology clinics of North America, 45(3), 535–547. 
  8. https://learning.nspcc.org.uk/child-protection-system/wales 
  9. https://learning.nspcc.org.uk/child-protection-system/northern-ireland 
  10. https://learning.nspcc.org.uk/child-protection-system/scotland

Recommended reading:

  1. Department for Education (2020) Complexity and challenge: a triennial analysis of serious case reviews 2014-2017. London: Department for Education. 
  2. Hammond J, Lipsedge M. Assessing Parenting Capacity in Psychiatric Mother and Baby Units: A case report and review of literature. Psychiatr Danub. 2015;27 Suppl 1: S71‐S83. 
  3. Johannsen BMW et al (2016) All-cause mortality in women with severe postpartum psychiatric disorders. American Journal of Psychiatry, 173, 635-642. 
  4. Johannsen et al (2020) Self-harm in women with postpartum mental disorders. Psychological Medicine, 50, 1563-1569. 
  5. Khalifeh, H., Hunt, I.M., Appleby, L., Howard, L.M. (2016) Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. Lancet Psychiatry. 3(3), pp. 233‐242.  
  6. Khalifeh, H., Moran, P., Borschmann, R., Dean, K., Hart, C., Hogg, J., Osborn, D., Johnson, S., & Howard, L. M. (2015). Domestic and sexual violence against patients with severe mental illness. Psychological medicine, 45(4), 875–886. 
  7. Lysell H et al (2018) Maternal suicide: register based study of all suicides occurring after delivery in Sweden 1974-2009. PLoS ONE, 13(1): e0190133. 
  8. Smithson, R., and Gibson, M. Less than human: a qualitative study into the experience of parents involved in the child protection system. Child & Family Social Work. 2017;22:565–574.  
  9. Online resources: https://www.solacewomensaid.org/coronavirus-and-abuse 
  10. Online resources: https://avaproject.org.uk/wp-content/uploads/2020/04/FINAL-AVA-Briefing-for-MH-professionals-1.pdf 

Day 5: Friday 4 March 2022 -   Prescribing in the perinatal period 

Speakers: Prof Ian Jones and Dr Angelika Wieck

Intended learning objectives:

  1. At the end of day 5 participants will be able to: 
  2. Understand the kinds of methodological problems that hamper research into the reproductive safety of psychotropic drugs and be able to take these into account when interpreting peer-reviewed publications 
  3. Be familiar with currently available evidence on the reproductive safety of the main psychotropic drugs, resources that provide high quality evidence updates and current influential prescribing guidance 
  4. Be able to apply current evidence and general principles for the pharmacological management of pregnant and breastfeeding women to clinical scenarios. 
Mandatory reading: The below must be read with the letter (PDF) from Dr Wieck and Professor Jones before the session. 

  1. Kolding L, Ehrenstein V, Pedersen L, Sandager P, Petersen OB, Uldbjerg N, Pedersen LH. Antidepressant use in pregnancy and severe cardiac malformations: Danish register-based study. BJOG 2021;128:1949–1957.  
  2. Supplement to Kolding et al 2021 document 1
  3. Supplement to Kolding et al 2021 document 2
  4. Zixuan Wang, MSc; Adrienne Y. L. Chan, MPH; David Coghill, MD; Patrick Ip, MPH; Wallis C. Y. Lau, PhD; Emily Simonoff, MD; Ruth Brauer, PhD; Li Wei, PhD; Ian C. K. Wong, PhD; Kenneth K. C. Man, PhD  Association Between Prenatal Exposure to Antipsychotics and Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Preterm Birth, and Small for Gestational Age JAMA Intern Med. 2021;181(10):1332-1340. doi:10.1001/jamainternmed.2021.4571 Published online August 16, 2021.  

Essential reading:

  1. McAllister-Williams, R. H., Baldwin, D. S., Cantwell, R. et al (2017). British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum. Journal of psychopharmacology (Oxford, England)31(5), 519–552.
  2. MHRA: Valproate use by women and girls (2018). www.gov.uk/guidance/valproate-use-by-women-and-girls
  3. National Institute for Health and Care Excellence (2014). Antenatal and Postnatal Mental Health - Clinical Management and Service Guidance. Clinical Guideline 192.

 Recommended reading:

  1. Jones, I., Chandra, P. S., Dazzan, P., & Howard, L. M. (2014). Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet (London, England), 384(9956), 1789–1799.
  2. Wieck A & Jones IR (2020) Psychotropics in pregnancy and lactation. In: Seminars in Clinical Psychopharmacology. Haddad PM, Nutt DJ (eds.). RCPsych/Cambridge University Press. 
  3. Wieck A, Abel KMA (2016) Sexual, reproductive and antenatal care of women with mental illness. In: Comprehensive Women’s Mental Health (DJ Castle and KM Abel, eds). Cambridge University Press, Cambridge.

Day 6 - Friday 18 March 2022 - Personality Disorder 

Speakers: Dr Gwen Adshead and Dr Nic Horley

Intended learning objectives:

At the end of day 6 participants will be able to:

  1. Demonstrate an understanding of personality function and dysfunction
  2. Understand how personality function may become disordered in pregnancy and postnatally
  3. Appreciate the importance of assessment and treatment of personality disorder by perinatal mental health services
  4. Understand the different psychological therapies for women with personality disorder and their use during the perinatal period
  5. Outline the psychological interventions which can support the parent-infant relationship for women with personality disorder and their infants.

Essential reading:

  1. Blankley, G., Galbally, M., Snellen, M., Power, J. and Lewis, A.J., (2015). Borderline personality disorder in the perinatal period: early infant and maternal outcomes. Australasian Psychiatry, 23(6), pp.688-692.
  2. Hudson, C., Spry, E., Borschmann, R. et al . (2017). Preconception personality disorder and antenatal maternal mental health: A population-based cohort study. Journal of affective disorders, 209, pp.169-176.
  3. Mikulincer, M. and Florian, V., (1999). Maternal-fetal bonding, coping strategies, and mental health during pregnancy–the contribution of attachment style. Journal of Social and Clinical Psychology, 18(3), pp.255-276. 
  4. Petfield, L., Startup, H., Droscher, H., & Cartwright-Hatton, S. (2015). Parenting in mothers with borderline personality disorder and impact on child outcomes. Evidence-based mental health, 18(3), 67–75.
Recommended reading:

  1. Hobson, R.P., Patrick, M., Crandell, L., Garcia-Perez, R. and Lee, A., (2005). Personal relatedness and attachment in infants of mothers with borderline personality disorder. Dev Psychopathol, 17(2), pp.329-347.
  2. Porcerelli, J.H., Huth-Bocks, A., Huprich, S.K. and Richardson, L., (2016). Defense mechanisms of pregnant mothers predict attachment security, social-emotional competence, and behavior problems in their toddlers. American Journal of Psychiatry, 173(2), pp.138-146.
  3. Risholm Mothander, P., Furmark, C., & Neander, K. (2018). Adding "Circle of Security - Parenting" to treatment as usual in three Swedish infant mental health clinics. Effects on parents' internal representations and quality of parent-infant interaction. Scandinavian journal of psychology, 59(3), 262–272
  4. Smith-Nielsen, J., Steele, H., Mehlhase, H., Cordes, K., Steele, M., Harder, S. and Væver, M.S., (2015). Links among high EPDS scores, state of mind regarding attachment, and symptoms of personality disorder. Journal of Personality Disorders, 29(6), pp.771-793.
  5. Wilson, H., & Donachie, A. L. (2018). Evaluating the Effectiveness of a Dialectical Behaviour Therapy (DBT) Informed Programme in a Community Perinatal Team. Behavioural and cognitive psychotherapy, 46(5), 541–553.

Day 7 - Monday 25 April 2022 - Legal and Forensic 

Speakers: Dr Gwen Adshead, Dr Olivia Protti, Dr Sumi Ratnam, Dr Livia Martucci, Dr Lucy Stephenson, Dr Roch Cantwell, and Ms Sophia Roper, Barrister

Intended learning objectives:

At the end of day 7 participants will be able to: 

  1. Understand how PMH teams and Forensic services can work together in a collaborative way 
  2. Understand the psychopathology of women who kill their children 
  3. Recognise the relevant legal frameworks and to formulate a legally informed advance decision making document with women in the perinatal period 
  4. Describe upcoming reforms to the Mental Health Act and the impact on advance decision making in the perinatal period 
  5. Distinguish between ethical/moral issues and legal frameworks and how to approach them separately 
Essential reading:

  1. Brockington I (1998) Infanticide (chapter 8) Motherhood and Mental Health. 
  2. Owen, G. S., Gergel, T., Stephenson, L. A., Hussain, O., Rifkin, L., & Keene, A. R. (2019). Advance decision-making in mental health - Suggestions for legal reform in England and Wales. International journal of law and psychiatry, 64, 162–177. 
  3. Stephenson, L. A., Gergel, T., Ruck Keene, A., Rifkin, L., & Owen, G. (2020). The PACT advance decision-making template: preparing for Mental Health Act reforms with co-production, focus groups and consultation. International journal of law and psychiatry, 71, 101563. 
  4. https://www.mwcscot.org.uk/law-and-rights/advance-statements  
  5. Welldon Estela V. (1992) Mother, Madonna, whore: The idealization and denigration of motherhood. 

Recommended reading:

  1. Flynn, S. M., Shaw, J. J., & Abel, K. M. (2013). Filicide: mental illness in those who kill their children. PloS one, 8(4), e58981. 
  2. Hindley, G., Stephenson, L. A., Ruck Keene, A., Rifkin, L., Gergel, T., & Owen, G. (2019). "Why have I not been told about this?": a survey of experiences of and attitudes to advance decision-making amongst people with bipolar. Wellcome open research, 4, 16. 
  3. Ruck Keene, A. et al (2020) Carrying out and recording capacity assessments. 39 Essex Chambers. www.39essex.com/mental-capacity-guidance-note-brief-guide-carrying-capacity-assessments/ 
  4. Ruck Keene, A. et al (2020) Determining and recording best interests. 39 Essex Chambers. www.39essex.com/mental-capacity-guidance-note-best-interests-july-2020/ 
  5. Thornicroft, G., Farrelly, S., Szmukler, G., Birchwood, M., Waheed, W., Flach, C., Barrett, B., Byford, S., Henderson, C., Sutherby, K., Lester, H., Rose, D., Dunn, G., Leese, M., & Marshall, M. (2013). Clinical outcomes of Joint Crisis Plans to reduce compulsory treatment for people with psychosis: a randomised controlled trial. Lancet (London, England), 381(9878), 1634–1641. 
  6. Case comments: Re AB (Termination of pregnancy) - https://www.39essex.com/cop_cases/re-ab-termination-of-pregnancy/ 
  7. Case comments: GSTT& SLAM vR –  
  8. Report of an independent inquiry into the care and treatment of Daksha Emson and her daughter Freya: www.simplypsychiatry.co.uk/sitebuildercontent/sitebuilderfiles/deinquiryreport.pdf 
  9. Vivian Gamor Serious Case Review
  10. The Devil you know: Stories of human cruelty and compassion. Gwen Adshead, Eileen Horne. Faber and Faber 2021 

Day 8 - Friday 6 May 2022 - Pre-pregnancy Counselling, pre-birth planning; addictions 

Speakers: Dr Maddalena Miele, Dr Lucinda Green, and Dr Emily Finch

Intended learning objectives:

At the end of day 8 participants will be able to:

  1. Understand the range of factors which should be discussed during the preconception consultation and the rationale for these 
  2. Have a framework to share the outcome of the consultation in a meaningful and sensitive way to women and their partners, highlighting risks, protective factors and the risks and benefits of treatments. 
  3. Understand how to organise and chair a perinatal mental health pre-birth planning meeting to ensure that the woman, her partner and other family members and the relevant professionals have a shared understanding of any concerns, needs and risks as well as the woman and family’s strengths. 
  4. Develop effective perinatal mental health care plans collaboratively with women, partners, other carers and professionals. 
  5. Understand the issues encountered in measuring how common substance misuse in pregnancy is. 
  6. Explore ways to identify substance misuse in pregnancy 
  7. Understand what interventions are available to reduce the harm from substance misuse in pregnancy 

Essential reading:

  1. Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group (2017) Drug misuse and dependence: UK guidelines on clinical management. London: Department of Health – page 220 pregnancy section - https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/673978/clinical_guidelines_2017.pdf 
  2. Pre-conception advice: Best Practice Toolkit for Perinatal Mental Health Service (2019) Pan-London Perinatal Mental Health Networks. www.healthylondon.org/wp-content/uploads/2019/05/Pre-conception-advice-Best-Practice-Toolkit-for-Perinatal-Mental-Health-Services.pdf  
  3. Pre-Birth Planning: Best Practice Toolkit for Perinatal Mental Health Services (2019) Pan-London Perinatal Mental Health Networks. https://www.healthylondon.org/wp-content/uploads/2019/01/Pre-birth-planning-guidance-for-Perinatal-Mental-Health-Networks.pdf 

Recommended reading:

  1. Marlow, S., & Finch, E. (2016). Women and addiction. In D. Castle & K. Abel (Eds.), Comprehensive Women's Mental Health (pp. 174-196). Cambridge: Cambridge University Press. 
  2. Shawe, J. Steegers, E.A.P., Verbiest, S. (Eds) (2020). Preconception Health and Care: A Life Course Approach. Springer. 
  3. WHO (2014). Guidelines for the identification and management of substance use disorders in pregnancy. https://www.who.int/publications-detail/9789241548731  
  4.  Wilson CA, Finch E, Kerr C, Shakespeare J. (2020) Alcohol, smoking, and other substance use in the perinatal period. BMJ. 369:m1627. 
Day 9 - Monday 16 May 2022 - Eating Disorders; pregnancy loss, infertility and complex pregnancy related issues 

Speakers: Dr Catia Acosta, Dr Lucinda Green, and Dr Sarah Finnis

Intended learning objectives:

At the end of day 9 participants will be able to: 

  1. Screen for and identify women who have a diagnosis of an eating disorder in the perinatal period. 
  2. Assess women who have eating disorders in the perinatal period, including assessment of the risk to the woman, the foetus and the infant and requesting physical investigations and discussing risk concerns with women. 
  3. Devise a perinatal mental health care plan for a woman who has an eating disorder in the perinatal period, in partnership with the woman, the eating disorder service and other relevant professionals. 
  4. Understand the factors which contribute to birth trauma (PTSD) 
  5. Understand how pregnancy related trauma and loss can affect women and partners. 
  6. Demonstrate knowledge and understanding of the challenges and complexities for women and partners associated with assisted conception.

Essential reading:

  1. NICE (2017). Eating disorders: recognition and treatment. 
  2. Acosta, C., Treasure, J. (2015) Eating Disorders: Overview and Management in Women. Current progress in obstetrics and gynaecology, volume 3. Ed: Studd J, Tan SL.  
  3. Daugirdaitė, V., van den Akker, O., & Purewal, S. (2015). Posttraumatic stress and posttraumatic stress disorder after termination of pregnancy and reproductive loss: a systematic review. Journal of pregnancy, 2015, 646345. 
  4. Bhat, A., & Byatt, N. (2016). Infertility and Perinatal Loss: When the Bough Breaks. Current psychiatry reports, 18(3), 31. 

Recommended Reading:

  1. Bye, A., Shawe, J., Bick, D., Easter, A., Kash-Macdonald, M., & Micali, N. (2018). Barriers to identifying eating disorders in pregnancy and in the postnatal period: a qualitative approach. BMC pregnancy and childbirth, 18(1), 114. 
  2. Christiansen D. M. (2017). Posttraumatic stress disorder in parents following infant death: A systematic review. Clinical psychology review, 51, 60–74. 
  3. Easter, A., Treasure, J., & Micali, N. (2011). Fertility and prenatal attitudes towards pregnancy in women with eating disorders: results from the Avon Longitudinal Study of Parents and Children. BJOG : an international journal of obstetrics and gynaecology, 118(12), 1491–1498. 
  4. Farren, J., Jalmbrant, M., Ameye, L., Joash, K., Mitchell-Jones, N., Tapp, S., Timmerman, D., & Bourne, T. (2016). Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. BMJ open, 6(11), e011864. 
  5. Fogarty, S., Elmir, R., Hay, P. et al. (2018).The experience of women with an eating disorder in the perinatal period: a meta-ethnographic study. BMC Pregnancy Childbirth 18, 121. 
  6. Hunter, A., Tussis, L., & MacBeth, A. (2017). The presence of anxiety, depression and stress in women and their partners during pregnancies following perinatal loss: A meta-analysis. Journal of affective disorders, 223, 153–164. 
  7. Kitzinger, S (2006) Birth Crisis. Routledge. 
  8. Koert E, Malling GMH, Sylvest R, et al. Recurrent pregnancy loss: couples' perspectives on their need for treatment, support and follow up. Hum Reprod. 2019;34(2):291-296. 
  9. Martínez-Olcina, M., Rubio-Arias, J. A., Reche-García, C., Leyva-Vela, B., Hernández-García, M., Hernández-Morante, J. J., & Martínez-Rodríguez, A. (2020). Eating Disorders in Pregnant and Breastfeeding Women: A Systematic Review. Medicina (Kaunas, Lithuania), 56(7), 352. 
  10. McCluskey, G. and Gilbert, P. (2015) Implications counselling for people considering donor-assisted treatment. Fully updated version. BICA Publications. 
  11. Pearson G. The Burden of Choice: Collected stories from parents facing a diagnosis of abnormalities during pregnancy. Dormouse Press: 2013 
  12. Quagliata E (Ed.). (2013) Becoming Parents and Overcoming Obstacles: Understanding the Experience of miscarriage, premature births, infertility and postnatal depression. Karnac Books. 
  13. Svanberg, E. (2019) Why Birth Trauma Matters. Pinter & Martin. 
  14. The Lancet (2020). Eating disorders: innovation and progress urgently needed. Lancet (London, England), 395(10227), 840. 
  15. Van Der Kolk, B. (2015) The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma.  Penguin.

Day 10-  Tuesday 7 June 2022 - Leadership and service development 

Speakers: Dr Lucinda Green & Dr Nic Horley

Intended learning objectives:

At the end of day 10 participants will be able to: 

  1. Understand and consider the evolving landscape within the provision of PMH services across the nations. 
  2. Understand the advantages of compassionate leadership approaches for leaders and teams 
  3. Recognise the importance of self-compassion  
  4. Plan changes to their own clinical practice and services as a result of learning on the course 

Essential reading:

  1. West, M., Eckert, R., Collins, B., &Chowla, R. (2017) Caring to Change. How compassionate leadership can stimulate innovation in health care. The King’s Fund  
  2. https://www.kingsfund.org.uk/publications/what-commissioning-and-how-it-changing 
  3. https://www.kingsfund.org.uk/publications/integrated-care-systems-explained 

Recommended Reading:

  1. Conversano, C., Ciacchini, R., Orrù, G., Di Giuseppe, M., Gemignani, A., & Poli, A. (2020). Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review. Frontiers in psychology, 11, 1683. https://doi.org/10.3389/fpsyg.2020.01683. 
  2. de Zulueta P. C. (2015). Developing compassionate leadership in health care: an integrative review. Journal of healthcare leadership, 8, 1–10. 
  3. Neff, KD, Knox, MC, Long, P, Gregory, K. (2020) Caring for others without losing yourself: An adaptation of the Mindful Self‐Compassion Program for Healthcare Communities. J Clin Psychol. 76, 1543– 1562. 
  4. NHS England (2014) Building and Strengthening Leadership: Leading with Compassion 
  5. https://www.leadershipacademy.nhs.uk/resources/healthcare-leadership-model/   
  6. https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/nhs-long-term-plan-june-2019.pdf  
The full programme for the Masterclass for New Consultants 2022 is available online (PDF)    

We look forward to seeing you all in January 2022!

The programme will run from 17-21  January 2022.

Themes

  • 17 January 2022 - Day 1 - Introductions.  Overview of where the UK and Ireland are in relation to service development; assessment and communication; the lived experience of women and their partners
  • 18 January 2022 - Day 2 -  Mental disorders in the perinatal period; pre-birth planning 
  • 19 January 2022 - Day 3 -  Safeguarding; prescribing in the perinatal period
  • 20 January 2022 - Day 4 -  Evaluating the infant; substance dependency and misuse; interpreting the evidence in relation to prescribing in pregnancy
  • 21 January 2022 - Day 5 -  Personality Disorder in the perinatal period; psychological treatments; risk, leadership 

The aims of this masterclass programme are to:  

  • enable and support senior trainees develop skills and knowledge in their assessment, understanding and management of the complex clinical work involved in working with women of childbearing potential and in the perinatal period 
  • encourage participants to integrate current evidence into clinical practice  
  • develop self-reflection skills  
  • emphasise the importance of the perspectives of women, infants, partners and families throughout the perinatal pathway  
  • improve patient safety 
  • improve the experience of women and families during the perinatal period and within perinatal mental health services. 

The following key issues are fundamental aspects of perinatal mental health care and will be discussed and considered throughout the programme:  

  • safeguarding children and adults  
  • culture and difference  
  • collaborative working with women, partners and families  
  • women’s own experience of perinatal mental disorders and care  
  • legal issues  

Day 1 - Monday 17 January 2022 - Overview of where the UK and Ireland are in relation to service development; assessment and communication; the lived experience of women and their partners  

Facilitators: Dr Lucinda Green, Dr Roch Cantwell and Dr Liz McDonald 

Guest Speaker: Dr Clare Dolman 

Learning objectives:

  1. Understand the different approaches to development and delivery of PMH services within the different nations.
  2. Describe the range of factors that can affect a woman’s mental health in the perinatal period and her experience of pregnancy and parenting.
  3. Summarise, formulate and communicate assessments to enable women, families and professionals to understand the factors which have contributed to her mental health problems, associated risks and/or her risk of developing a perinatal mental illness. 
  4. Demonstrate an awareness of the barriers to care for women in the perinatal period
  5. Understand the factors influencing women’s decision-making around pregnancy and childbirth
  6. Recognise how healthcare professionals can improve the experience of women and families receiving perinatal mental healthcare
  7. Recognise the effect of a woman’s perinatal mental illness on her partner.

Recommended reading: 

  1. Perinatal Mental Health Services - CR232 (rcpsych.ac.uk)
  2. Scotland:   Perinatal and Infant Mental Health Programme Board: delivery plan - September 2021 to September 2022 - gov.scot (www.gov.scot)
  3. https://www.pmhn.scot.nhs.uk/delivering-effective-services/delivering-effective-services-report/
  4. Scottish care pathways
  5. England care pathways
  6. Wales:  together-for-mental-health-delivery-plan-2019-to-2022.pdf (gov.wales)
  7. Ireland:https://www.hse.ie/eng/services/list/4/mental-health-services/specialist-perinatal-mental-health/specialist-perinatal-mental-health-services-model-of-care-2017.pdf
  8. PMH Partners Ambition FAQs.  PMH Partners Ambition FAQ - National Perinatal Mental Health Workspace - FutureNHS Collaboration Platform
  9. NHS England (2016) The Five Year Forward View for Mental Health
  10. NHS England (2019) The NHS Long Term Plan
  11. Lever Taylor, B., Billings, J., Morant, N., Bick, D., & Johnson, S. (2019). Experiences of how services supporting women with perinatal mental health difficulties work with their families: a qualitative study in England. BMJ Open, 9(7):e030208.
  12. Dolman, C., Jones, I., & Howard, L. M. (2013). Pre-conception to parenting: a systematic review and meta-synthesis of the qualitative literature on motherhood for women with severe mental illness. Archives of women's mental health, 16(3), 173–196
  13. Ruffell, B., Smith, D.M. & Wittkowski, A J. (2019) The Experiences of Male Partners of Women with Postnatal Mental Health Problems: A Systematic Review and Thematic Synthesis. Child Fam Stud.;28: 2772–2790. 

Day 2 - Tuesday 22 January 2022 - Mental disorders in the perinatal period; pre-birth planning 

Facilitators: Drs Lucinda Green, Roch Cantwell and Liz McDonald

Learning objectives:

  1. Understand the course of depression, OCD, schizophrenia, BPAD and Post-partum psychosis within the perinatal context 
  2. Understand how to organise and chair a perinatal mental health pre-birth planning meeting to ensure that the woman, her partner and other family members and the relevant professionals have a shared understanding of any concerns, needs and risks as well as the woman and family’s strengths. 
  3. Develop effective perinatal mental health care plans collaboratively with women, partners, other carers and professionals. 
Recommended reading: 

  1. Di Florio A &Jones IR. (2019) Postpartum Depression. BMJ Best Practice. 4.  
  2. Bergink, V., Rasgon, N., & Wisner, K. L. (2016). Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood. The American journal of psychiatry, 173(12), 1179–1188.  
  3. Challacombe, F. L., Bavetta, M., & De Giorgio, S. (2019). Intrusive thoughts in perinatal obsessive-compulsive disorder. BMJ (Clinical research ed.), 367, l6574.  
  4. Forde R, Peters S, Wittkowski A. Recovery from postpartum psychosis: a systematic review and metasynthesis of women's and families' experiences [published online ahead of print, 2020 Feb 4]. Arch Womens Ment Health. 2020;10.1007/s00737-020-01025-z 
  5. Pre-Birth Planning: Best Practice Toolkit for Perinatal Mental Health Services (2019) Pan-London Perinatal Mental Health Networks. https://www.healthylondon.org/wp-content/uploads/2019/01/Pre-birth-planning-guidance-for-Perinatal-Mental-Health-Networks.pdf   
  6. AriannaDi Florio, et al Post-partum psychosis and its association with bipolar disorder in the UK: a case-control study using polygenic risk scores Lancet Psychiatry 2021; 8: 1045–52  

Day 3 -  Wednesday 19 January 2022 - Safeguarding; prescribing in the perinatal period 

Facilitators: Drs Lucinda Green and Liz McDonald 

Guest Speakers: Dr Angelika Wieck and Prof Ian Jones

Learning objectives:

  1. Describe the factors highlighted in child serious case reviews which can affect children’s safety and wellbeing and increase the risk of abuse and neglect. 
  2. Recognise how perinatal mental health services, working effectively in partnership with a range of professionals, can ensure child safeguarding concerns are identified early and that effective care, treatment and support for women and families can reduce the risk of harm to infants and children. 
  3. Be familiar with currently available evidence on the reproductive safety of the main psychotropic drugs, resources that provide high quality evidence updates and current influential prescribing guidance 

Recommended reading: 

  1. Department for Education (2018). Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children. London: HM Government  
  2. Howard, L. M., Oram, S., Galley, H., Trevillion, K., & Feder, G. (2013). Domestic violence and perinatal mental disorders: a systematic review and meta- analysis. PLoS medicine, 10(5), e1001452  
  3. Hahn, C. K., Gilmore, A. K., Aguayo, R. O., & Rheingold, A. A. (2018). Perinatal Intimate Partner Violence. Obstetrics and gynecology clinics of North America, 45(3), 535–547  
  4. McAllister-Williams, R. H., Baldwin, D. S., Cantwell, R. et al (2017). British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum. Journal of psychopharmacology (Oxford, England), 31(5), 519–552.  
  5. National Institute for Health and Care Excellence (2014). Antenatal and Postnatal Mental Health - Clinical Management and Service Guidance. Clinical Guideline 192.  
  6. MHRA: Valproate use by women and girls (2018). www.gov.uk/guidance/valproate-use-by-women-and-girls   
  7. Pre-conception advice: Best Practice Toolkit for Perinatal Mental Health Service (2019) Pan-London Perinatal Mental Health Networks. www.healthylondon.org/wp-content/uploads/2019/05/Pre-conception-advice-Best-Practice-Toolkit-for-Perinatal-Mental-Health-Services.pdf 

Day 4  - Thursday 20 January 2022 -  Evaluating the infant; substance dependency and misuse; interpreting the evidence in relation to prescribing in pregnancy 

Facilitators: Dr Liz McDonald and Dr Roch Cantwell 

Guest Speakers: Dr Angelika Wieck, Prof Ian Jones, Dr Maddalena Miele and Dr Emily Finch

Learning objectives:

  1. Understand the kinds of methodological problems that hamper research into the reproductive safety of psychotropic drugs and be able to take these into account when interpreting peer-reviewed publications 
  2. Be able to apply current evidence and general principles for the pharmacological management of pregnant and breastfeeding women to clinical scenarios. 
  3. Understand the key ways in which perinatal mental health problems can affect the ability of women to interact with their infant  
  4. Demonstrate a basic knowledge of the current clinical approaches to assessing parent-infant relationships 
  5. Outline the determinants of a sensitive parent-infant interaction 
  6. Understand the issues encountered in measuring how common substance misuse in pregnancy is. 
  7. Explore ways to identify substance misuse in pregnancy 
  8. Understand what interventions are available to reduce the harm from substance misuse in pregnancy

Mandatory reading: The below must be read with the letter from Dr Wieck and Professor Jones before the session. 

  1. Continuation of Atypical Antipsychotic Medication during Early Pregnancy and the Risk of Gestational Diabetes Yoonyoung Park, Sonia Hernandez-Diaz et al Am J Psychiatry. 2018 June 01; 175(6): 564–574. doi:10.1176/appi.ajp.2018.17040393. 
  2. Maternal Use of Specific Antidepressant Medications During Early Pregnancy and the Risk of Selected Birth Defects. Anderson et al. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2020.2453  

Recommended reading:

  1. P.O. Svanberg , J. Barlow & W. Tigbe (2013) The Parent–Infant Interaction Observation Scale: reliability and validity of a screening tool, Journal of Reproductive and Infant Psychology, 31:1, 5-14. 
  2. Stein A, Pearson RM, Goodman SH, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800‐1819. 
  3. Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group (2017) Drug misuse and dependence: UK guidelines on clinical management. London: Department of Health – page 220 pregnancy section
  4. 4. Ibiza paper
  5. 5. Check chapter for more refs

Day 5 - Friday 21 January 2022 - Day 5 Personality Disorder in the perinatal period; psychological treatments; risk, leadership

Facilitators: Drs Lucinda Green, Roch Cantwell and Liz McDonald

Guest Speaker: Dr Nic Horley

Learning objectives:

  1. Understand how personality function may become disordered in pregnancy and postnatally
  2. Appreciate the importance of assessment and treatment of personality disorder by perinatal mental health services
  3. Understand the different psychological therapies for women with mental disorders and their use during the perinatal period
  4. Describe the epidemiology of self-harm and suicide in the perinatal period.
  5. Describe the distinctive clinical features of maternal suicide.
  6. Recognise risk in relation to maternal suicide and apply this to clinical assessment.
  7. Understand the advantages of compassionate leadership approaches for leaders and teams
  8. Recognise the importance of self-compassion 

Recommended reading:

  1. Steele KR, Townsend ML, Grenyer BFS (2019) Parenting and personality disorder: An overview and meta-synthesis of systematic reviews. PLoS ONE 14(10): e0223038. https://doi.org/10.1371/journal.pone.0223038 
  2. Parenting and Borderline Personality Disorder: Ghosts in the Nursery Louise Newman and Caroline Stevenson Clin Child Psychol Psychiatry 2005 10: 385 DOI: 10.1177/1359104505053756 
  3. Adshead, G. Parenting and personality disorder: Clinical and child protection implications Advances in Psychiatric Treatment · January 2015 
  4.  Blankley et al. Borderline personality disorder in the perinatal period. Australas Psychiatry 2015; 23:688-92.
  5. Petfield L et al. Parenting in mothers with borderline personality disorder and impact on child outcomes Evidence-Based Mental Health 2015;18:67-75
  6. Risholm Mothander, P., C. Furmark, and K. Neander (2018), Adding “Circle of Security–Parenting” to treatment as usual in three Swedish infant mental health clinics. Effects on parents’ internal representations and quality of parent‐infant interaction. Scandinavian Journal of Psychology. 59: p. 262-272
  7. Oates M & Cantwell R (2011) Deaths due to psychiatric causes. Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer 2006- 2008. British Journal of Obstetrics and Gynaecology, 118 (s1), 132-142. 
  8. Cantwell R, Knight M, Oates M, Shakespeare J on behalf of the MBRRACE-UK mental health chapter writing group (2015) Lessons on maternal mental health. In Knight M, Tuffnel D, Kenyon S, Shakespeare J, Gray R, Kyrinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care – Surveillance of maternal deaths in the UK 2011-13 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-13. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2015: p22-41. 
  9. Cantwell R, Youd E and Knight M on behalf of the MBRRACE-UK mental health chapter-writing group (2018) Messages for mental health. In Knight M, Bunch K, Tuffnell D, Jayakody H, Shakespeare J, Kotnis R, Kenyon S, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2014- 16. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2018: p42-60
  10. West, M., Eckert, R., Collins, B., &Chowla, R. (2017) Caring to Change. How compassionate leadership can stimulate innovation in health care. The King’s Fund 
The full Perinatal Psychiatry Masterclass for Senior Trainees programme is available online.

We look forward to seeing you all on Monday!

 

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