Specialist Perinatal Mental Health Services Research Articles

A Specialised Antenatal Music Therapy (SAMT) programme for pregnant women with mental health conditions: A mixed-methods proof-of-concept study in Ireland

ABSTRACT Introduction Perinatal mental health has a long-term impact on maternal and infant well-being. Non-pharmacological treatment options are needed for pregnant women and emerging evidence has shown the potential of music therapy to improve perinatal mental health and antenatal attachment. However, research is lacking on individual music therapy for pregnant women with mental health conditions and formal music therapy services are currently absent within perinatal mental health care in Ireland. This mixed-methods, proof-of-concept study aimed to assess the feasibility and preliminary evidence on the effectiveness of a specialised antenatal music therapy (SAMT) programme for pregnant women attending the Specialist Perinatal Mental Health Service (SPMHS). Method Pregnant women between 25 and 33 weeks gestation with various mental health conditions were recruited through the SPMHS to receive six in-person or online sessions of SAMT. Feasibility outcomes included retention, adherence, and fidelity.\\ Assessment of participants’ wellbeing, anxiety, and antenatal attachment were conducted before and after SAMT and each session. Semi-structured interviews were conducted and analysed using thematic analysis. Results Twelve pregnant women were included and nine completed SAMT and assessments, demonstrating a 75% retention rate. High levels of adherence and fidelity were reported. Significant improvements were observed in participants’ wellbeing, anxiety levels, and antenatal attachment. Qualitative findings highlighted the therapeutic benefits, the accessibility and challenges of the online setting, distinctive therapeutic experiences, and participants’ recommendations. Discussion The findings suggest implementing SAMT within the Irish SPMHS is feasible and beneficial. The study offers insights into the therapeutic mechanisms of SAMT and supports the progression to a larger trial.

Developing systemic therapies in a specialist perinatal mental health service using an attachment narrative therapy approach

This paper describes the development of systemic therapies in a Specialist Perinatal Mental Health Service (SPMHS) that developed Attachment Narrative Therapy (ANT) specifically for families in the perinatal stage of the family life cycle. ANT offers a good fit in the perinatal period, integrating systemic family therapy, narrative therapy, and attachment theory. From pregnancy to the child being two is a family life cycle stage of great change and reorganisation. This involves opportunities and challenges for attachments and relationships between parents, the baby and wider family/carers. Attending to cross-generational narratives and attachments are important in ensuring the perinatal stage is navigated successfully. Peri-ANT, a semi-structured version of ANT, was developed as a manualised approach. It can be flexibly adapted to the unique circumstances of each family. The paper describes the perinatal context, service needs and priorities, and the development of Peri-ANT including construction of the manual and how it was delivered.

Culturally Sensitive Perinatal Mental Health Care: Experiences of Women From Minority Ethnic Groups.

Current research has identified how ethnic minority women experience poorer health outcomes during the perinatal period. In the United Kingdom, specialist perinatal mental health services provide mental health treatment for women throughout the perinatal period. Service users have previously highlighted that perinatal services are hard to access and lack cultural sensitivity, whereas healthcare professionals have described limited opportunities and resources for developing cultural competency. We explored the experiences of ethnic minority women with National Health Service (NHS) specialist perinatal teams and identified what culturally sensitive perinatal mental health care means to this group. Individual semi-structured interviews were conducted, and an interpretative phenomenological analysis framework was used to analyse the interview transcripts. Participants were recruited from NHS specialist perinatal teams and online via social media. Six women were interviewed. Four group experiential themes central to the experiences of participants emerged: (1) strengthening community networks and peer support; (2) valuing cultural curiosity; (3) making sense of how culture, ethnicity, race and racism impact mental health; and (4) tailoring interventions to ethnic minority women and their families. The findings capture how ethnic minority women experience specialist perinatal teams and offer insights into practising culturally sensitive care. Perinatal mental health professionals can support ethnic minority women by strengthening their access to community resources and peer support; being curious about their culture; helping them to make sense of how culture, ethnicity, race and mental health interact; and applying cultural and practical adaptations to interventions. A Lived Experience Advisory Group (LEAG) of women from ethnic minority groups contributed to the design and conduct of this study. The LEAG had lived experience of perinatal mental health conditions and accessing specialist perinatal teams. The LEAG chose to co-produce specific aspects of the research they felt fit with their skills and available time throughout five group sessions. These aspects included developing the interview topic guide, a structure for debriefing participants and advising on the social media recruitment strategy.

Pregnancy in the shadow of psychosis: Navigating first-time motherhood with increased likelihood of postpartum psychosis and postnatal depression.

WHAT IS KNOWN ON THE SUBJECT?: New parents who have previously experienced psychosis outside and/or following childbirth have an increased likelihood of experiencing an episode during the postpartum period. The decision to try to conceive can be agonising. Receiving care from a specialist perinatal community mental health team can improve outcomes. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This article offers a first-person insight into the steps the author took to minimise the impact of an episode of postpartum psychosis and/or postnatal depression whilst navigating new motherhood. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This lived experience narrative aligns with the evidence base that demonstrates specialist perinatal community mental health services improve outcomes. It highlights the importance of maternity care providers asking about mental health history to identify any previous episodes or family history and offering referral to a specialist perinatal mental health service if available. ABSTRACT: Introduction Postpartum psychosis is a life-changing but treatable condition that usually occurs in the first few days to weeks after childbirth affecting 1-2 in 1000 pregnancies. Those who have experienced psychosis before, either as a single episode, related or unrelated to childbirth or as part of a long-term mental health condition have a higher likelihood of experiencing an episode in the postnatal period. Aim In this lived experience narrative the author shares personal experience of planning and navigating pregnancy with a higher likelihood of experiencing postpartum psychosis and postnatal depression around this major life transition due to previous episodes. Methods The author utilises a first-person approach to share and reflect on her lived experience. Findings The author shares her experience of receiving care and some of the steps she took to try to manage the impact of pregnancy and birth on her mental health during this major life transition. She describes how care from a specialist perinatal community mental health team and peer support contributed significantly to her family's well-being. Discussion Specialist perinatal community mental health services can improve outcomes for those with a higher likelihood of experiencing postpartum psychosis and postnatal depression by facilitating planning and mitigating some of the risks that could lead to relapse in the perinatal period.

A service evaluation exploring ethnic monitoring in a Specialist Perinatal Mental Health service: Barriers and improvement opportunities

A service evaluation exploring ethnic monitoring in a Specialist Perinatal Mental Health service: Barriers and improvement opportunities

Specialist perinatal mental health services: future developments to meet the needs of families.

Specialist perinatal mental health services: future developments to meet the needs of families.

How do patient and care experience data inform policy and practice? Insights from the Irish National Care Experience Programme

Abstract Issue Patient experiences are central to the delivery of quality, person-centred care and an important predictor of outcomes. Prior to 2017, there was no unified, national approach to the collection of care experience data in Ireland. Description of the problem The National Care Experience Programme is a partnership between a regulator, policy makers and the Irish public health service, with a suite of surveys of inpatient, maternity, nursing home and end of life care. The surveys aim to learn from people's feedback on health and social care services to identify areas of good experience and areas requiring improvement. Results Findings have informed national policies, including a healthcare communication programme to support staff to develop communication skills with patients and families. Survey data provide a key input to the Irish health quality indicator framework and the Health Systems Performance Assessment Framework, which assess the overall performance of the Irish health system. National Maternity Experience Survey results informed the allocation of funding for post-natal supports and new lactation consultant posts, and supported the implementation of a specialist perinatal mental health services model of care, leading to increased diagnosis and vigilance of mental health issues ante- and postnatally. National Nursing Home Experience Survey findings supported legislative amendments, including provision for the delivery of in-person advocacy awareness campaigns and the strengthening of complaints processes within nursing homes. Lessons In order to maximise the use of survey findings and ensure the voices of people using health and social care services are acted on, routine surveying of care experiences is required to track the impact of policy and practice initiatives. The programme is currently expanding to include people's experiences of cancer care and mental health services, in addition to exploring options for continuous, local care experience surveys.

Evaluation of a new Perinatal Mental Health Service in a University Maternity Hospital.

Specialist Perinatal Mental Health Services (SPMHS) are a new development in Ireland. This service evaluation examined the impact of the introduction of a SPMHS multidisciplinary team (MDT) on prescribing practices and treatment pathways in an Irish maternity hospital. Clinical charts were reviewed to collect data on allreferrals, diagnoses, pharmacological and non-pharmacological interventions delivered in a SPMHS over a 3-week period in 2019. The findings were compared to the same 3-week period in 2020 following the expansion of the SPMHS MDT. In 2019 (n = 32) and 2020 (n = 47), most (75 and 79%, respectively) assessments were antenatal. The proportion of patients prescribed psychotropic medication within the SPMHS was not significantly different from 2019 (31%) to 2020 (23%), though more patients were already prescribed psychotropic medications at the time of referral (22% in 2019 v. 36% in 2020). There was an increase in MDT interventions in 2020 with more input from psychology, clinical nurse specialist (CNS), and social work intervention. Adherence to prescribing standards improved from 2019 to 2020. Prescribing patterns remained unchanged between 2019 and 2020. Improvement was observed in adherence to prescribing standards and there wasincreased provision of MDT interventions in 2020. Broader diagnostic categories were also used in 2020, possibly suggesting that the service is now providing more individualized care.

Experiences of women with autistic spectrum condition accessing the Brighton and Hove Specialist Perinatal Mental Health Service

PurposeThis study aims to describe the experiences and barriers to care for women with autistic spectrum condition (ASC) under the care of the Brighton and Hove Specialist Perinatal Mental Health Service (BHSPMHS) and provide recommendations to improve the service.Design/methodology/approachPatients with an ASC diagnosis or suspected diagnosis and awaiting assessment under the care of BHSPMHS were offered to take part in the study. Five patients were interviewed to explore their experiences.FindingsParticipants had a mix of positive and negative experiences of services. Positives included the continuous support and allowing flexibility around appointments. Dialectical behavioural therapy groups running online instead of in-person was highlighted as a universal negative as well as delays in diagnosing ASC.Practical implicationsThose likely to meet the criteria for ASC but are awaiting formal diagnosis should be treated with appropriate adjustments to service provision as those who have received a diagnosis. Recommendations for service improvements include the provision of smaller, in-person therapy groups. Adjustments to treatments may include flexibility around appointment times and location.Originality/valueThere is little research into the experiences of people with ASC under the care of perinatal mental health teams. As specialist perinatal services expand, it is important to understand the experiences of women with ASC being cared for by these services, to ensure they are accessible and inclusive. The results of this study will be used to guide service development and act as a model for other services, with the intention of improving care for this patient group.

Developing Specialist Perinatal Mental Health Services: the door of opportunity.

The development of Specialist Perinatal Mental Health Services in Ireland in recent years (2018-2021) is described. The paper highlights the role of unexpected opportunity in advancing this much needed service for women, infants and their families. It also emphasises the need for funding combined with an implementation mechanism to ensure that the service emerging is true to the Model of Care designed and is available in a uniform manner to women nationally.

Best practice in perinatal mental healthcare

Journal of Health VisitingVol. 11, No. 3 EditorialBest practice in perinatal mental healthcarePolly MoffatPolly MoffatE-mail Address: [email protected]Editor, JHVSearch for more papers by this authorPolly MoffatPublished Online:13 Mar 2023https://doi.org/10.12968/johv.2023.11.3.93AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Institute of Health Visiting, Maternal Mental Health Alliance (2023) Supporting High-Quality Perinatal Mental Health Care. https://maternalmentalhealthalliance.org/news/ihv-mmha-resource-inform-high-quality-perinatal-mental-health-care (accessed 7 March 2023) Google ScholarNHS England, NHS Improvement (2021) Involving and Supporting Partners and Other Family Members in Specialist Perinatal Mental Health Services.’ Good Practice Guide. www.england.nhs.uk/wp-content/uploads/2021/03/Good-practice-guide-March-2021.pdf (accessed 7 March 2023) Google Scholar FiguresReferencesRelatedDetails 2 March 2023Volume 11Issue 3ISSN (print): 2050-8719ISSN (online): 2052-2908 Metrics History Published online 13 March 2023 Published in print 2 March 2023 Information© MA Healthcare LimitedPDF download

Anxiety in a Specialist Perinatal Mental Health Service: patient characteristics, management, and outcomes.

To outline characteristics of patients with anxiety diagnoses attending a Specialist Perinatal Mental Health Service (SPMHS) in Ireland, the mental health care received by those patients, mental health and obstetric outcomes for those patients, and immediate neonatal outcomes for their babies. A retrospective chart review was conducted of patients with antenatal anxiety diagnoses who attended the SPMHS in University Maternity Hospital Limerick, from initiation of the service to the end of its first year. Data were collected on 100 patients, 81 with a mental health diagnosis prior to attending the SPMHS, 32 with prior engagement with psychiatry, and 23 with a previous perinatal diagnosis. The mean age of patients was 32.4 (19-47, std 6.158). Beyond initial assessment, the Mental Health Midwife was involved in the care of 61% of patients, more than any other specialty including psychiatry. Twenty-seven patients had psychiatric medication either started or altered by the SPMHS. The most common reason for eventual discharge was that patients were well. Two patients presented in mental-health-related crisis to emergency services and one patient was admitted to an acute psychiatric ward. Patients attending the SPMHS for anxiety spanned a broad spectrum of demographics and diagnoses and received varied set of interventions. A significant proportion of patients had a primary diagnosis of Pregnancy-related anxiety. The Mental Health Midwife played a key role in management of these patients. Though rates of mental health crises and admissions were low, the absence of a Mother and Baby Unit in Ireland was highlighted.

Healthcare professionals’ experiences and perceptions of providing support for mental health during the period from pregnancy to two years postpartum

ObjectiveMental health issues in the perinatal period are common, and can have negative consequences for maternal and child health. Healthcare professionals (HCPs) who provide women with perinatal care are well-placed to detect mental health issues and provide support. This study therefore examines HCPs’ experiences and perceptions of providing mental health support during the perinatal period, including during the COVID-19 pandemic. DesignAn exploratory realist qualitative study was conducted. SettingRepublic of Ireland ParticipantsA purposive sampling strategy was employed to recruit HCPs (e.g., general practitioners, midwives, public health nurses, practice nurses, doulas, and breastfeeding counsellors), via professional bodies in Ireland. An invitation to participate was also circulated via Twitter. A total of 18 HCPs participated in semi-structured interviews conducted between 18/8/2020 and 24/5/2021. Measurements and findingsSemi-structured interviews were conducted according to a topic guide designed by a multidisciplinary team. Data were analysed using thematic analysis. Four themes were developed: ‘Supporting women in healthcare settings,’ ‘Skills and capacity to provide adequate care,’ ‘Structural barriers to care provision,’ and ‘The impact of the COVID-19 pandemic on stress support.’ Key conclusionsHCPs reported providing emotional support and advocacy, but highlighted challenges, including limited capacity to address women's concerns, clinical culture and hierarchy, insufficient organisational investment, and social inequities in support access. Some HCPs felt these barriers could lead to additional psychological harm. HCPs also reported that the pandemic had introduced novel stressors and changed the nature of the mental health support they provided. Implications for practiceInterventions incorporating education and physical resources for HCPs, increased investment in specialist perinatal mental health services, increased investment in holistic supports, and changes to address cultural challenges in care environments, may facilitate – or enhance – support for women.

Prescribing of Psychiatric Drugs in Pregnancy: A Review of Current Practice in a Community Mental Healthcare Setting

AimsPrescribing of psychotropic medications in pregnancy is still considered a ‘grey area’ in clinical practice. National Institute for Health and Care Excellence (NICE) in the UK suggests that the decisions should be person-specific, considering the risks to both the mother and unborn child, and the patient is supported to make an informed decision. It is important to explore the use of psychotropic medications during pregnancy, or lack of it, and its subsequent impact on maternal mental health. It was intended to review the decisions expectant mothers are making regarding taking psychiatric medications during pregnancy, and the associated clinical outcomes. Their mental capacity for taking decisions was also checked.MethodsA retrospective audit of case notes of patients (n = 16) known to community psychiatric team (CMHT) and specialist perinatal mental health (PNS) services in Wolverhampton, who notified their pregnancy between December 2020 and December 2021. Demographic and clinical data were collected from the electronic records.ResultsThe sample had a mean age of 28.8 ± 6.3 years (range: 19 to 39 years), and 68.8% of them were Caucasian. A wide range of psychiatric diagnoses were present, most (62.5%) had comorbid diagnoses; and 25% had substance use, most commonly cannabis. Mean duration of gestation at the review following notification of pregnancy was 14.5 ± 7.7 (range: 6 to 29) weeks. It was observed that 25% were not taking psychiatric medications prior to pregnancy, 43.8% stopped taking their medication prior to the psychiatric review, most stopping abruptly, and 31.2% had continued their medication. The medications included aripiprazole, olanzapine, quetiapine, venlafaxine, sertraline and promethazine. Following the review, only 18.8% continued their medications. Of the 13 (81.3%) patients who were not taking medications, 9 (69.2%) had adverse mental health outcomes, with 2 (15.4%) patients requiring inpatient care. However, later 8 (61.5%) started taking medications whilst under the care of PNS. All of them had mental capacity to decide regarding their psychiatric treatment at the review.ConclusionMost psychiatric patients avoided taking psychotropic medications initially during pregnancy, however, a considerable proportion restarted their medications following review with the perinatal psychiatry team. The majority of patients who did not take medications had negative mental health consequences. It is important to develop an evidence base about the use of psychiatric medications in pregnancy and the associated short and long-term outcomes that may help the quality of information shared with patients.

A qualitative study of minority ethnic women’s experiences of access to and engagement with perinatal mental health care

BackgroundApproximately one in five women will experience mental health difficulties in the perinatal period. However, for a large group of women, symptoms of adverse perinatal mental health remain undetected and untreated. This is even more so for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care.AimsTo explore minority ethnic women’s experiences of access to and engagement with perinatal mental health care.MethodsSemi-structured interviews were conducted with 18 women who had been diagnosed with perinatal mental health difficulties and who were supported in the community by a specialist perinatal mental health service in South London, United Kingdom. Women who self-identified as being from a minority ethnic group were purposefully selected. Data were transcribed verbatim, uploaded into NVivo for management and analysis, which was conducted using reflective thematic analysis.ResultsThree distinct overarching themes were identified, each with two or three subthemes: ‘Expectations and Experiences of Womanhood as an Ethnic Minority’ (Shame and Guilt in Motherhood; Women as Caregivers; Perceived to Be Strong and Often Dismissed), ‘Family and Community Influences’ (Blind Faith in the Medical Profession; Family and Community Beliefs about Mental Health and Care; Intergenerational Trauma and Family Dynamics) and ‘Cultural Understanding, Empowerment, and Validation’ (The Importance of Understanding Cultural Differences; The Power of Validation, Reassurance, and Support).ConclusionWomen of ethnic minority background identified barriers to accessing and engaging with perinatal mental health support on an individual, familial, community and societal level. Perinatal mental health services should be aware ethnic minority women might present with mental health difficulties in different ways and embrace principles of cultural humility and co-production to fully meet these women’s perinatal mental health needs.

Women's experience of mild to moderate mental health problems during pregnancy, and barriers to receiving support

ObjectiveTo explore the experiences of women during pregnancy with mild to moderate mental health problems and describe the barriers to receiving support in relation to their mental health. Research design and participantsThis paper reports part of a larger project which recruited women and midwives in one hospital in Wales. Participants completed questionnaires in early pregnancy in an antenatal clinic, and the characteristics of women with and without symptoms of anxiety and depression compared. All women were invited to express interest in a follow up interview in late pregnancy. Women identified to have depression and anxiety in early pregnancy, but not under the care of perinatal mental health services, were eligible for interview. Interviews were conducted with 20 women using a visual timeline to aid discussion and were thematically analysed. FindingsIn late pregnancy mental health disorders were reported by nine women, of which five were diagnosed during adulthood. EPDS scores found 15 women had symptoms of mild to moderate depression and GAD-7 scores indicating 15 women with mild to moderate anxiety. Three themes were identified: moods and emotions - past, present and future; expectations and control; knowledge and conversations. Key conclusions and implications for practiceDue to limited access to specialist perinatal mental health services women relied on support networks and self-care to maintain their mental health. More time and better continuity at antenatal appointments along with improved mental health literacy may increase discussions regarding women's mental health during pregnancy. In addition investment is required to develop strategies and improve access to mental health services for women with mild to moderate mental health problems.

Association between hyperemesis gravidarum and psychological symptoms, psychosocial outcomes and infant bonding: a two-point prospective case–control multicentre survey study in an inner city setting

ObjectivesTo assess if there is any association between hyperemesis gravidarum (HG), psychological morbidity and infant bonding and to quantify any psychosocial consequences of HG.DesignTwo-point prospective case–control, multicentre survey study with...

Experiences of intensive home treatment for a mental health crisis during the perinatal period: A UK qualitative study.

Some women with severe perinatal mental health difficulties in England are cared for by acute home treatment services, known as Crisis Resolution Teams (CRTs), which provide short-term home-based treatment for adults experiencing a mental health crisis. Intensive home treatment has been trialed in a number of countries, but it is not known how well suited it is to the needs of perinatal women. This qualitative study aimed to explore how women and practitioners experience the provision of intensive home treatment for perinatal mental health problems. Semi-structured interviews were conducted with women who had received intensive home treatment in the perinatal period (n=15), and focus groups were held with practitioners working in CRTs or in specialist perinatal mental health services (3 groups, n=25). Data were analysed thematically. Women commonly found intensive home treatment problematic, experiencing it as intrusive and heavily risk-focused, with poor staff continuity and little tailoring to the perinatal context. However, women valued emotional support when provided, particularly when it had a perinatal focus, sometimes based on practitioners sharing their own experiences. Some women also appreciated avoiding hospital admission, but choice was often limited. Practitioners reported a lack of perinatal training among CRT staff and described difficulties tailoring treatment to perinatal women's needs. Currently, intensive home treatment, as offered by CRTs, may not be well suited to women with perinatal mental health difficulties. Findings suggest a need to develop community crisis responses that are better tailored to the needs of this population.

Acceptance and Commitment Therapy for perinatal mood and anxiety disorders: A feasibility and proof of concept study.

The aim of the current study was to assess the feasibility, safety, and effectiveness of a newly developed Acceptance and Commitment Therapy (ACT) intervention developed specifically to address the unique context of pregnancy and parenthood. The intervention was delivered to women accessing a specialist Perinatal Community Mental Health Service (PCMHS). An open-label pilot study was conducted of an 8-week, group-delivered ACT intervention targeting women with moderate-to-severe mood and/or anxiety disorders during pregnancy and/or postpartum. Outcomes included session attendance rates, dropout rates, crisis/inpatient service use, and standardized symptom scales. Participant's responses to open-ended questions contained in an end of therapy questionnaire were analysed using thematic analysis. Seventy-four women were referred to the intervention with 65 (88%) completing treatment. The median number of sessions attended was 7. No women required input from crisis/inpatient services. All reported finding the intervention helpful. The implementation of ACT in daily life, therapist support, and group processes were cited as helpful aspects of the intervention. At post-treatment, there was a significant reduction in global distress (d=0.99) and depressive symptoms (d=1.05), and an increase in psychological flexibility (d=0.93). On the secondary outcome of global distress, 38% of women were classified as recovered, 31% had reliably improved, 27% remained the same, and 4% had reliably deteriorated. The delivery of ACT in a routine practice setting is feasible, safe, and effective. A randomized control trial (RCT) is needed to establish the efficacy and cost-effectiveness of this group-delivered ACT intervention. Group-delivered Acceptance and Commitment Therapy (ACT) is acceptable for women with moderate-to-severe perinatal mood and/or anxiety disorders and can be feasibly delivered in a routine practice setting. The trans-diagnostic nature of ACT enables the concurrent treatment of depressive and anxiety symptoms within the same intervention which is particularly helpful in the perinatal context given the comorbidity of mood and anxiety disorders. With training and supervision, mental health practitioners without extensive education in the delivery of psychological therapies can facilitate the ACT group programme. As this was a feasibility study, there was no control group, adherence to the manual was not assessed, and the absence of a follow-up period limits our knowledge of the longer-term benefits of the ACT group programme.

A qualitative investigation of models of community mental health care for women with perinatal mental health problems

Background Specialist community perinatal mental health teams support women diagnosed with moderate to severe psychiatric difficulties in pregnancy or postnatally. These teams are being expanded across the UK, and there is considerable international interest in this model of care. However, not all women access these teams, and many are instead supported by community mental health services that do not specialise in the perinatal period. Aims To explore perinatal women’s experiences of specialist perinatal versus generic non-perinatal community mental health support. Methods Semi-structured interviews were conducted with 36 women diagnosed with perinatal mental health difficulties who were supported in the community either by a specialist perinatal or general non-perinatal mental health service. Data were analysed thematically. Results Women felt that specialist perinatal and non-perinatal services alike were under-resourced and somewhat too narrow in their remit, but reported positive experiences across both settings. They particularly valued the specialist expertise offered by perinatal teams, but also valued greater continuity of care over a longer period, which some non-perinatal teams provided. Conclusions The findings suggest that women who experience perinatal mental health difficulties value specialist perinatal expertise, but that general, non-perinatal teams may also have advantages for some. Further research into optimal care arrangements is merited.