Community Perinatal Mental Health Team

The Community Perinatal Mental Health Team (CPMHT) welcomes referrals across the NHS Lothian area for women in the perinatal period (from pre-conceptual advice, until the baby’s 1^st birthday). Direct referrals are accepted from any health professional. The service is based at St John’s hospital, Livingston, and provides outreach across the City of Edinburgh, East Lothian, Midlothian and West Lothian. These outreach services include clinics at a variety of locations.

Please note that the team can only accept referrals for women / birthing parent who are, or will be, the primary carer for the baby.

The Lothian CPMHT consists of Consultant Psychiatrists, a Nurse Consultant, Team Leader, Community Psychiatric Nurses (designated nurses covering specific Lothian regions), Nursery Nurses, Consultant and Clinical Psychologist, a Perinatal Social Worker, Parent Infant Therapist, Junior Doctors, Occupational Therapy, Specialist Midwife and Specialist Pharmacist.

Professionals Clinical Advice Line

The service offers routine perinatal mental health advice to all professionals across Lothian:

Monday to Friday 10:00 – 16:00 each week, except public holidays.
Please call on 01506 523918 (53918) during these times
Email: loth.perinatalcommunitymentalhealth@nhs.scot.

PLEASE NOTE THAT THESE PHONE NUMBERS / EMAIL ADDRESS ARE FOR PROFESSIONAL USE ONLY.

Urgent Perinatal Mental Health Advice

To discuss an urgent clinical matter please contact the team Monday – Friday 10:00 – 16:00 on 01506 524 176
Out of hours please use existing local urgent and emergency mental health referral routes (eg MHAS, IHTT) or self-presentation at A&E for assessment.

Services provided.

The service does not currently provide an emergency assessment service. If that is needed, please use existing local urgent mental health referral pathways, or self-presentation at A&E for assessment. However, the CPMHT is happy to receive onwards referrals from existing mental health crisis services (eg MHAS, ACAS and IHTT), and to offer joint assessment where possible.

Services provided include:

Pre-conception counselling for patients with significant psychiatric illness and/or complex medication regimes (e.g. history of bipolar affective disorder)
Mental health assessment and management during pregnancy and the postpartum period (moderate-severe illness)
Pre-birth planning and monitoring for patients who are at high risk of significant perinatal illness (e.g. where there is a history of bipolar affective disorder, previous postpartum psychosis, schizophrenia, significant affective disorder, eating disorder).

Management of mild-moderate mental health conditions in primary care
Women who have a mild-moderate mental health condition should be engaged with first-line treatment in primary care, including options such as referral to local counselling services or primary care psychology, and medication where indicated. Where appropriate, please also refer to third sector organisations – please see the Perinatal Mental Health Resources and Links page for more detail.

Where additional parenting support is required, this should be discussed with the Health Visitor and involvement with local agencies considered.

Medication information and advice can also be sought from NHS Lothian Medicines Information Service (0131 242 2920) and please see NHS Lothian’s handout on antidepressants.

Online resources, updated nationally, include:

Bumps – Best use of medicines in pregnancy
Choice and Medication leaflets – Drugs in Pregnancy printable leaflets

The CPMHT is happy to provide advice on management options to primary care if needed.

Who can refer:

Referrals are accepted from any health professionals including Midwives, GPs, Health Visitors, Psychiatrists and CPNs.

Referrals can also be accepted directly from Social Workers.

Who to refer:

Women with current moderate/severe mental ill health that has not responded to management in Primary Care and/or where the risks cannot be managed safely in Primary Care.
Women – even if they appear well – who:
1. Have a previous history of perinatal mental illness (e.g. postnatal depression, postpartum psychosis, severe depression, anxiety, PTSD or OCD), that required treatment in hospital/secondary care.
2. Have a diagnosis of bipolar affective disorder, schizophrenia, schizoaffective disorder, or other psychotic illness. Previous history of severe recurrent depression that required treatment in hospital/secondary care.
3. Have a family history of bipolar affective disorder, schizophrenia or postpartum psychosis where there is also a personal history of moderate – severe mental ill-health.
4. Are currently prescribed a complex psychotropic regime, Sodium Valproate, or other mood stabiliser, for pre-conceptual advice.

The CPMHT is keen to ensure equity of access to service users from our diverse communities, including where English is not the first language. In this case, please inform the service, which can arrange interpreting services where appropriate, or other approaches to facilitate engagement.

The CPMHT is keen to ensure equity of access to services from LGBTQ+ backgrounds including gestational fathers where there is a moderate-complex history of mental illness.

Who not to refer:

Women whose babies are over a year old
When the woman is not the primary carer for the infant.

Those requiring emergency assessment, which should be sought through existing local urgent referral pathways (see Emergencies Mental Health (Adults) for detail).