Antenatal screening and early-intervention: A mental health update from the NSPCC

Abstract

The NSPCC is dedicated to perinatal wellbeing and advocating for a preventative model of care that has the potential to improve the mental health for parents, families and communities. Here in the first of two articles, Camilla Sanger, Alice Haynes, Gary Mountain and Naomi Bonett-Healy provide an update of antenatal mental health research and recommended practice, with a specific focus on the role midwives can play in screening and identifying mental health problems.

Sensitivity and attachment interventions in early childhood: A systematic review and meta-analysis

“…More recently, in the implementation of home visiting programmes, there has been a shift towards more relationship based, psychotherapeutic approaches promoting parental reflectiveness and or mentalization through relationships in order to promote positive parenting, attachment and maternal sensitivity (Munro, 2011). T M ing the Baby® project commissioned by the National Society for the Prevention of Cruelty in Children (NSPCC) incorporates these types of approaches and is currently being piloted in the UK by the NSPCC (Sanger et al, 2015;NSPCC, 2015) having proven successful in the USA. This is an intensive, flexible, relationshipbased, interdisciplinary, trauma-informed and mentalization-based programme, embedded in community health care.…”

“…This is in keeping with results from other studies with a meta-analysis by Brooten et al (2003) which concluded that a greater dose of advanced practice nursing services was associated with better patient outcomes as well as decreased health-care costs. D (GM) current experiences within a NSPCC funded international research project, the complexity of the work that is often involved in home visiting programmes necessitates the use of expert practitioners, often delivering complex interventions who in turn require intensive training and clinical supervision in order to acquire specific skills and developmental approaches for working with young mothers (Sanger et al, 2015). Questions still remain as to how best to meet the complex and substantial needs of populations of high risk young mothers and their children with frequent histories of complex trauma and adversity.…”

“…The Minding the Baby® (Sadler et al, 2013) is an example of a pioneering program whereby a wellresearched home visiting intervention program is being translated into the UK context as part of an ambitious multi-site NSPCC sponsored RCT (Longhi et al, 2016). To date indications are that the programme is successfully engaging families in effective working relationships with professionals effecting long term positive growth and change (Sanger et al, 2015).…”

“…There is a stream of evidence also suggests that home visiting interventions that are restricted to a narrow range of outcomes, are often less effective than a more broad approach where multiple needs are addressed (Bull et al, 2004). Therefore it would be useful to explore other outcomes alongside attachment and sensitivity such as immunization rates, child abuse rates, parental mental health, educational achievement (Nievar et al, 2010), obstetric outcomes and rapid successive pregnancy rates (Sanger et al 2015) which are also very significant to the health and wellbeing of children and young people.…”

Midwives’ experiences of caring for women’s emotional and mental well‐being during pregnancy

“…Midwives are uniquely positioned to address the mental health needs of pregnant women due to the frequent contact expectant mothers will have with midwives, allowing a trusting relationship to be built (Madden et al, 2018; Sanger et al, 2015). However, working within a multidisciplinary team to include mental health services has been found to have better outcomes for women (Madden et al, 2018; Sanger et al, 2015). Despite the frequent contact pregnant women have with health professionals, identification of mental health problems is thought to be as low as 50% (NICE, 2014).…”