European Psychiatry - Volume 41 - April 2017

68 / 916

S64 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S53–S68
Workshop: Mothers with major mental illness and
their young infants: Can we meet the challenges?
W037
Risks and challenges in perinatal
mental health
A. Wieck
Laureate House, Wythenshawe Hospital, Manchester, United
Kingdom
Mental illness affects 1 in 5 women during pregnancy and the first
year postnatal and in about 1 in 20 women the condition is serious.
When a woman with major mental illness becomes pregnant she
and her child face a number of risks. These include poor pregnancy
and neonatal outcomes and a sharp rise of psychiatric admissions
after childbirth. Mental illness is also one of the leading causes
of maternal death. Risks to children are impaired parenting and
developmental disadvantage in emotional, behavioral and cogni-
tive domains. Parental mental illness also has a significant role in
infanticide and abuse-related serious harmto children, with infants
<1 year old being most at risk.
A recent analysis has shown that the resulting economic costs
to public services and the wider society are extremely high. In
view of the wide-ranging consequences, a number of European
countries have set up specialized perinatal mental health ser-
vices. These consist of specialized inpatient units and community
teams. The essential components of their service are preconception
counselling, expert advice on the use of medication during preg-
nancy and breastfeeding, joint inpatient admissions of mothers and
babies, interventions to improve parenting, and advice to children’s
social services. None of these countries, however, are yet offering
universal access.
In order to improve service provision and outcomes it is impor-
tant that perinatal mental health is acknowledged more widely as
a public health priority. The workshop will provide an opportu-
nity for participants to discuss approaches to raise awareness and
promote perinatal service developments.
Disclosure of interest The author has not supplied his declaration
of competing interest.
W038
Psychiatric mother and baby inpatient
units
F. Gressier ∗, N.M.C. Glangeaud , A. Mezzacappa , O. Cazas ,
A.L. Sutter-Dallay
1 Assistance publique-hôpitaux de Paris- Bicêtre, University hospital,
Department of Psychiatry, Le Kremlin Bicêtre, France
2 Université Paris-Saclay, Université Paris-Sud- UVSQ- CESP- Inserm
U1178, Bicêtre university hospital, Le Kremlin Bicêtre, France
3 Inserm, UMR 1153- Obstetrical- Perinatal and Pediatric
Epidemiology Research Team Epopé, Paris, France
4 Research center Inserm 1219, Population health Bordeaux
university, Bordeaux, France
5 University department of Adult Psychiatry, Charles-Perrens
hospital, Bordeaux, France
∗ Corresponding author.
During the perinatal period, women may experience severe mental
health problems. Research has shown the potential negative impact
of mother-baby’s separation and of parental psychiatric illness, on
the child. MBUs care requires different staff’s expertise in order
to: treat women with psychiatric disorders, ensure child care and
development, and support appropriate mother–infant interaction
with “good enough” mothering. For this, a multidisciplinary team
is needed. Specific attention is also given to the child’s father. Most
MBUs may admit women with infants from birth till one year old
and during several weeks or months.
More than two third of admitted women are discharged either
symptom-free or greatly improved. An efficient follow up at dis-
charge should be prepared with the women, the child’s father,
when presents, and linked to familial, social andmedical resources.
Moreover, MBUs staff should collaborate with other psychia-
trists, obstetricians, midwives, pediatricians, and social workers.
Mother–baby units should be part of a local health perinatal net-
work including maternity unit, neonatal care, and community
resources.
Referral for admission in MBUs may be required for women with
a first acute episode, or a relapse, of a severe psychiatric disorder
such as postpartum psychosis, manic disorder, major depressive
episodes, schizophrenia, personality or behavior disorders. More-
over for prevention purposes, referral of women with known
chronic mental health problems may start already during preg-
nancy.
Challenge of benefice and limit of MBUs’ care will be discussedwith
participants.
Disclosure of interest Florence Gressier has given talks for
Lundbeck and Servier and received a grant from Servier for a post-
doctoral degree (2011-2012).
W039
Maternal mental illness and early
parenting interventions
A.L. Sutter-Dallay
Bordeaux University, Bordeaux Population Health, Bordeaux cedex,
France
The importance of the “1001 critical days” (conception to age 2)
underlies the need to act early in life to enhance children’s develop-
mental outcomes. Lack of intervention is likely to affect the children
of today but also the generations to come. For adults, transition to
parenthood is amajor stressful life event. The strong emotional load
of this experience can make this transitional period much more
challenging for adults with psychological, social and economic vul-
nerabilities, and lead to unadjusted interactions.
Then, applying the “transactional model of development”
(Sameroff, 2009) to the early perinatal period helps us to under-
stand how the needs of infants can easily affect a parent’s mental
state and induce inadequate parenting behaviors. These in turn
make the infant’s interactions more difficult and the infant’s devel-
opment more likely to be impaired. Perinatal mental health is thus
an important public health challenge for it is essential to provide
services to enhance maternal and infant emotional well-being at
a moment that is simultaneously when the mother’s social and
emotional vulnerabilities are at their height and a critical time in
the child’s development.
Perinatal mental health policies, including joint care of parents and
infants, must provide positive support for the potential virtuous
circle between the skills and vulnerabilities of the infant and the
parents.
This presentation will explore the different types of joined peri-
natal care for parents and infants that cover a range of services,
from parent-infant psychotherapies to joint mother-baby hospi-
talizations.
Disclosure of interest The author has not supplied his declaration
of competing interest.