Updated: Oct 16
This week, 4th – 10th May 2020, is Maternal Mental Health Awareness Week, aiming to raise awareness, support women and their partners who are affected and help them access information and help. This includes new parents by surrogate or adoption.
This blog post discusses the apps and services available online to get obtain information, assessment and help for anxiety, low mood and other mental health conditions during the perinatal period.
The perinatal period discussed covers the time during pregnancy up to one year after birth.
Mental health conditions include Depression, Anxiety, psychosis, Post-Traumatic Stress Disorder, Obsessive Compulsive Disorder. For information about specific mental health conditions in the perinatal period including symptoms and treatment, click on the links in the resources section at the end of the article.
Seeking medical advice early on is important so the right support can be provided.
This article is aimed primarily for partners, close family members or friends of expectant or new mums.
Recognising mental health problems
Being pregnant, preparing for a new baby and then having a new baby or child is a big change which understandably results in a number of emotions. The range and mix of emotions and physical feelings causing emotions will be different for each and every person and can include happiness, joy, tiredness, worry, relief, delight, fear, anxiety, exhaustion, pressure, pain, elation, overwhelm and guilt. With each day this range and mix of emotions is likely to change and some will dominate more than others. How do you know what is normal, when to be worried and when help should be sought?
The illustrations in this Buzzfeed post were commissioned by a Postnatal Stress Treatment centre in the USA to raise awareness of some of the feelings and thoughts that mothers have found difficult to share with their partners, friends and family. You can also watch this video by Perinatal Positivity created to encourage mothers to seek medical support.
Mental health 'check-in'
In the same way you might use a weighing scale or favourite pair of jeans to check whether your weight or size is changing, you can perform regular basic review or ‘checks’ of your mood. Healthcare professionals (Midwives, Health Visitors, GPs, Obstetricians) will do this during appointments but in between perform the check with your partner.
Mood Self-Assessment Online
This link will connect you to a Mood assessment questionnaire on NHS.UK that will take a few minutes to complete. The outcome of the assessment will guide you on whether any action needs to be taken. There aren't any published guidelines or evidence on the frequency that people should take this test. Taking this test at least every 1-2 months is a decent timeframe or if you prefer use a mood tracking app (see below).
If you or your partner have persistent feelings of fear, worry, low mood and lack of motivation, or wanting to self-harm it’s important to be assessed by a healthcare professional.
If you are ever unsure, speak to your healthcare professional (Midwife, GP, Health visitor, Obstetrician) or call NHS111.
Links to relevant information resources can be found at the end of this article.
Mood tracking and self-care by Apps
A journal can be used to track mood. Here are some apps that have been NHS approved or by highly rated by Orcha for this purpose:
MyPossibleSelf: Mental Health
MyPossibleSelf is listed on the NHS apps library and has received with a high score of 76% from Orcha. MyPossibleSelf provides content to reduce stress, anxiety and low mood in 8 weeks. You can track your mood daily, understand the signs and symptoms to look out for and find practical steps to look after your own health. I tested the app and found it very simple to use. You can use the mood tracker and one of the modules for free when you download the app. All other modules require a monthly subscription of £5.99 each month or £59.99 for the year.
Wysa: Mental Health Support
Wysa is not listed on the NHS apps library but has received a high score of 96% from Orcha and won the Orcha Best App for Stress award in 2019. At this current time the app has scored 4.8* (out of possible 5*) from 606 ratings on the Apple store and 4.7* (out of 5*) from 44,418 ratings on Google Play. You can track your mood daily, book a session with a professional therapist and access a number of tools for stress, anxiety and depression using Cognitive Behavioural Therapy. The range of features in the basic version is limited. The premium app costs £99.99 after a 7 day free trial period.
First steps to getting help
The majority of patients I've seen with antenatal and postnatal mental health conditions have felt under immense pressure and fear of being judged so did not want to or felt unable to share their feelings with friends or family members. Therefore if you think your partner or friend is struggling or you are worried about them, encourage them to speak to a healthcare professional (Midwife, GP, Health Visitor, Obstetrician or call NHS111) in confidence. You can send them a text message saying you are thinking about them and available to talk. Include a link to this article in the message.
GPs, psychologists and psychiatrists can be consulted with in person, by phone, by text or by video through the NHS or privately. After assessment, the GP may make a referral to IAPT (see below), the local Perinatal Mental Health Team (a specialist mental health team for antenatal and postnatal period) or the local community mental health team. The GP may also recommend and prescribe medication for anxiety or depression.
Treatment can involve talking therapy, medication or a combination of both. This is why it's so important to get medical advice which will provide the opportunity to be assessed.
Self-referral to Improving Access to Psychological Therapies (IAPT)
In England, patients can self-refer to a local talking therapies service, 'Improving Access to Psychological Therapies (IAPT) ' provided by the NHS. IAPT offer evidence-based psychological therapies to people with anxiety disorders and depression. A questionnaire on the website can be completed and an initial assessment arranged by phone. Afterwards, depending on the outcome of your assessment, talking therapies may be offered, in person, phone or online.
The website for the local IAPT service can be found by clicking on this link, entering your postcode and locating the page for self-referral.
If a perinatal mental health team or IAPT team in not available locally, then the GP may be able to advise or make a referral to other relevant services e.g. counselling. If there may be a waiting period Private services can be considered. Private counsellor/psychologist or psychiatrists are available on a self pay or payment from a health insurance provider. Such services can be available in person, by phone or video. The GP should be able to advise you on which would be the most appropriate type of professional to see for your individual circumstances and may be able to make a recommendation or you can find private healthcare professionals online (see 'Finding Private healthcare professionals online' below).
Counsellors and Psychologists are trained in assessment of mental health conditions and providing psychotherapy/talking therapies. See the resources section at the end of the article for more information.
Psychiatrists are medical doctors who specialise in the assessment and treatment of mental health conditions. They can prescribe drugs, psychotherapy and other treatment procedures. In the UK, Psychiatrists treat more complex or severe mental health conditions some of which may be related to physical medical conditions (In the UK GPs treat mild to moderate mental health conditions). They work alongside the mental health team (in hospital or in the community) which comprises of Mental health specialist nurses, Mental Health Social workers and Clinical Psychologists.
Finding Private healthcare professionals online
Private GPs and Mental Health Specialists can be found by:
1. Using a third party search tool. You can use these tools to find specialists and GPs (accepting self pay or health insurance)
Doctify - includes reviews from patients
My Health Specialist - includes recommendations from GPs who have referred their patients to these specialists
2. Directly contacting a support service that is included in your employee benefit package e.g. Peppy Health
3. Asking your health insurance provider or searching on their website
4. Contacting an online service provider direct
Dr Julian - Access to counsellors and psychologists by video or text
Babylon Health - Private GP service and talking therapy service by video
Dr Morton's - Private GPs and Obstetricians by phone or video
Wysa (mentioned earlier)- you can book to speak to a therapist on the app
5.Search the British Association for Counselling and Psychotherapy (BACP) register or UK council for Psychotherapists (UKCP) register for individual practitioners - Therapists in person, by video or speak by phone or text
Please take care.
This article does not cover mental health issues related to pregnancy loss, general mental health wellbeing and mental health conditions.
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For more information about Maternal Mental Health Awareness Week click on this link to visit the Maternal Mental Health Alliance website.
Choosing a Counsellor or Psychotherapist, BACP