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Perinatal and Infant Mental Health

Sat 12 Dec 2015

Parent Infant Partnership (PIP) is a leading partner of the Association of Infant Mental Health and member of the Maternal Mental Health Alliance. We are working in colloboration with both organisations to support a national step change for perinatal and infant mental health across the country.

The place of a PIP service within an adult mental health perinatal strategy.

The prime task of the early intervention delivered by a PIP team is to improve or maintain the overall quality of the relationship between the caregiver and their baby or toddler so the child’s subsequent developmental trajectory is as favourable as is possible.  Referrals are taken on the basis of risk, making this a truly preventative service as help can be offered before too much has gone awry in the relationship between caregiver and baby. This differs from a perinatal service where intervention is limited to parents, mostly mothers, struggling with severe mental illness. In this way both services will be sometimes be working alongside each other, protecting and encouraging the establishment of all the positive parental hopes and fantasies that accompany the birth of a baby and the start of a family. All parents want their children to do well in life, but for some their circumstances militate against this.  The relationships parents have with their baby is the greatest asset they can pass on; neither teaching, television nor toys can ever replace this; and later in life, without a positive early relationship none of these will be used to advantage.  So getting it roughly right at the beginning sets up a good foundation for the future for the child, the family and ultimately for society.

Since the caregiving relationship may be negatively influenced by many issues in the life of the mother and father, including the risk of mental ill-health over the perinatal period, all therapeutic work can begin before the birth of the child.  PIP teams are in a position to support the work of perinatal teams over the entire perinatal period, but with a significantly different focus on the caregiving relationship rather than the mental state of the parent. Pregnancy should be a safe time for the baby, so therapy can concentrate on parental and practical issues, although many issues, including the high level of stress that may accompany mental illness, can have a negative impact on the foetus. All PIP teams use a risk factor analysis in order to identify potential stressors on or within a vulnerable family that may have a negative influence of the central parent baby relationship, and this can be used to identify families where extra help might be needed before the baby is born.

Once the relationship becomes the target of intervention then this perspective opens the way to intervening at many different points in the system, some quite distal from either parent or baby but still a source of stress that is impinging on the relationship.  This reinforces the importance for both a PIP and a perinatal team to be well embedded in the wider professional network around parents and parents to be. Every time we can help to reduce the overall burden on a family then we are removing an obstacle to its success and increasing the likelihood of the child’s positive development.  Almost invariably this calls for complex multi-agency working. PIP UK supports all forms of preventative intervention that aim to protect and improve the caregiving relationship, and through the 1001 Critical Days Campaign has catalysed dynamic connections between multiple statutory and voluntary agencies as well as creating links with many strands of relevant cutting edge research in the UK.