The effectiveness of perinatal mental health services
Research type
Research Study
Full title
The Effectiveness and cost-effectivenesS of Mother and Baby Units versus general psychiatric Inpatient wards and Crisis Resolution Team services (ESMI)
IRAS ID
155154
Contact name
Louise M. Howard
Contact email
Sponsor organisation
King’s College London
Research summary
The Royal College of Psychiatrists state that women needing psychiatric admission post-delivery should be admitted to Mother and Baby Units (MBUs). MBUs aim not only to care for the mother's psychiatric needs but also to support the mother and baby relationship, which may be at risk in this group. However, there has been little research on the effectiveness of MBUs and no data comparing MBUs with other services for acutely ill women in the postnatal period. Many areas of the UK do not have access to MBUs and their size and operational characteristics vary considerably. NICE guidance recommends further development of, and research into, services for women with acute postnatal severe disorders. Data are, therefore, urgently required for commissioners of perinatal mental health services if access is to become more equitable.
People with acute disorders not necessitating detention under the Mental Health Act can be cared for by Crisis Resolution Teams (CRTs) in their home. This may be offered instead of MBU or general psychiatric ward admission and, therefore, also needs to be included in any comparison of services for acute severe perinatal disorders. A strength of CRT care is that the mother may be able to be at home with her infant and share care with the child’s father/other family members. However caution has been expressed about the use of CRTs for women with acute severe postnatal disorders, because postnatal psychotic episodes can develop into very serious disorders within hours, leading to an increased risk of suicide and infanticide.
We will conduct a quasi-experimental cohort study of women with acute severe mental disorders who need intensive treatment urgently following birth. This study aims to investigate the effectiveness and cost-effectiveness of MBUs compared with general psychiatric wards or care from CRTs for acute severe postnatal disorders.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
14/LO/0765
Date of REC Opinion
3 Jul 2014
REC opinion
Further Information Favourable Opinion