No significant relationships.

No significant relationships.

No significant relationships.

Clinicians often do not have experience assessing perinatal patients unless they work as part of a perinatal team. Informal feedback points to a lack of confidence in performing perinatal assessments.

The aim of the project was to assess clinicians’ confidence in performing perinatal assessments in outpatient and inpatient settings including the Emergency Department. Additionally, we wanted to assess whether access to a perinatal assessment tool was beneficial. We hypothesise that clinicians lack confidence in performing perinatal assessments and would benefit from using a perinatal assessment tool.

We designed a survey of 10 questions assessing the above. The survey was sent out to psychiatric trainees and nurses at South London & Maudsley NHS Foundation Trust. The participant’s confidence in completing perinatal assessments in various settings was assessed using a 5 point Likert scale.

52 responses were received. 50% of participants felt not so confident in performing perinatal assessments in the outpatient setting. 40.38%(n=21) of participants felt not so confident in exploring the mother and foetal relationship. 71.15% (n=37) of participants felt that they would benefit from additional teaching with 48.1% of participants citing that they would benefit from access to an assessment tool.

As predicted, the results of the survey show that clinicians lack confidence in performing perinatal assessments. Therefore, we have commenced work on modifying the existing Stafford Interview. This is a structured interview that explores the obstetric and psycho-social background and psychiatric complications of pregnancy. The survey is due to be replicated in other project locations to allow transcultural comparison.

No significant relationships.

PICU inpatients are likely to be at increased risk of having unmet SRH needs due to barriers to accessing services. Since May 2018, an in-reach SRH assessment has been available to all psychiatric inpatients on ES1 ward, if referred. Analysis of referrals over 15 months identified only 24 had been made during this time.

To assess the SRH needs of women admitted to ES1 PICU, the feasibility of providing a SRH in-reach clinic, and the acceptability of delivering a nurse lead referral programme.

A bi-monthly SRH in-reach clinic and a nurse led SRH referral pathway were implemented on ES1 over a seven-month period. A staff training needs assessment was performed followed by training, a protocol was developed, staff attitudes were explored, and patient engagement was sought.

A total of 41% (32/77) of patients were referred, which was a 29% increase. 53.1% (17/32) of the total referrals had a true SRH need, equating to a 10% increase and 22% (17/77) of all PICU admissions. 90% of referrals were made by nursing staff. A staff focus group (n15) highlighted the acceptability and perceived importance of offering SRH care in PICU, if interventions were appropriately timed and the patient’s individual risk profile was considered.

Results identify that SRH needs for PICU admissions are greater than previously realised. Providing a nurse led referral pathway for an SRH in-reach clinic is acceptable, feasible and beneficial for PICU patients. This project has resulted in service improvements including offering asymptomatic STI testing to all PICU admissions.

No significant relationships.

There is little prospective data on the risk factors for later suicide in women who experience perinatal mental disorders, particularly beyond one-year postnatal.

Among a cohort of women who were in contact with a mental healthcare provider during the perinatal period, to: (1) Describe sociodemographic and clinical characteristics of the women who died by suicide (2) Understand when, in relation to childbirth, most suicides tended to occur.

Data-linkage of de-identified service-user electronic healthcare records, national hospital episode statistics and mortality data generated a cohort of women in contact with a mental healthcare service provider in London, UK, perinatally. Using Natural Language Processing and structured field extraction, we identified clinical, socio-demographic characteristics, self-harm exposure, and suicide.

Among 5204 women, clinical and demographic characteristics of women who did and did not die by suicide were similar apart from indicators of illness severity including perinatal sedative medication prescription, clinician-rated functional impairment and smoking, which were more common in women who died by suicide. Suicide deaths occurred most frequently in the second year post-delivery. The most common method of suicide ocurring wihtin two years was by violent means, whereas after two years postnatal, the most common method was non-violent.

Our findings support the extension of perinatal mental healthcare service provision to two years post-delivery.

No significant relationships.

The Unit of Clinical Psychiatry of the University Hospital “Ospedali Riuniti – Ancona”, in collaboration with the Marche Region Health System, is conducting a national observational project entitled “Measures related to the prevention, diagnosis, treatment and assistance of postpartum depressive syndrome”, aiming at promoting women’s Mental Health, particularly in pregnancy and peripartum period.

The primary objective is implementing all measures/interventions needed to promptly screening, early diagnosising, and supporting/caring women with mental health disease during pregnancy and peripartum period. A dedicated training program was performed by our clinical team belonging to the Peripartum Psychiatry Outpatient Service of the Unit of Clinical Psychiatry, at the University Hospital “Ospedali Riuniti”, Ancona, Italy, to a selected audience of Gynecologists/Obstetricians/Nurses/Psychologists/Psychiatrists/GPs and Pediatricians.

The training program is a 2-days residential course, held on 21-22th September, 2020. After the training program, all participants (n= 70) were asked to provide an informed consent and complete an online questionnaire to evaluate knowledge/opinions/experiences and clinical practices in the field of depression in pregnancy and postpartum.

A 40-items questionnaire investigated: a) general attitude in performing screening of depression/anxiety during pregnancy; b) overall knowledge about peripartum depression; c) overall knowledge about management/treatment; d) how physicians manage patients with peripartum depression/anxiety (i.e., how they perform screening/diagnosis/treatment during pregnancy, their levels of knowledge/confidence about psychopharmacology in pregnancy).

The findings of the residential course may allow clinicians to adequately inform and help in drafting a preventive, screening and management program able to assist regional stakeholders in the prevention, diagnosis, treatment and assistance of perinatal depression.

No significant relationships.

Depression is a common complication of pregnancy and the postpartum period. Up to 70% percent of women report depressive symptoms during their pregnancy, and approximately 10-16% meet full criteria for major depressive disorder. Women with a history of perinatal or non-perinatal major depression are likely to relapse during pregnancy. Research shows that exposure to untreated depression and stress can have negative consequences on the birth outcome and child development. Given the harmful effects of this disease on both the mother and child, it is essential that all pregnant patients be screened for depression. Literature review did not reflect many studies that focus on depression screening in this population, let alone in pregnant patients with Human Immunodeficiency Virus (HIV). Our study focuses on the impact the mandatory screening tool had on the incidence of depression screening in pregnant HIV patients.

- Gain understanding of the Family Focused HIV Health Care Program for Women - Understand the importance of a mandatory screening tool for depression

Using standardized Quality Improvement tools Implementation of screening tool in notes & enforcing a hard stop in the medical records

We noted both qualitative & quantitative improvement in depression screening. Qualitatively the screening has been standardized by creating a universal workflow by the inclusion of screening tools (PHQ2 and PHQ9) in Electronic Medical records. Quantitatively there has been a 34.9% improvement in screening by the case managers in the post interventional quarter.

Significant improvement noted in the incidence of depression screening by implementation a mandatory screening tool