It was amazing to be at the House of Commons last week for the #HopeDec09 event, organised by obstetrician, Raja Gangopadhay, and attended by around 150 others with an interest, passion or professional role in perinatal mental health.

APP’s Chair, Giles Berrisford, opened proceedings in his role of Associate National Clinical Director PMH, reporting that things do seem to be changing and there is more awareness and profile than ever before, but of course, there is so much more to do.

It is always inspiring to hear Alain Gregoire of the MMHA speak and his words about maternal mental health and its far-reaching consequences being “the most important issue for humanity today” was really great to hear. 

I wish there had been more time to talk about APP and the amazing peer support it offers, together with our pilot Regional Reps work to spread awareness of the organisation and that PP can affect anyone, as it did me. This slide said a lot for me: "Full Recovery is Possible. Please seek help early. No-one is immune." 

The event focused on the importance of addressing mental health conditions during pregnancy and beyond and we heard from a diverse range of those with “lived experience” – it is so important to share these stories. PP and schizophrenia were powerfully presented by artist, Sanchita Islam and PND movingly by Lindsay Robinson of haveyouseenthatgirl.com and Mark Williams of Fathers Reaching Out Wales.

Antoinette Sandbach MP also had a number of people in tears as she spoke emotively about her experience of bereavement and the effect that this can have on women and families. The heads that nodded along (including my own), as if to say “me too” at various times during all of the speeches was really amazing to see.

It was fantastic that the whole of the UK and beyond was represented in the room, with people standing up to talk about changes in Scotland and the ongoing campaign for a Mother & Baby Unit in Wales. Lindsay had also spoken of changes she is working towards in Northern Ireland. As a proud Yorkshire lass, I enjoyed meeting up with others from the north – it is sometimes easy for us to be forgotten in the blur of all things perinatal and activity that naturally often centres on London and the other big cities. I had great conversations with another peer support organisation Raindrops to Rainbows, who are based in the north-east and supporting women and families affected by PND, so there may be ways for us to link in in the future. Our chats continued on the train north at the end of a long, exciting and inspirational day.

Words from representatives of the Royal Colleges of GPs and Midwives together with a former Royal Obstetrician and a response from the Duchess of Cornwall which was read to the room showed that the event had a really high profile. Together with those from the media and a range of organisations I hope that this really gave the event some clout to effect real change. I hear that it trended on Twitter throughout the day – surely the mark of success!

Hannah Bissett is APP's Assistant Peer Support Coordinator. 

Congratulations to APP Peer Support Coordinator, Ellie Ware, who has been appointed to the Executive Group of the Sussex Perinatal Mental Health Clinical Network.

Sussex is one of 20 areas across the country which will benefit from funding to improve care for pregnant women and new mums experiencing, or at risk of experiencing, mental health difficulties.

The Executive Group is intended to be the "driving vehicle for the perinatal mental health programme of work" and oversee delivery of outcomes. In other words, make sure that change happens and services improve. Ellie says:

Fantastic recognition for the good work APP does!

APP Director, Dr Jess Heron, was invited to 10 Downing Street to attend a reception of small charities across the UK that make a big difference to people's lives.

The government recognises that the economic climate is hard for small charities and has pledged to find ways to help small charities doing good work become sustainable.

Dr Heron said "It's fantastic for our work and the amazing dedication of our volunteers to be recognised in this way. We know that we save lives and that we have caused a sea-change in public interest and understanding of PP, but it's great when it's recognised by others"

On 30th Nov Dr Jess Heron, Director of APP was asked to speak on Radio Wiltshire's Breakfast programme. She was asked to respond to the news that Wiltshire mum, Holly York, said that the NHS let her down after she gave birth and was suffering from extreme Postpartum Psychosis.

Jess took the opportunity to explain more about Postpartum Psychosis and to comment on its current status within the field of perinatal mental health. In addition she made an appeal for continued support of APP charity as a consequence upon the ending of major funding by The Big Lottery.

You can listen again here.

The Marce Society was founded in 1980 by Professor Ian Brockington (also founder of APP’s research network). The Society promotes research into the mental health of women, their infants, and partners around the time of childbirth, and the Marce Society’s biennial conference plays host to the most cutting edge international research in Perinatal Mental Health. Dr Sue Smith, Consultant Perinatal Psychiatrist, Cardiff, first attended the Conference in 1996. She reports for APP on the differences she has noticed between then and now.

On returning from the Marcé biennial meeting in Melbourne in September I was keen to consolidate the copious notes I had made and summarise what I had learnt. Digging around in my office I found that I had done a similar exercise after attending my first Marcé meeting in London in 1996. I was struck by the similarities between what was presented and discussed then and what was still on the agenda 20 years later.

However what has changed is the number of people who are talking about perinatal mental health, the increased multidisciplinary aspect of the membership of the Marcé, the input from women with lived experience and the ‘women power’ represented by the number of recent female presidents!

It is probably fair to say that in 1996 perinatal mental health services were regarded as something of a luxury. Twenty years on despite still trying to understand the biological underpinnings of peripartum mood disorder (and I left scratching my head after some of these talks!) the absence of a service is now more of a talking point than the presence of one. In the UK the tireless work of the Maternal Mental Health Alliance has highlighted the areas where services are lacking - and the hope is that its launch globally, announced at the conference by Alain Gregoire, will achieve similar things on a worldwide scale.

Accepting that for many countries services are limited and that those attending Marcé are likely to be people from places where services are developing or have developed, it is still impressive that I heard many inspirational talks from various parts of the world including  Australia, New Zealand, Canada, USA, Portugal, Scandinavia, France, Malaysia, Bangalore and of course the UK.

A major theme throughout the conference was the importance of pregnancy and within this  a particularly fascinating talk was given by Rachel Yehuda from the USA. Her work on holocaust survivors may have demonstrated that psychological difficulties in their offspring could be related to preconception effects of trauma, passed on at conception and further developed during pregnancy.

The concept "It takes a village to raise a child" was a lovely way of introducing a number of talks about how in western societies the role of the family and wider social networks in supporting women in the postnatal period has largely been lost. The challenge is how to replicate this sensitively within the networks of professionals women now encounter in the perinatal period.

There were a number of presentations about fathers and the importance of acknowledging their part in it all. It was interesting to hear about a service where dads were texted daily to ask how they were. It also reminded them to complement their wives/ partners who appreciated this even though they knew they had needed prompting to do it! It was great to see Mark Williams from Wales talk passionately about his experience when his wife suffered severe postnatal depression - though I think his "by 'ere" may have confused some people!

On the theme of decision making about and within pregnancy, it was great to hear Claire Dolman talking about the dilemmas of pregnancy in bipolar disorder and the recent BJPsych open article she did with Ian Jones and Louise Howard.

Simone Vigod from Toronto talked about a decision aid they are developing regards taking antidepressants during pregnancy. Initial results did not demonstrate a great reduction in decisional conflict but with some refinement this could be a very useful tool.

It is very unusual to see a drug company representative at a perinatal meeting but Sage Therapeutics from the USA bucked this trend by presenting their very early but potentially exciting research using allopregnanolone, a metabolite of progesterone, for postnatal depression. It is early days but initial results were promising so watch this space!

It wasn’t all hard work - the Gala Dinner was followed by us being taught how to do Bollywood dancing in advance of the next meeting in Bangalore - some of you may recognise who is getting into the swing of it all!

My take home messages were
-  pregnancy is a very important time
-  more research is still needed regards the biological underpinnings of peripartum mood disorders as every answer we get provokes another question
-  remember the dads
-  a lot of people care about this field including those with the power to do something about it i.e those with the purse strings - so we have to keep nagging!
- roll on Bangalore 2018