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Marce Society

Today (17/09/15) Cocoon was thrilled to attend the UK and Ireland Marce Society meeting in central London.  It was a packed agenda, with the latest research in perinatal mental illness, parent – infant interactions, risk factors and treatments.  Marce is the oldest and most respected research organisation in this field, and the meeting attracted leading professionals from across academia and clinical practice.
The various sessions could loosely be grouped into: risk factors, impacts, and treatments.  A selection of the more accessible presentations are summarised below.
Overall, it was a fantastic day of learning and fellowship.  Connecting with other peer support charities over lunch was a particular highlight, as was finding other people keen to help with a future anti-stigma campaign, particularly from an ethnic minority background.
Cocoon hopes to attend many more Marce events in the future, and continue to learn and grow from absorbing this latest research and vast clinical experience.
Risk factors
Dr Rima Lamba gave a fascinating talk on her doctoral research into migrant Pakistani-Muslim women’s experience of PND.  Her talk brought home the impact that cultural and psychosocial factors can have – both in the illness, and its treatment.
Katie Hazelgrove and Alessandra Biaggi summarise their PhD project, an extensive study of risk factors for postpartum psychosis.  The “markers” they described included brain factors, stressful or traumatic life events, hormones, inflammation, “social cognitive” evaluation and neurology.
We heard a fascinating report into the incidence of “tocophobia” which translates into a fear of birth, and pregnancy.  This has been under recorded and under researched, but is slowly becoming more understood.  It is thought to occur in up to 1 in 10 women.  Women with previous birth trauma or still birth are known to be at much higher risk (of “secondary” tocophobia).
Both Dr Alain Gregoire and Dr Trudi Seneviratne gave talks on the measurement of patient outcomes in the perinatal field.   This included he new “POEM” method: Patient-rated Outcome and Experience Measure.  Look out for a survey form coming to a clinic near you!
Lauren Capron told us of her investigative work into antenatal depression and anxiety and impacts on the function of the placenta.  She has found a relationship (as measured by the “HPA axis” or stress hormone response mechanism), but only in a Caucasian sub sample.
Treatments and Service Improvements 
Cheryl Adams, from the Institute of Health Visiting, gave an update on their Perinatal Mental Health Champions project.  They have now trained almost 600 health visitor champions, in a cascading “Train the Trainer” model.  Their perinatal mental health training modules are available freely online, on the iHV website.
Louise Howard gave a comprehensive account of the updated NICE clinical guidelines (CG192) and how these might be implemented.  She was the chair of the guideline development group, as well as a practicing perinatal psychiatrist and a woman with lived experience of PND!
She summarised the guidelines as:
– identification of women with mental health problems
– comprehensive assessment of their needs
– integrated care plans
– treatment options
– assessment of the Mother – Baby relationship
– Information and advice.
She explained that there were many barriers to successful implementation of the guideline.  However, she also identified many possible solutions:
– Trusts performing “gap analysis” of their services
– NICE audit tools and implementation guide
– NHS England’s “Access and Waiting Time” programme (includes: a commissioning guide, perinatal IAPT, and new funding of £15M a year for 5 years)
– The Chief Medical Officer’s annual report
– A possible perinatal anti-stigma campaign.

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