Members of the Action on Postpartum Psychosis (APP) team, including staff, trustees and ambassadors, spoke to a global audience of expert researchers, clinicians and women and families with lived experience as part of the International Marcé Society for Perinatal Mental Health Conference. 

Here are some of the highlights from the social media conversation taking place during the conference #Marce22.

Hannah Bissett (APP National NHS Contracts Coordinator), Dr Clare Dolman (APP trustee, Co-chair of the Bipolar Commission and Ambassador Bipolar UK, Trustee Maternal Mental Health Alliance), Laura Dockrill (APP Ambassador), Dr Sally Wilson (APP National Training and Research Coordinator) and Dr Jess Heron (APP CEO) at the International Marcé Society for Perinatal Mental Health Conference, 2022.

The conference took place between Monday 19th and Friday 23rd September and welcomed leading experts in perinatal mental health from institutions and organisations around the world. The Society is led by a board of experts including APP’s very own trustee, Professor Ian Jones, who also served as the conference’s co-chair.

Come & say hello on the @ActionOnPP stand here at the Welcome Reception for @TheMarceSociety ahead of the conference this week #Marce22 . Looking forward to seeing lots of #perinatal folk - new & old faces - and being together in #London #global #community #maternalMHmatters 💜 pic.twitter.com/q6emHKukav

— Hannah Bissett (@spannerb79) September 18, 2022

One of the key aims of this year’s conference was to highlight the UK’s best practice in lived experience involvement, and encourage this trend internationally. The conference events took place both in London and virtually.

Having the opportunity to speak at such an event enabled us to share best practice and stimulate conversation specifically around postpartum psychosis (PP), raising awareness of the illness, as well as our campaign asks, amongst a much wider pool of academics and health professionals. The more researchers and professionals talking about postpartum psychosis, the more collective power we have to build knowledge, effect change, challenge stigma and improve services for women and families affected.

Dr Jess Heron, CEO of APP, said “We are delighted to be attending conferences face to face again, to continue raising the profile of postpartum psychosis in the perinatal research community. We shared our research showing: that care for PP has improved considerably in 10 years; that women admitted to MBUs have better outcomes than those separated from their baby in General Psychiatric Units; that peer support is essential and life-saving during recovery; and the impact of our co-produced and co-delivered health professional training on clinical practice, empathy and knowledge. The week long academic conference is a valuable opportunity for us to hear from world leading experts about their cutting edge work. The voices and values of the Third Sector and lived experience play an important role in academic conferences, helping translate the evidence base into practice, reducing stigma, and influencing research of importance to women and families."

Hannah Bissett, APP National NHS Contracts Coordinator, said: "As a lived experience speaker, I attended Marcé to talk about what women and families need from perinatal services. Hearing the expert speakers that day in other talks, including describing experiences of PP in India and Malawi was very moving and inspiring. Whilst I do not have a research background or clinical training, Marcé welcoming lived experience speakers was an important step in sharing our voices. The virtual conference also had a wealth of streamed content and representing our peer support team sharing an evaluation of our projects in the APP symposium was a huge privilege - I'm not sure if an in-person session or virtual talk is most nerve-wracking! I hope to attend Marcé again in the future and reconnect with some of the wonderful people we met from the ‘perinatal family’."

The two sessions APP was involved with or leading were:

What do women and families need from perinatal mental health services?

This session was chaired by Dr Clare Dolman (APP trustee) and featured our brilliant ambassador Laura Dockrill, who powerfully and beautifully shared her personal experience of PP, as well as our National NHS Contracts Coordinator, Hannah Bissett, speaking about the value of peer support in perinatal services. They were joined by Dr Henry Fay on video– a former GP with experience of PP as a partner, and trustee of the Maternal Mental Health Alliance.

Laura Dockrill (APP Ambassador), Hannah Bissett (APP National NHS Contracts Coordinator) and Dr Clare Dolman (APP trustee, Co-chair of the Bipolar Commission and Ambassador Bipolar UK, Trustee Maternal Mental Health Alliance).

Already inspired @TheMarceSociety conference listening to life experiences and @ActionOnPP . We don’t talk about it, pretending it doesn’t exist fertile ground for mental health problems and stigma to thrive. Ever more important @MMHAlliance raising awareness

— Laura Seebohm (@LauraSeebohm) September 19, 2022

Involving people with lived experience « can make difficult-to-acknowledge information accepted and heard » by childbearing women and their families - way to go! #Marcé2022 @TheMarceSociety pic.twitter.com/8omUhbuzJy

— Antje Horsch (@DrAntjeHorsch) September 19, 2022

Powerful start to this session - keeping mums at the centre of all we do #marce22 @TheMarceSociety @BipolarUK @ActionOnPP @LauraDockrill @jonesir @Macdench @rcpsychPeri pic.twitter.com/YApKMKDC0D

— Julie Anderson (@drjulespsych) September 19, 2022

Now listening to service user’s perspectives on women’s and families needs from #PerinatalMentalHealth services. #Marce2022 @TheMarceSociety #PostpartumPsychosis #LivedExperience pic.twitter.com/fJGBZbJyEm

— Lara Seefeld (@seefeld_lara) September 19, 2022

Peer supporters employed and integrated into multidisciplinary care - I wish we could have such a model of care in Switzerland 🇨🇭 #Marcé2022 ⁦@TheMarceSociety⁩ pic.twitter.com/WyeQK1k0c0

— Antje Horsch (@DrAntjeHorsch) September 19, 2022

Postpartum psychosis: strategies and collaborations to increase knowledge, address stigma and improve care globally

This session was chaired by our CEO Dr Jess Heron and featured discussion from Hannah Bissett as well as Dr Sally Wilson, APP’s National Training and Research Coordinator. The APP team presented evaluations of some of APP’s projects including: APP’s health professional training in PP; peer support services; the ongoing campaign for Mother & Baby Units; and outlined the way care for PP has changed over the past 10 years. The discussion focused on the impact evaluation of each project, exploring the ingredients for lasting impact, lessons learned, and how this learning might be used to influence care for women and families affected by PP globally.

Lack of parent-infant units (supporting admission of birthing individual and their infant to inpatient care) can be catastrophic. Lifelong trauma, shame, indignity, isolation. Sign petition for parent-infant units in Northern Ireland: https://t.co/lWpH4rHWTf #Marce22 @ActionOnPP pic.twitter.com/9m8wsmWf0Y

— Dr. Catriona Hippman (@catriona_hippma) September 23, 2022

Thank you @catriona_hippma - great to have you there yesterday.

So grateful for #peersupport and @ActionOnPP: they saved my life 💜#Marce22 @TheMarceSociety #perinatalmentalhealth https://t.co/frZUBTcsrq

— Dr Sally Wilson (@SallyMacWils) September 24, 2022

Brilliant to hear what an impact @ActionOnPP has had since 2013. We need this in Canada! All maternity, psychiatric, and primary care providers should be competent to care for people who develop postpartum psychosis @lifewithababy @canpmhc @bcmidwives @SOGCorg @CMA_Docs #Marce22 pic.twitter.com/8C5l9s1OhT

— Dr. Catriona Hippman (@catriona_hippma) September 23, 2022

@ActionOnPP isn't just for people with postpartum psychosis; it's for partners and carers as well! #postpartumpsychosis #PP #PPP #partners #peersupport #Marce22 pic.twitter.com/hrIPvve5fU

— Dr. Catriona Hippman (@catriona_hippma) September 23, 2022

About the International Marcé Society for Perinatal Mental Health

The International Marcé Society for Perinatal Mental Health was formed at an international conference in 1980. The purpose of that conference was to bring together different strands of research in puerperal mental disorders. It was recognised that there needed to be a forum to discuss puerperal mental illness in its broadest sense, and as such the Society was formed. The Society was named after Louis Victor Marcé, a French psychiatrist who wrote the first treatise entirely devoted to puerperal mental illness, published in 1858.

Other notable sessions at this year’s conference included Postpartum Psychosis: Cross-cultural conceptualisation in Malawi, India and the UK; Advances in the Pharmacology of Mood Disorders during Pregnancy; Offspring of parents with Psychosis: Pre-postnatal indicators of risk and resilience; Consensus and Controversies in the classification of Postpartum Psychosis in DSM-V; Prophylactic medication in pregnant women with bipolar disorder; as well as a session focused on fathers’ mental health: Fathers’ Perinatal Experiences, Mental Health and Impact on Family Health.

Kathryn Grant (APP Volunteer) sharing her lived experience for the session ‘Prophylactic medication in pregnant women with bipolar disorder’

#Marce22 keynote @LucyChappell2 @DHSCgovuk @NIHRresearch . Wonderful to hear about the importance of #perinatalmentalhealth #research - and that #postpartumpsychosis is a priority. Input of women & families as stakeholders to ensure that #livedexperience is heard @ActionOnPP 💜 pic.twitter.com/ujmyZFMEXs

— Hannah Bissett (@spannerb79) September 21, 2022

Enjoyed discussing prophylactic medication use in pregnant women with bipolar and new data at our #marce22 @TheMarceSociety symposium with experts Prof Veerle Bergink, Dr Angelika Wieck @katgrant30 and @jonesir pic.twitter.com/F2g0mK6L71

— Dr Marisa Dias (@MarisaCDias) September 22, 2022

Great panel discussion, with @ClareDolman, our PPI Lead, speaking to the topic of 'Consensus and Controversies in the classification of Postpartum Psychosis in DSM-V' #Marce22 pic.twitter.com/jF2GBPMEnM

— SWMH IoPPN, UK (@SWMH_IoPPN) September 21, 2022

What a great week at the @TheMarceSociety conference 💜

Great to meet so many people face-to-face and talk to them about #perinatalmentalhealth and #pospartumpsychosis research@ActionOnPP #marce22 pic.twitter.com/B3KjAeqeQr

— Dr Sally Wilson (@SallyMacWils) September 26, 2022

Thank you to @TheMarceSociety and @ActionOnPP for making me feel so welcome at my first perinatal MH conference! Inspired by your compassion & brilliance to develop research on psychological approaches to support women & families who have experienced postpartum psychosis.#Marce22

— Dr Jo Hodgekins 💙 (@johodgekins) September 21, 2022

Find out more about the conference here

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APP has contributed to a Government call for evidence to inform the first ever Women’s Health Strategy for England which was published on 20 July 2022. We asked the Government to ensure that the strategy improved the lives of women affected by postpartum psychosis through continued investment in specialist perinatal mental health services, prioritising research into PP and improving support for women with PP during the menopause. We welcome these pledges, however committed funding is needed and we will continue to campaign for the needs of women with PP to be addressed in implementing this strategy.

Perinatal mental health services

“The package includes £100 million for bespoke parent-infant relationship and perinatal mental health support. We are increasing provision of specialist community perinatal mental health services, which provide care and treatment for women with moderate to severe or complex mental health needs, and support the developing relationship between mother and baby. They also offer women with mental health needs advice for planning a pregnancy. The Long Term Plan commits to at least 66,000 women with moderate to severe or complex perinatal mental health needs having access to specialist community care”

Research

A recent study found that although affecting 20% of women, perinatal mental health receives only 4% of all research investment in pregnancy. The Women’s Health Strategy sets a 10-year ambition that “there is more research into women’s health issues – for example, gynaecological conditions, menstrual health, fertility, pregnancy, menopause and post-reproductive health – which leads to a greater understanding of conditions that impact women and how we can meet women’s health needs”.

Menopause

The Government has set a 10-year ambition that “women can access high-quality, personalised menopause care within primary care and, if needed, specialist care in a timely manner, and disparities in access to menopause treatment are reduced” and that “healthcare professionals in primary care are well informed about the menopause, and able to offer women evidence-based advice and treatment options, including HRT and alternatives”

APP welcomes The Women’s Health Strategy for England pledge to invest £100 million in community perinatal mental health services and parent-infant support. We continue to campaign for equal access to MBU beds across the UK.

Changes to the Mental Health Act - what do they mean for women with PP and their families?

APP took part in a Government consultation on changes to the Mental Health Act in January 2021. The Mental Health Act is the legal framework for detaining a person for mental health treatment (being “sectioned”). As PP can escalate quickly and women with PP may lack capacity to make decisions about their own treatment, many women are admitted to hospital under the Mental Health Act.

A draft Bill was published in July 2022 and we are pleased to see the following changes which are especially relevant to families affected by PP

• There is a greater focus on patient choice and autonomy in making decisions about what treatment they would want if they should lose capacity.
• Patients can draw up an ‘advanced decision’ which explains their treatment preferences, and appoints a ‘nominated person’ to advocate for these treatments if they are detained. This can be a partner, family member or friend. The advanced decision is valid if signed by the patient, nominated person and a health professional.
• Any admission to hospital under the Mental Health Act should have a clear therapeutic benefit.
• Patients needing to be detained can no longer be held in a police cell or prison when waiting for assessment.

APP highlighted that we believe a perinatal mental health professional should be consulted in decisions to detain a woman with PP. In our experience, other mental health professionals may not be aware of the level of risk in PP, and the way that symptoms can ‘come and go’ in the early stages of the illness. This means that a woman may be assessed as having capacity or low risk when this can quickly change - causing delays to the urgent admission she needs.

APP also stressed that women with PP should always be admitted to a specialist Mother and Baby Unit as these provide specialist skills and a clear therapeutic benefit for the whole family unit. We believe that the separation of mothers and babies in general psychiatric wards goes against the principles of the new Mental Health Act.

We are very grateful to families with personal experience of bereavement due to PP who courageously shared their experience with us to include in our submission to the Government.

APP welcomes the new draft Mental Health Bill which protects the rights of women with PP who are sectioned to treatment with ‘clear therapeutic benefit’. APP has advised that all admissions under Mental Health Act for women with PP should be to a MBU.