Perinatal Psychiatry Masterclass for new consultants resources

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

New Consultants masterclass resources

This programme will run from 12 September 2022 – 30 March 2023

Themes

5 October 2022 – Day 1 – Introductions; PMH service development across the UK and Ireland; Assessment and communication

6 October 2022 – Day 2 – Lived experience, co-production, partners

10 November 2022 – Day 3 – The infant

21 November 2022 – Day 4 – Risk and Safeguarding: adults and children

6 December 2022 – Day 5 – Prescribing in the perinatal period

9 January 2023 – Day 6 – Mental Health Law, Mental Capacity and the Court of Protection: issues in the perinatal period, Advance decision making in the perinatal period, Substance misuse in the perinatal period

31 January 2023 – Day 7 – Personality Disorder

21 February 2023 – Day 8 – Pre-pregnancy Counselling, Pre-birth planning, Infertility and fertility treatment, Women who kill their infants

20 March 2023 – Day 9 – Eating Disorders; pregnancy loss, infertility and complex pregnancy related issues

30 March 2023 – Day 10 – Leadership and service development

Aims

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

The full programme for the Masterclass for New Consultants 2023 is available online (PDF)

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.

Speakers: Dr Giles Berrisford

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 Scotland:
  4. https://www.pmhn.scot.nhs.uk/delivering-effective-services/delivering-effective-services-report/
  5. Wales: together-for-mental-health-delivery-plan-2019-to-2022.pdf (gov.wales)
  6. 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
  7. The Perinatal Mental Health Care Pathways (2018) NHS England. NHS Improvement, National Collaborating Centre for Mental Health
  8. Perinatal mental health: a review of progress and challenges. World Psychiatry. 2020;19(3):313-327.

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.

Speakers: Dr Clare Dolman, Dr Henry Fay, Clotilde Rebecca Abe and Hannah Bissett

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.
  4. Darwin, Z., Domoney, J., Iles, J. et al. Involving and supporting partners and other family members in specialist perinatal mental health services. NHS England (2021) https://www.england.nhs.uk/wp-content/uploads/2021/03/Good-practice-guide-March-2021.pdf

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. Griffiths J, Lever Taylor B, Morant N, Bick D, Howard LM, Seneviratne G, Johnson S. A qualitative comparison of experiences of specialist mother and baby units versus general psychiatric wards. BMC Psychiatry. 2019;19(1):401
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. Pilav, S., De Backer, K., Easter, A. et al. A qualitative study of minority ethnic women’s experiences of access to and engagement with perinatal mental health care. BMC Pregnancy Childbirth 22, 421 (2022)
  8. Powell C, Bedi S, Nath S, Potts L, Trevillion K, Howard L. Mothers' experiences of acute perinatal mental health services in England and Wales: a qualitative analysis. J Reprod Infant Psychol. 2022;40(2):155-167.
  9. Royal College of Obstetricians and Gynaecologists (2017) Maternal mental health women’s voices.
  10. 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.
  11. 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.
  12. 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

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.

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 medicine10(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 America45(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 medicine45(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. https://www.solacewomensaid.org/get-informed/resources-library

Speakers: Prof Ian Jones and Dr Angelika Wieck

Intended learning objectives

At the end of day 5 you should be able to

  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 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
  3. 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 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. Grigoriadis et al. Pregnancy and Delivery Outcomes Following Benzodiazepine Exposure: A Systematic Review and Meta-analysis. Can J Psychiatry. 2020 Dec;65(12):821-834. doi: 10.1177/0706743720904860 .
  5. Grigoriadis et al 2020 Supplement 

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. National Institute for Health and Care Excellence (2014). Antenatal and Postnatal Mental Health – Clinical Management and Service Guidance. Clinical Guideline 192.
  3. MHRA: Valproate use by women and girls (2018). www.gov.uk/guidance/valproate-use-by-women-and-girls

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.

Speakers: Ms Sophia Roper, Barrister , Dr Livia Martucci, Dr Lucy Stephenson , Dr Emily Finch

Intended learning objectives

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

  1. Recognise the relevant legal frameworks and to formulate a legally informed advance decision making document with women in the perinatal period
  2. Describe upcoming reforms to the Mental Health Act and the impact on advance decision making in the perinatal period
  3. Distinguish between ethical/moral issues and legal frameworks and how to approach them separately
  4. Understand the issues encountered in measuring how common substance misuse in pregnancy is.
  5. Explore ways to identify substance misuse in pregnancy
  6. Understand what interventions are available to reduce the harm from substance misuse in pregnancy

Essential reading

  1. 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.
  2. 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.
  3. https://www.mwcscot.org.uk/law-and-rights/advance-statements
  4. 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

Recommended reading

  1. 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.
  2. 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/
  3. 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/
  4. Thornicoft, 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.
  5. Case comments: Re AB (Termination of pregnancy) - https://www.39essex.com/cop_cases/re-ab-termination-of-pregnancy/
  6. TBC
  7. 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.
  8. WHO (2014). Guidelines for the identification and management of substance use disorders in pregnancy. https://www.who.int/publications-detail/9789241548731
  9. Wilson CA, Finch E, Kerr C, Shakespeare J. (2020) Alcohol, smoking, and other substance use in the perinatal period. BMJ. 369:m1627.

Speakers: Dr Gwen Adshead and Nic Horley

Intended learning objectives

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

  1. To gain greater understanding of personality function and dysfunction
  2. To understand how personality function may become disordered in pregnancy and postnatally
  3. To appreciate the importance of assessment and treatment of PD by perinatal 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

Speakers: Dr Maddalena Miele and Dr Gwen Adshead

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. Describe and recognise the psychological consequences of infertility and fertility treatment
  6. Understand the role of the counsellor in the infertility clinic
  7. Understand the psychopathology of women who kill their children

Essential reading

  1. 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
  2. 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
  3. Brockington I (1998) Infanticide (chapter 8) Motherhood and Mental Health.
  4. Welldon Estela V. (1992) Mother, Madonna, whore: The idealization and denigration of motherhood.

Recommended reading

  1. Shawe, J. Steegers, E.A.P., Verbiest, S. (Eds) (2020). Preconception Health and Care: A Life Course Approach. Springer.
  2. Becker, M. A., Chandy, A., Mayer, J., Sachdeva, J., Albertini, E. S., Sham, C., & Worley, L. (2019). Psychiatric Aspects of Infertility. The American journal of psychiatry, 176(9), 765–766.
  3. McCluskey G & Gilbert P. Implications counselling for people considering donor-assisted treatment. Fully updated version. British Infertility Counselling Association: 2015.
  4. Szkodziak, F., Krzyżanowski, J., & Szkodziak, P. (2020). Psychological aspects of infertility. A systematic review. The Journal of international medical research, 48(6), 300060520932403.
  5. Vikström J, Josefsson A, Bladh M, Sydsjö G. Mental health in women 20-23 years after IVF treatment: a Swedish cross-sectional study. BMJ Open. 2015;5(10):e009426.
  6. Flynn, S. M., Shaw, J. J., & Abel, K. M. (2013). Filicide: mental illness in those who kill their children. PloS one, 8(4), e58981.
  7. 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
  8. The Devil you know: Stories of human cruelty and compassion. Gwen Adshead, Eileen Horne. Faber and Faber 2021

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., Martini, M. G., & Micali, N. (2021). Eating disorders, pregnancy and the postnatal period: a review of the recent literature. Current opinion in psychiatry, 34(6), 563–568.
  2. 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.
  3. Christiansen D. M. (2017). Posttraumatic stress disorder in parents following infant death: A systematic review. Clinical psychology review, 51, 60–74.
  4. 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.
  5. 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.
  6. 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.
  7. Herbert D, Young K, Pietrusińska M, MacBeth A. The mental health impact of perinatal loss: A systematic review and meta-analysis. J Affect Disord. 2022;297:118-129.
  8. 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.
  9. Kitzinger, S (2006) Birth Crisis. Routledge.
  10. 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.
  11. 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.
  12. McCluskey, G. and Gilbert, P. (2015) Implications counselling for people considering donor-assisted treatment. Fully updated version. BICA Publications.
  13. Pearson G. The Burden of Choice: Collected stories from parents facing a diagnosis of abnormalities during pregnancy. Dormouse Press: 2013
  14. Quagliata E (Ed.). (2013) Becoming Parents and Overcoming Obstacles: Understanding the Experience of miscarriage, premature births, infertility and postnatal depression. Karnac Books.
  15. Svanberg, E. (2019) Why Birth Trauma Matters. Pinter & Martin.
  16. The Lancet (2020). Eating disorders: innovation and progress urgently needed. Lancet (London, England), 395(10227), 840.
  17. Van Der Kolk, B. (2015) The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma. Penguin.
  18. Westby CL, Erlandsen AR, Nilsen SA, Visted E, Thimm JC. Depression, anxiety, PTSD, and OCD after stillbirth: a systematic review. BMC Pregnancy Childbirth. 2021 Nov 18;21(1):782.

Speakers: Dr Roch Cantwell, Dr Liz McDonald, Dr Lucinda Green and 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 (PDF)
Read more to receive further information regarding a career in psychiatry