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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?


Risks and challenges in perinatal

mental health

A. Wieck

Laureate House, Wythenshawe Hospital, Manchester, United


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.


Psychiatric mother and baby inpatient


F. Gressier

1 , 2 ,

, N.M.C. Glangeaud


, A. Mezzacappa


, O. Cazas



A.L. Sutter-Dallay

4 , 5


Assistance publique-hôpitaux de Paris- Bicêtre, University hospital,

Department of Psychiatry, Le Kremlin Bicêtre, France


Université Paris-Saclay, Université Paris-Sud- UVSQ- CESP- Inserm

U1178, Bicêtre university hospital, Le Kremlin Bicêtre, France


Inserm, UMR 1153- Obstetrical- Perinatal and Pediatric

Epidemiology Research Team Epopé, Paris, France


Research center Inserm 1219, Population health Bordeaux

university, Bordeaux, France


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


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-


Challenge of benefice and limit of MBUs’ care will be discussedwith


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).


Maternal mental illness and early

parenting interventions

A.L. Sutter-Dallay

Bordeaux University, Bordeaux Population Health, Bordeaux cedex,


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


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-


Disclosure of interest

The author has not supplied his declaration

of competing interest.