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19/94 Perinatal Mental Health commissioning brief

 

Contents

Summary
The National Institute for Health Research (NIHR) is interested in receiving research applications to improve the mental health of women and their families in the perinatal period. For the purposes of this call, perinatal mental health is defined as the period from preconception to 24 months after birth.

Applicants should justify the importance of their proposed research and identify how the work supports aspirations to reduce health inequalities, improve health outcomes, enable individuals to better manage their own health, extend or support the roles of health and social care staff or improve the delivery of health and social care services. Proposals should also reflect the role of social care in delivering improved outcomes for individuals and the health and social care system and the inclusion of a social care component/outcomes should be included, where appropriate. 

Specifically for the purposes of this call, applicants are encouraged to include geographic populations with high disease burden, which have been historically under served by NIHR research activity in order to ensure that NIHR research is conducted in the areas where health needs are greatest. We would encourage applicants to bring on one or two centres with high disease burden that have been relatively inactive in this area to date.

Given the scope of this call, we would welcome applications that span the remit of one or more of the participating research programmes and which comprise of co-ordinated teams of investigators spanning different specialties/disciplines and geographical centres.  

We expect to receive applications that are co-produced, demonstrating an equal partnership with service commissioners, providers and service users in order to provide evidence and actionable findings of immediate utility to decision-makers and service users. Applicants may wish to consult the NIHR INVOLVE guidance on co-producing research.


Deadline for proposals:
The deadline for stage 1 applications is 1pm Wednesday 27 November 2019.

A webinar to support applicants will be held on Tuesday 10 September 2019 at 1:30pm, potential attendees should register their interest at the following email address crossprogramme@nihr.ac.uk. For support developing applications, applicants are also encouraged to contact their local NIHR Research Design Service (RDS) or equivalent in the first instance.  


Supporting information
The first 1001 days of a child’s life, from conception to the age of 2, are crucial in giving them the best possible start in life.  However, during this period one in four mothers will experience mental health problems.  There is a strong link between parental mental health and the mental health of children meaning the impact of mental health problems in this critical period can have a lasting impact. 

The financial cost of maternal perinatal mental ill health is estimated to have a long-term cost to society of approximately £8.1 billion for each one-year cohort of births in the UK; the emotional cost to the individual and their family can be immense.

The development and improvement of perinatal mental health services is highlighted as a key priority in England and the devolved nations. In England, a transformation programme is underway supported by funding of £365m to enable 30,000 women to have access to improved perinatal mental health support by 2020/21 and a further 24,000 by 2023/24.

The NHS Long Term Plan states that access to and quality of mental health care for mothers and their families will be improved by increasing access to services and treatments for women with moderate to severe perinatal mental health difficulties, expanding access to evidence-based psychological therapies within perinatal specialist mental health services, offering support to  fathers/partners who experience mental health difficulties and focusing on parents who experience mental health difficulties arising from the maternity experience. 


Specific areas of interest for research

The following broad themes have been described below with examples of particular areas of interest for research. However, these are examples and do not represent an exhaustive list.  

Preconception
Preconception advice and interventions for women with mental illness.
Delivery of preconception advice and interventions.

Prevention
Prevention of postnatal anxiety.
Improving engagement with prevention interventions.
Antenatal preparation.

Service delivery
Evaluation of the In-reach/Out-reach teams in the Mother and Baby Units.
Efficacy of peer support workers across perinatal services. 
Decision support tools to aid referrals.

Mental health disorders
Interventions for perinatal anxiety.
Group therapies for antenatal/postnatal depression.
Management of pregnant women with personality disorder.
Preventing and treating postpartum psychosis.
Drug safety during the perinatal period.
Specific perinatal interventions compared with non-perinatal adapted interventions.
Efficacy of couple interventions within the perinatal period.

Pregnant women with substance abuse problems
Evaluation of service provision.
Workforce development needs for staff working in the area.
Interventions to enhance engagement with antenatal services. 
Interventions for addressing substance abuse in the perinatal period.

Traumatic events and the perinatal period
Detection and treatment of post-traumatic stress disorder following childbirth.
Mental health screening and psychosocial support for women and their partners who have experienced pregnancy loss e.g. miscarriage, stillbirth, infant death.
Managing impact of traumatic events occurring prior to pregnancy.
Supporting women who have had previous traumatic birth experiences.
Mental health and parent-infant interventions for women and partners accessing neonatal services.

Partners/families
Anxiety, depression and mental health screening measures for partners in the perinatal period.
Psychosocial interventions for partners/carers of women accessing specialist perinatal mental health services.

Parenting
This is an important theme; however, applicants should take particular note of the NIHR portfolio in this area as there are already a number of published and ongoing projects.

Social care provision/safeguarding
Mental health interventions when a family is on the edge of care.

Sleep
Non-pharmacological interventions to improve sleep quality in the perinatal period.

Staff wellbeing
Prevention and treatment of workplace traumatisation and post-traumatic stress disorder in staff in maternity services.


How to apply & supporting information:

The Programmes involved in this call are:

Applicants should note that:

  • Proposals must be within the remit of at least one participating NIHR Programme. However, we expect to receive applications which span the remit of one or more programme. To enable applications to be written without concern for individual programme remits or boundaries, applications will be submitted to one cross programme team, rather than to individual programmes.
  • Patient and public involvement must be included within the application and study design to ensure the research is relevant and appropriate to patients and the public.
  • Ambitious applications consisting of more than one clearly linked work package as well as applications for individual studies will be welcomed. We would also encourage the building of research capacity through the research process. 
  • The participating NIHR programmes fund rigorous, problem-focused research to assess the impact of existing health technologies. Applicants must demonstrate that the proposed methodology is appropriate and robust, with consideration given to methodological limitations.
  • Applicants should clearly state how their proposed research addresses an explicit evidence gap and how the research adds value to the existing NIHR research portfolio.
  • This call represents an ongoing area of interest for the NIHR and, following this opportunity, the NIHR research programmes would still be interested in receiving applications in this area to their researcher-led workstreams. 


Contact Information

General questions about the call should be addressed to your local RDS in the first instance or further guidance may be obtained by sending a short summary (maximum 1 A4 page) of their research proposal, in a structured format including rationale, research question, proposed methodology and outcome/evaluation methods to the following address: crossprogramme@nihr.ac.uk