Pregnancy and Maternity

Specialist Perinatal CMHT – Equitable Service Access for Diverse Groups

Briefing Paper

Date: Thursday 26^th October 2020

Author: Carla Mobear

Introduction

This paper presents an updated position of the Specialist Perinatal CMHT action plan to improve and ensure equitable access to women from BAME backgrounds and is specifically associated with improving the health and outcomes for these women and their children.

Current position

Currently the approaches to improve equity of access across Greater Manchester to the Specialist Perinatal CMHT including:As part of the initial collation of service data between April 2019 and August 2020 the service has a preliminary understanding of which women have accessed the service over time, and how this has changed. What is not currently known is how service data maps against the local population diversity and need; in order to inform weather certain groups are not accessing the service as would be expected. In addition, the service needs to consider and review the number of BAME women who are gaining access to the Specialist Perinatal CMHT via urgent care and or inpatient services, as this would provide some indication of timely access to service.

Standardisation of the ‘Obstetric liaison clinic’ model and an operating procedure that reflects considerations of culturally specific consideration.
Establishing and increasing community based locations to deliver Specialist Perinatal CMHT clinics over alternative sites to the hospital setting i.e. children centres, GP centres, Community hubs, Home visits)
Consistent CMHT MDT offer to all clusters across GM following completion of recruitment to full establishment.

Goals

To compare access by women from BAME backgrounds to local weighted population need across GM.
To scope and mirror engagement pathways with system partners for women from BAME backgrounds.
To adapt the service model to improve equity of access
To increase access to women from BAME backgrounds
To increase the knowledge and understanding of ‘culturally sensitive parenting’ within the Perinatal Specialist service

Progress to date

Data:

The service has to date obtained and collated the baseline service level data about the characteristics of women who have accessed the service to date and by cluster (April 2019 – August 2020) and is now comparing the characteristics of those women who have accessed the service to date with the local MH index population of each cluster.

Pathways:

The service had its first meeting with Greater Manchester Centre for Voluntary Organisations (GMCVO) (22/10/20). The purpose of this meeting was to establish contacts and develop a working relationship. During the meeting, the specialist Perinatal CMHT offered attendance attend any group that may be interested in a session on perinatal wellbeing. Alongside this, we proposed that the Perinatal and Infant mental Health leads would provide free training for staff working within the GMCVO.

A meeting was held with the Specialist Mental health Midwife lead for GM (22/10/20) who has been asked to identify any midwives who have a specific role in supporting BAME women. This same request was also made to the specialist Perinatal Health Visitor during a meeting (24/09/20)

On 12/03/20 The service met with representatives from the GM Jewish Maternity services and Family Support (JEMS) and Jewish Action for Mental Health (JAMH). During this meeting we explored how as a service we could support families form the Jewish Community.

Training:

Service leaders attended the Caribbean and African Health Network (Greater Manchester) (CAHN) International Women’s' day 09/03/20). This event focused on the MBRRACE (2019) report which highlights that Black women are five times and Asian women two times more likely to die because of complications in their pregnancy. This was an extremely important event and highlighted the need for the all services to advocate for BAME pregnant women within maternity services. As part of the day the perinatal CMHT delivered, a workshop entitled “What is Perinatal Wellbeing and how can Services support this?’

The service attended a live Webinar delivered by MENUCHA who are a NW London based Voluntary service raising awareness of perinatal illness in the Orthodox Jewish community. This opportunity allowed the service to consider salient issues such as the importance of the Jewish calendar when booking appointments, how to respect the home environment during visits and the role of the father, Rabbi and extended community during the perinatal period.

We have also tried to develop our learning around the South Asian community and on 08/10/20, staff from our service attended the Community of Cultures Maternity Forum, Mental Health and emotional wellbeing in the South Asian communities. This webinar facilitated a frank and open discussion about caring for women in the perinatal period and we discussed the practicalities of using interpreters.

As part of the GM Perinatal and Infant MH leads Steering group, we have actively sought, and are now in the process of commissioning training around culturally sensitive parenting. We aim to have this training accessible to approximately 80 perinatal/infant MH health care professionals’ i.e. perinatal health visitors, specialist MH midwives, perinatal CPNs before April 2021

Promotion:

The Perinatal and Infant MH Steering group is now commissioning a video which explains perinatal and infant mental health service across GM. The content of this video is not fully confirmed however the aim will be to minimise the use use of language within and allow a voice over to be used in different languages which will support the culturally sensitive content to be used.

Other:

The Perinatal and Infant MH steering group is considering what GM perinatal and infant MH leaflets should be routinly available in translated languages.