{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T09:28:32Z","timestamp":1788341312685,"version":"build-2803163510"},"reference-count":102,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002001","name":"Health and Social Care Delivery Research (HSDR) Programme","doi-asserted-by":"publisher","award":["17\/49\/38"],"award-info":[{"award-number":["17\/49\/38"]}],"id":[{"id":"10.13039\/501100002001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Soc Care Deliv Res"],"abstract":"<jats:sec id=\"abs1-1\"><jats:title>Background<\/jats:title>\n<jats:p>Perinatal mental health disorders affect one in five mothers during pregnancy or within 2 years post childbirth. These disorders can lead to poor pregnancy and childbirth outcomes and maternal deaths. Additionally, they negatively affect a child\u2019s cognitive, social and emotional development. Stigma and a lack of specialised services have limited access to mental health care. National Health Service England invested \u00a3365M in community perinatal mental health teams, but their impact on women and infants\u2019 outcomes are not known.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-2\"><jats:title>Objectives<\/jats:title>\n<jats:list list-type=\"order\">\n<jats:list-item><jats:p>Develop a taxonomy of community perinatal mental health teams (work package 1).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Compare and validate two assessments of quality of mother\u2013infant interaction for use by community perinatal mental health teams (work package 2).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Evaluate the effectiveness and cost-effectiveness of community perinatal mental health teams (work packages 3 and 4).<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:sec>\n<jats:sec id=\"abs1-3\"><jats:title>Design<\/jats:title>\n<jats:p>Mixed-methods study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-4\"><jats:title>Setting<\/jats:title>\n<jats:p>Community perinatal mental health teams in England.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-5\"><jats:title>Participants<\/jats:title>\n<jats:p>Women who were pregnant or within 2 years postnatal.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-6\"><jats:title>Methods and outcome measures<\/jats:title>\n<jats:p>Work package 1: Typology of community perinatal mental health teams in England.<\/jats:p>\n<jats:p>Work package 2: Reliability and validity of two observational assessments of parent\u2013infant interaction.<\/jats:p>\n<jats:p>Work package 3: Realist evaluation interviews with women, partners\/close others, and staff to determine effective community perinatal mental health team components.<\/jats:p>\n<jats:p>Work package 4: Analysis of linked data:<\/jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Association of community perinatal mental health teams with access to secondary care mental health services.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Risk of acute relapse and improved obstetric and neonate outcomes for women with pre-existing severe disorders in areas with community perinatal mental health teams compared to generic services.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Economic analysis of cost of community perinatal mental health teams.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:sec>\n<jats:sec id=\"abs1-7\"><jats:title>Results<\/jats:title>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Objective 1: Community perinatal mental health team typologies revealed in 2020, 84% had basic staffing levels and 63% had more multi-professionals.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Objective 2: The \u2018Parent Infant Interaction Observation Scale\u2019 and \u2018National Institute of Child Health and Human Development\u2019 assessments of mother\u2013infant interaction were reliable and valid; the National Institute of Child Health and Human Development is more suitable for community perinatal mental health teams.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Objective 3:<\/jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Work package 3: Interviews with 139 women, 55 partners\/close others and 80 health workers highlighted the importance of specialist perinatal knowledge, responding in a warm and non-judgemental way, working closely with other healthcare providers, optimising medication, supporting mothers to reduce conflict and improve social support, helping mother\u2013infant bonding, and teaching emotional management.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Work package 4: Analysis of linked health data revealed higher risks for obstetric and neonate problems in women with severe mental health disorders, particularly recent or very serious episodes.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Work package 4: Areas with community perinatal mental health teams saw increased mental health access among perinatal women and reduced need for acute care, albeit at a higher cost and with greater neonatal risks.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:list-item>\n<\/jats:list>\n<\/jats:sec>\n<jats:sec id=\"abs1-8\"><jats:title>Limitations<\/jats:title>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>High levels of missing data on diagnosis and mental health outcomes in existing health and service data.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Lack of data on child outcomes.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Evaluation occurred during community perinatal mental health team changes and the coronavirus disease discovered in 2019 pandemic limiting a full assessment of the impact of community perinatal mental health teams on maternal and child outcomes.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:sec>\n<jats:sec id=\"abs1-9\"><jats:title>Conclusions<\/jats:title>\n<jats:p>Community perinatal mental health teams can support perinatal women with complex, moderate\/severe mental health disorders, but further attention to women\u2019s physical needs is essential. The use of observational assessments of parent\u2013infant relationships will enhance the evaluation of community perinatal mental health teams\u2019 impact on infant outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-10\"><jats:title>Future work<\/jats:title>\n<jats:p>Research should focus on prospective studies that gather mental health and child outcomes from community perinatal mental health teams and primary care mental health, to assess broader impacts of perinatal-specific treatment across care pathways.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-11\"><jats:title>Study registration<\/jats:title>\n<jats:p>This study is registered on Research Registry as researchregistry5463.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-12\"><jats:title>Funding<\/jats:title>\n<jats:p>This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17\/49\/38) and is published in full in <jats:italic>Health and Social Care Delivery Research<\/jats:italic>; Vol. 13, No. 38. See the NIHR Funding and Awards website for further award information.<\/jats:p>\n<\/jats:sec>","DOI":"10.3310\/rrap0011","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:21:23Z","timestamp":1760782883000},"page":"1-92","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness and cost-effectiveness of community perinatal mental health services on access, experience, recovery\/relapse and obstetric and neonate outcomes: the ESMI-II mixed-methods study"],"prefix":"10.3310","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3458-430X","authenticated-orcid":true,"given":"Heather","family":"O\u2019Mahen","sequence":"first","affiliation":[{"name":"Mood Disorders Centre, Faculty of Life and Health Sciences, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9942-744X","authenticated-orcid":true,"given":"Louise","family":"Howard","sequence":"additional","affiliation":[{"name":"Section of Women\u2019s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0988-8718","authenticated-orcid":true,"given":"Helen","family":"Sharp","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5118-6912","authenticated-orcid":true,"given":"Antoinette","family":"Davey","sequence":"additional","affiliation":[{"name":"Mood Disorders Centre, Faculty of Life and Health Sciences, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1294-7719","authenticated-orcid":true,"given":"Louise","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6517-3485","authenticated-orcid":true,"given":"Ipek","family":"Gurol-Urganci","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3094-9255","authenticated-orcid":true,"given":"Margaret","family":"Heslin","sequence":"additional","affiliation":[{"name":"King\u2019s Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1046-7598","authenticated-orcid":true,"given":"Julia","family":"Langham","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2169-7138","authenticated-orcid":true,"given":"Ebun","family":"Makinde","sequence":"additional","affiliation":[{"name":"Mood Disorders Centre, Faculty of Life and Health Sciences, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4220-3626","authenticated-orcid":true,"given":"Emma","family":"Tassie","sequence":"additional","affiliation":[{"name":"King\u2019s Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1209-8167","authenticated-orcid":true,"given":"Silia","family":"Vitoratou","sequence":"additional","affiliation":[{"name":"Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7997-9468","authenticated-orcid":true,"given":"Jo","family":"Brook","sequence":"additional","affiliation":[{"name":"Tavistock and Portman NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2232-7464","authenticated-orcid":true,"given":"Gina","family":"Collins","sequence":"additional","affiliation":[{"name":"Mood Disorders Centre, Faculty of Life and Health Sciences, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0318-417X","authenticated-orcid":true,"given":"Chris","family":"McCree","sequence":"additional","affiliation":[{"name":"Centre for Parent and Child Support and Community Perinatal Services, South London and Maudsley Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6722-1006","authenticated-orcid":true,"given":"Dharmintra","family":"Pasupathy","sequence":"additional","affiliation":[{"name":"Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1283-0346","authenticated-orcid":true,"given":"Andrew","family":"Pickles","sequence":"additional","affiliation":[{"name":"King\u2019s Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-9595","authenticated-orcid":true,"given":"Sarah","family":"Morgan-Trimmer","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Institute of Health Research, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5384-4157","authenticated-orcid":true,"given":"Geoffrey","family":"Wong","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3012-4584","authenticated-orcid":true,"given":"Katie","family":"Atmore","sequence":"additional","affiliation":[{"name":"Section of Women\u2019s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8557-7276","authenticated-orcid":true,"given":"Debra","family":"Bick","sequence":"additional","affiliation":[{"name":"Warwick Clinical Trials Unit, University of Warwick, Warwick, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8629-1723","authenticated-orcid":true,"given":"Laura","family":"Bozicevic","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7466-1651","authenticated-orcid":true,"given":"Clare","family":"Dolman","sequence":"additional","affiliation":[{"name":"Section of Women\u2019s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-621X","authenticated-orcid":true,"given":"Jill","family":"Domoney","sequence":"additional","affiliation":[{"name":"Section of Women\u2019s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1357-9579","authenticated-orcid":true,"given":"Jessica","family":"Gay","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8528-8167","authenticated-orcid":true,"given":"Chloe","family":"Hayes","sequence":"additional","affiliation":[{"name":"Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2492-1552","authenticated-orcid":true,"given":"Jennifer","family":"Holly","sequence":"additional","affiliation":[{"name":"Section of Women\u2019s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9186-2330","authenticated-orcid":true,"given":"Miriam","family":"Refberg","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7084-1495","authenticated-orcid":true,"given":"Sarah","family":"Byford","sequence":"additional","affiliation":[{"name":"King\u2019s Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-2335","authenticated-orcid":true,"given":"Jan","family":"van der Meulen","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2025,10]]},"reference":[{"key":"key2025101815375200_ref1-bib1","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1016\/S0140-6736(14)61276-9","article-title":"Non-psychotic mental disorders in the perinatal period","volume":"384","author":"Howard","year":"2014","journal-title":"Lancet"},{"key":"key2025101815375200_ref2-bib2","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(14)61278-2","article-title":"Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period","volume":"384","author":"Jones","year":"2014","journal-title":"Lancet"},{"key":"key2025101815375200_ref3-bib3","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1192\/bjp.2017.9","article-title":"Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy","volume":"212","author":"Howard","year":"2018","journal-title":"Br J Psychiatry"},{"key":"key2025101815375200_ref4-bib4","doi-asserted-by":"crossref","first-page":"20m13398","DOI":"10.4088\/JCP.20m13398","article-title":"High prevalence and incidence of obsessive\u2013compulsive disorder among women across pregnancy and the postpartum","volume":"82","author":"Fairbrother","year":"2021","journal-title":"J Clin Psychiatry"},{"key":"key2025101815375200_ref5-bib5","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.jad.2016.10.009","article-title":"The prevalence of posttraumatic stress disorder in pregnancy and after birth: a systematic review and meta-analysis","volume":"208","author":"Yildiz","year":"2017","journal-title":"J Affect Disord"},{"key":"key2025101815375200_ref6-bib6","doi-asserted-by":"crossref","first-page":"102590","DOI":"10.1016\/j.midw.2019.102590","article-title":"The characteristics and prevalence of phobias in pregnancy","volume":"82","author":"Nath","year":"2020","journal-title":"Midwifery"},{"key":"key2025101815375200_ref7-bib7","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1192\/apt.bp.107.004333","article-title":"Puerperal psychosis: identifying and caring for women at risk","volume":"15","author":"Jones","year":"2009","journal-title":"Adv Psychiatr Treat"},{"key":"key2025101815375200_ref8-bib8","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1176\/appi.ajp.2015.15010124","article-title":"Risk of postpartum relapse in bipolar disorder and postpartum psychosis: a systematic review and meta-analysis","volume":"173","author":"Wesseloo","year":"2016","journal-title":"Am J Psychiatry"},{"key":"key2025101815375200_ref9-bib9","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1016\/S0140-6736(14)61277-0","article-title":"Effects of perinatal mental disorders on the fetus and child","volume":"384","author":"Stein","year":"2014","journal-title":"Lancet"},{"key":"key2025101815375200_ref10-bib10","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S2215-0366(18)30006-3","article-title":"Mitigating the effect of persistent postnatal depression on child outcomes through an intervention to treat depression and improve parenting: a randomised controlled trial","volume":"5","author":"Stein","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"key2025101815375200_ref11-bib11","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1001\/jamapsychiatry.2017.4363","article-title":"Association of persistent and severe postnatal depression with child outcomes","volume":"75","author":"Netsi","year":"2018","journal-title":"JAMA Psychiatry"},{"key":"key2025101815375200_ref12-bib12","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1017\/S0033291717001246","article-title":"Impact of dysfunctional maternal personality traits on risk of offspring depression, anxiety and self-harm at age 18 years: a population-based longitudinal study","volume":"48","author":"Pearson","year":"2018","journal-title":"Psychol Med"},{"key":"key2025101815375200_ref13-bib13","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1007\/s00127-019-01790-y","article-title":"Maternal personality traits, antenatal depressive symptoms and the postpartum mother\u2013infant relationship: a prospective observational study","volume":"55","author":"Nath","year":"2020","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"key2025101815375200_ref14-bib14","volume-title":"Costs of Perinatal Mental Health Problems","author":"Bauer","year":"2014"},{"key":"key2025101815375200_ref15-bib15","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.4088\/JCP.15r10174","article-title":"The perinatal depression treatment cascade: baby steps toward improving outcomes","volume":"77","author":"Cox","year":"2016","journal-title":"J Clin Psychiatry"},{"key":"key2025101815375200_ref16-bib16","doi-asserted-by":"crossref","first-page":"g7394","DOI":"10.1136\/bmj.g7394","article-title":"Antenatal and postnatal mental health: summary of updated NICE guidance","volume":"349","author":"Howard","year":"2014","journal-title":"BMJ"},{"key":"key2025101815375200_ref17-bib17","volume-title":"The Perinatal Mental Health Care Pathways","author":"NHS England","year":"2018"},{"key":"key2025101815375200_ref18-bib18","volume-title":"Perinatal Mental Health Services: Recommendations for the Provision of Services for Childbearing Women","author":"Royal College of Psychiatrists","year":"2015"},{"key":"key2025101815375200_ref20-bib20","volume-title":"Mental Health Services Monthly Statistics: Final July, Provisional August 2017","author":"NHS Digital","year":"2017"},{"key":"key2025101815375200_ref21-bib21","volume-title":"Perinatal Mental Health Community Services Development Fund: Application Guidance","author":"NHS England","year":"2016"},{"key":"key2025101815375200_ref22-bib22","volume-title":"Five Year Forward Review","author":"NHS England","year":"2014"},{"key":"key2025101815375200_ref23-bib23","volume-title":"The NHS Long Term Plan. Vol. 1.2","author":"NHS England","year":"2019"},{"key":"key2025101815375200_ref24-bib24","volume-title":"Realistic Evaluation","author":"Pawson","year":"1997"},{"key":"key2025101815375200_ref25-bib25","volume-title":"Competency Framework for Perinatal Mental Health","author":"Health Education England","year":"2018"},{"key":"key2025101815375200_ref26-bib26","volume-title":"Antenatal and Postnatal Mental Health: Quality Standard [QS115]","author":"National Institute for Health and Care Excellence","year":"2016"},{"key":"key2025101815375200_ref27-bib27","volume-title":"Standard for Community Perinatal Mental Health Services","author":"Royal College of Psychiatrists","year":"2007"},{"key":"key2025101815375200_ref28-bib28","volume-title":"What Does Good Perinatal Clinical Psychology Provision Look Like?","author":"British Psychological Society","year":"2019"},{"key":"key2025101815375200_ref29-bib29","volume-title":"Implementing Routine Outcome Monitoring in Specialist Perinatal Mental Health Services","author":"Marriott","year":"2019"},{"key":"key2025101815375200_ref30-bib30","doi-asserted-by":"crossref","first-page":"1399841","DOI":"10.3389\/fpsyg.2024.1399841","article-title":"Identification of vulnerable mother-infant dyads in the perinatal period: a psychometric evaluation of two observational coding systems using varying interaction periods","volume":"15","author":"Sharp","year":"2024","journal-title":"Front Psychol"},{"key":"key2025101815375200_ref31-bib31","volume-title":"FROM-Perinatal Framework for Routine Outcome Measures in Perinatal Psychiatry","author":"Manning","year":"2018"},{"key":"key2025101815375200_ref32-bib32","volume-title":"MRC Cohort Directory: Wirral Child Health and Development Study","author":"Medical Research Council","year":"2023"},{"key":"key2025101815375200_ref33-bib33","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/02646838.2012.751586","article-title":"The Parent-Infant Interaction Observation Scale: reliability and validity of a screening tool","volume":"31","author":"Svanberg","year":"2013","journal-title":"J Reprod Infant Psychol"},{"key":"key2025101815375200_ref34-bib34","volume-title":"The Parent-Infant Observation Scale Manual","author":"Svanberg","year":"2009"},{"key":"key2025101815375200_ref35-bib35","volume-title":"Qualitative ratings for parent-child interaction at 3\u201315 months","author":"Cox","year":"2003"},{"key":"key2025101815375200_ref36-bib36","volume-title":"The NICHD Study of Early Child Care Mother\u2013Infant Interaction Scales","author":"Owen","year":"1992"},{"key":"key2025101815375200_ref37-bib37","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/j.1467-8624.2009.01296.x","article-title":"Differential effects of maternal sensitivity to infant distress and nondistress on social-emotional functioning","volume":"80","author":"Leerkes","year":"2009","journal-title":"Child Dev"},{"key":"key2025101815375200_ref38-bib38","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1037\/0893-3200.20.2.247","article-title":"Maternal sensitivity to infant distress and nondistress as predictors of infant-mother attachment security","volume":"20","author":"McElwain","year":"2006","journal-title":"J Fam Psychol"},{"key":"key2025101815375200_ref39-bib39","volume-title":"Manual for the ASEBA Preschool Forms and Profiles","author":"Achenbach","year":"2000"},{"key":"key2025101815375200_ref40-bib40","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/jpepsy\/jsh017","article-title":"The brief infant-toddler social and emotional assessment: screening for social-emotional problems and delays in competence","volume":"29","author":"Briggs-Gowan","year":"2004","journal-title":"J Pediatr Psychol"},{"key":"key2025101815375200_ref41-bib41","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1111\/j.1467-8624.1997.tb01967.x","article-title":"The effects of infant child care on infant-mother attachment security: results of the NICHD study of early child care","volume":"68","author":"NICHD Early Child Care Research Network","year":"1997","journal-title":"Child Dev"},{"key":"key2025101815375200_ref42-bib42","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/14616734.2016.1259335","article-title":"Parenting in infancy and self-regulation in preschool: an investigation of the role of attachment history","volume":"19","author":"Birmingham","year":"2017","journal-title":"Attach Hum Dev"},{"key":"key2025101815375200_ref43-bib43","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1017\/S0954579404044499","article-title":"The course of maternal depressive symptoms and maternal sensitivity as predictors of attachment security at 36 months","volume":"16","author":"Campbell","year":"2004","journal-title":"Dev Psychopathol"},{"key":"key2025101815375200_ref44-bib44","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.infbeh.2006.11.010","article-title":"Infant and parent factors associated with early maternal sensitivity: a caregiver-attachment systems approach","volume":"30","author":"Mills-Koonce","year":"2007","journal-title":"Infant Behav Dev"},{"key":"key2025101815375200_ref45-bib45","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.infbeh.2004.02.002","article-title":"Differences in attachment security between African-American and white children: ethnicity or socio-economic status?","volume":"27","author":"Bakermans-Kranenburg","year":"2004","journal-title":"Infant Behav Dev"},{"key":"key2025101815375200_ref46-bib46","volume-title":"Healthy child programme: Pregnancy and the first five years of life","author":"Shribman","year":"2009"},{"key":"key2025101815375200_ref47-bib47","volume-title":"Health Visitor Implementation Plan \u2013 A Call to Action","author":"Shribman","year":"2011"},{"key":"key2025101815375200_ref48-bib48","doi-asserted-by":"crossref","DOI":"10.1007\/s11136-017-1765-4","article-title":"COSMIN methodology for systematic reviews of Patient \u2013 Reported Outcome Measures (PROMs). User Manual","author":"Mokkink","year":"2018","journal-title":"Qual Life Res"},{"key":"key2025101815375200_ref49-bib49","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/BF02289113","article-title":"Coefficient alpha and the internal structure of tests","volume":"16","author":"Cronbach","year":"1951","journal-title":"Psychometrika"},{"key":"key2025101815375200_ref50-bib50","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1037\/1040-3590.9.1.47","article-title":"Do partners agree about abuse in their relationship? A psychometric evaluation of interpartner agreement","volume":"9","author":"Moffitt","year":"1997","journal-title":"Psychol Assess"},{"key":"key2025101815375200_ref51-bib51","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale","volume":"150","author":"Cox","year":"1987","journal-title":"Br J Psychiatry"},{"key":"key2025101815375200_ref52-bib52","volume-title":"The English indices of deprivation 2004","author":"Noble","year":"2004"},{"key":"key2025101815375200_ref53-bib53","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1037\/0012-1649.35.6.1399","article-title":"Child care and mother-child interaction in the first 3 years of life. NICHD early child care research network","volume":"35","author":"NICHD Early Child Care Research Network","year":"1999","journal-title":"Dev Psychol"},{"key":"key2025101815375200_ref54-bib54","doi-asserted-by":"crossref","DOI":"10.4324\/9780203758045","volume-title":"Patterns of Attachment: A Psychological Study of the Strange Situation","author":"Ainsworth","year":"2015"},{"key":"key2025101815375200_ref55-bib55","author":"Vitoratou","year":"2023","journal-title":"A Comprehensive Guide for Assessing Measurement Tool Quality: The Contemporary Psychometrics (ConPsy) Checklist"},{"key":"key2025101815375200_ref56-bib56","volume-title":"Nopaco: A Non-parametric Concordance Coefficient, Version 1.0.5","author":"Kuiper","year":"2019"},{"key":"key2025101815375200_ref57-bib57","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1037\/0033-2909.86.2.420","article-title":"Intraclass correlations: uses in assessing rater reliability","volume":"86","author":"Shrout","year":"1979","journal-title":"Psychol Bull"},{"key":"key2025101815375200_ref58-bib58","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1037\/h0026256","article-title":"Weighted kappa: nominal scale agreement provision for scaled disagreement or partial credit","volume":"70","author":"Cohen","year":"1968","journal-title":"Psychol Bull"},{"key":"key2025101815375200_ref59-bib59","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2307\/2529786","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"key2025101815375200_ref60-bib60","volume-title":"Robust Inference Using Weighted Least Squares and Quadratic Estimating Equations in Latent Variable Modelling with Categorical and Continuous Outcomes","author":"Muthen","year":"1997"},{"key":"key2025101815375200_ref61-bib61","volume-title":"Mplus User\u2019s Guide","author":"Muthen","year":"2017"},{"key":"key2025101815375200_ref62-bib62","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1186\/s12888-024-05804-1","article-title":"Women\u2019s engagement with community perinatal mental health services: a realist evaluation","volume":"24","author":"Fisher","year":"2024","journal-title":"BMC Psychiatry"},{"key":"key2025101815375200_ref63-bib63","doi-asserted-by":"crossref","first-page":"103116","DOI":"10.1016\/j.midw.2021.103116","article-title":"Women\u2019s experiences of maternity service reconfiguration during the COVID-19 pandemic: a qualitative investigation","volume":"102","author":"Silverio","year":"2021","journal-title":"Midwifery"},{"key":"key2025101815375200_ref64-bib64","doi-asserted-by":"crossref","first-page":"2150132720944074","DOI":"10.1177\/2150132720944074","article-title":"A mixed-methods pilot study of perinatal risk and resilience during COVID-19","volume":"11","author":"Farewell","year":"2020","journal-title":"J Prim Care Community Health"},{"key":"key2025101815375200_ref65-bib65","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s00737-020-01073-5","article-title":"Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women","volume":"23","author":"Moyer","year":"2020","journal-title":"Arch Womens Ment Health"},{"key":"key2025101815375200_ref66-bib66","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jad.2020.07.126","article-title":"Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic","volume":"277","author":"Lebel","year":"2020","journal-title":"J Affect Disord"},{"key":"key2025101815375200_ref67-bib67","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1080\/02646838.2020.1786910","article-title":"The COVID-19 pandemic and perinatal mental health","volume":"38","author":"Caparros-Gonzalez","year":"2020","journal-title":"J Reprod Infant Psychol"},{"key":"key2025101815375200_ref68-bib68","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1002\/ijgo.13365","article-title":"Violence against women during the COVID-19 pandemic: an integrative review","volume":"151","author":"S\u00e1nchez","year":"2020","journal-title":"Int J Gynaecol Obstet"},{"key":"key2025101815375200_ref69-bib69","doi-asserted-by":"crossref","first-page":"674194","DOI":"10.3389\/fpsyt.2021.674194","article-title":"One year into the pandemic: a systematic review of perinatal mental health outcomes during COVID-19","volume":"12","author":"Iyengar","year":"2021","journal-title":"Front Psychiatry"},{"key":"key2025101815375200_ref70-bib70","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1177\/0030222820977305","article-title":"What exactly is \u2018complicated\u2019 grief? A scoping research literature review to understand its risk factors and prevalence","volume":"86","author":"Wilson","year":"2022","journal-title":"Omega (Westport)"},{"key":"key2025101815375200_ref71-bib71","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s12916-016-0643-1","article-title":"RAMESES II reporting standards for realist evaluations","volume":"14","author":"Wong","year":"2016","journal-title":"BMC Med"},{"key":"key2025101815375200_ref72-bib72","doi-asserted-by":"crossref","first-page":"S72","DOI":"10.2105\/AJPH.2018.304844","article-title":"Structural interventions to reduce and eliminate health disparities","volume":"109","author":"Brown","year":"2019","journal-title":"Am J Public Health"},{"key":"key2025101815375200_ref73-bib73","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/S2215-0366(23)00200-6","article-title":"Obstetric and neonatal outcomes in pregnant women with and without a history of specialist mental health care: a national population-based cohort study using linked routinely collected data in England","volume":"10","author":"Langham","year":"2023","journal-title":"Lancet Psychiatry"},{"key":"key2025101815375200_ref74-bib74","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1002\/wps.20769","article-title":"Perinatal mental health: a review of progress and challenges","volume":"19","author":"Howard","year":"2020","journal-title":"World Psychiatry"},{"key":"key2025101815375200_ref75-bib75","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1017\/S2045796016000743","article-title":"Information for mental health systems: an instrument for policy-making and system service quality","volume":"26","author":"Lora","year":"2017","journal-title":"Epidemiol Psychiatr Sci"},{"key":"key2025101815375200_ref76-bib76","doi-asserted-by":"crossref","first-page":"F502","DOI":"10.1136\/archdischild-2018-315147","article-title":"Establishing a composite neonatal adverse outcome indicator using English hospital administrative data","volume":"104","author":"Knight","year":"2019","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"key2025101815375200_ref77-bib77","doi-asserted-by":"crossref","first-page":"e0153370","DOI":"10.1371\/journal.pone.0153370","article-title":"Establishing a national maternal morbidity outcome indicator in England: a population-based study using routine hospital data","volume":"11","author":"Nair","year":"2016","journal-title":"PLOS ONE"},{"key":"key2025101815375200_ref78-bib78","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1093\/ije\/dyx015","article-title":"Data resource profile: hospital episode statistics admitted patient care (HES APC)","volume":"46","author":"Herbert","year":"2017","journal-title":"Int J Epidemiol"},{"key":"key2025101815375200_ref79-bib79","volume-title":"Mental Health Services Data Set (MHSDS) \u2013 NHS Digital Data Specification","author":"NHS Digital","year":"2021"},{"key":"key2025101815375200_ref80-bib80","volume-title":"Personal Demographics Service","author":"NHS Digital","year":"2022"},{"key":"key2025101815375200_ref81-bib81","volume-title":"International Statistical Classification of Diseases and Related Health Problems","author":"World Health Organisation","year":"2010"},{"key":"key2025101815375200_ref82-bib82","volume-title":"OPCS Classifications of Interventions and Procedures Version 4.4","author":"NHS Digital","year":"2007"},{"key":"key2025101815375200_ref83-bib83","volume-title":"The English Indices of Deprivation 2015 Statistical Release","author":"Department of Communities and Local Government","year":"2015"},{"key":"key2025101815375200_ref84-bib84","volume-title":"Birth Characteristics in England and Wales: 2020. Annual Live Births in England and Wales by Sex, Birthweight, Gestational Age, Ethnicity and Month, Maternities by Place of Birth and With Multiple Births, and Stillbirths by Age of Parents and Calendar Quarter","author":"Office for National Statistics","year":"2022"},{"key":"key2025101815375200_ref85-bib85","volume-title":"NHS Maternity Care for Women with Multiple Births and Their Babies","author":"Ralph","year":"2020"},{"key":"key2025101815375200_ref86-bib86","volume-title":"The Healthcare Ecosystem","author":"NHS Digital","year":"2022"},{"key":"key2025101815375200_ref87-bib87","doi-asserted-by":"crossref","first-page":"241","DOI":"10.3109\/03014460.2011.551106","article-title":"Revised birth centiles for weight, length and head circumference in the UK-WHO growth charts","volume":"38","author":"Cole","year":"2011","journal-title":"Ann Hum Biol"},{"key":"key2025101815375200_ref88-bib88","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/sim.4067","article-title":"Multiple imputation using chained equations: issues and guidance for practice","volume":"30","author":"White","year":"2011","journal-title":"Stat Med"},{"key":"key2025101815375200_ref89-bib89","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00737-020-01099-9","article-title":"The impact of maternal prenatal mental health disorders on stillbirth and infant mortality: a systematic review and meta-analysis","volume":"24","author":"Adane","year":"2021","journal-title":"Arch Womens Ment Health"},{"key":"key2025101815375200_ref90-bib90","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1111\/j.1471-0528.2012.03446.x","article-title":"Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: the COSMOS randomised controlled trial","volume":"119","author":"McLachlan","year":"2012","journal-title":"BJOG"},{"key":"key2025101815375200_ref91-bib91","doi-asserted-by":"crossref","first-page":"e270","DOI":"10.1016\/j.wombi.2022.08.002","article-title":"Does midwifery continuity of care make a difference to women with perinatal mental health conditions: a cohort study, from Australia","volume":"36","author":"Cummins","year":"2023","journal-title":"Women Birth"},{"key":"key2025101815375200_ref92-bib92","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s00127-019-01814-7","article-title":"Maternal schizophrenia and adverse birth outcomes: what mediates the risk?","volume":"55","author":"Vigod","year":"2020","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"key2025101815375200_ref93-bib93","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/S2215-0366(23)00409-1","article-title":"Community perinatal mental health teams and associations with perinatal mental health and obstetric and neonatal outcomes in pregnant women with a history of secondary mental health care in England: a national population-based cohort study","volume":"11","author":"Gurol-Urganci","journal-title":"Lancet Psychiatry"},{"key":"key2025101815375200_ref94-bib94","volume-title":"Modern Epidemiology","author":"Rothman","year":"2008"},{"key":"key2025101815375200_ref95-bib95","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/1471-0528.12059","article-title":"Smoking cessation in pregnant women with mental disorders: a cohort and nested qualitative study","volume":"120","author":"Howard","year":"2013","journal-title":"BJOG"},{"key":"key2025101815375200_ref96-bib96","doi-asserted-by":"crossref","first-page":"e111682","DOI":"10.1371\/journal.pone.0111682","article-title":"Diagnostic overshadowing and other challenges involved in the diagnostic process of patients with mental illness who present in emergency departments with physical symptoms \u2013 a qualitative study","volume":"9","author":"Shefer","year":"2014","journal-title":"PLOS ONE"},{"key":"key2025101815375200_ref97-bib97","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/1471-244X-14-157","article-title":"Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study","volume":"14","author":"Farrelly","year":"2014","journal-title":"BMC Psychiatry"},{"key":"key2025101815375200_ref98-bib98","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1186\/s12913-024-10553-8","article-title":"An exploration of service use pattern changes and cost analysis following implementation of community perinatal mental health teams in pregnant women with a history of specialist mental healthcare in England: a national population-based cohort study","volume":"24","author":"Langham","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"key2025101815375200_ref100-bib100","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s10488-019-00958-7","article-title":"Measuring the activity of mental health services in England: variation in categorising activity for payment purposes","volume":"46","author":"Jacobs","year":"2019","journal-title":"Adm Policy Ment Health"},{"key":"key2025101815375200_ref101-bib101","volume-title":"2018\/19 National Cost Collection Data Publication","author":"NHS England","year":"2019"},{"key":"key2025101815375200_ref102-bib102","volume-title":"Unit Costs of Health and Social Care 2017","author":"Curtis","year":"2017"},{"key":"key2025101815375200_ref103-bib103","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1136\/bmj.320.7243.1197","article-title":"How should cost data in pragmatic randomised trials be analysed?","volume":"320","author":"Thompson","year":"2000","journal-title":"BMJ"},{"key":"key2025101815375200_ref104-bib104","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1192\/bjp.2022.48","article-title":"Effectiveness and cost-effectiveness of psychiatric mother and baby units: quasi-experimental study","volume":"221","author":"Howard","year":"2022","journal-title":"Br J Psychiatry"}],"container-title":["Health and Social Care Delivery Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2048966","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/sites\/journalslibrary\/files\/journal_data\/RRAP0011\/RRAP0011.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2048966","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:21:40Z","timestamp":1760782900000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/hsdr\/RRAP0011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":102,"alternative-id":["10.3310\/RRAP0011"],"URL":"https:\/\/doi.org\/10.3310\/rrap0011","relation":{},"ISSN":["2755-0079"],"issn-type":[{"value":"2755-0079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"This content has been made freely available to all.","name":"free","label":"Free to read"},{"value":"06-2019","name":"contractual_start_date","label":"contractual_start_date","group":{"name":"article_history","label":"Article History"}},{"value":"09-2023","name":"editorial_review_begun","label":"editorial review begun","group":{"name":"article_history","label":"Article History"}},{"value":"03-2025","name":"accepted_for_publication","label":"Accepted for publication","group":{"name":"article_history","label":"Article History"}}]}}