Dr. Amir Niazi:

I thank the Chairperson and members of the committee very much for the invitation to talk about the issues relating to perinatal mental health. My colleague, Dr. Margo Wrigley, the national lead for the specialist perinatal mental health programme, and I are here on behalf of the HSE.

In my role as national clinical adviser and group lead in mental health, I work with national leads and programme managers on the design and implementation of the clinical programmes in mental health. The specialist perinatal mental health programme is one of these. Other programmes we look after include programmes on: self-harm in emergency departments; early intervention in psychosis; eating disorders in adults and children; attention deficit hyperactivity disorder, ADHD, in adults; and dual diagnosis, which is where addiction issues and mental health issues present together. We also support service improvement programmes such as those on mental health services for those with intellectual disability and older persons.

All of these clinical programmes and service improvements have certain things in common. One is that they address unmet clinical need. Most of the mental health services are delivered by primary and secondary care services but there are certain cohorts of patients that need bespoke specialised services. Clinical programmes and service improvement programmes plug that gap. We have an overarching aim of standardising quality, evidence-based practice across mental health services. This means that the service provided in Dublin should be the same as that provided in Cork, in Donegal or anywhere else in the country. We try to step in early. Early intervention is key. Community orientation is one of our focuses. Rather than bringing people into acute units, we try to manage them in the community as much as possible. Most of our models of care and initiatives involve work with training bodies and voluntary organisations. We take a holistic approach with all of these programmes.

As I mentioned, most mental health services are delivered by primary and secondary care services. Only those patients who require a bespoke specialist response to ensure their needs are met promptly by skilled mental health professionals are referred to these clinical programmes. The specialist perinatal mental health programme specifically meets the mental health needs of women during pregnancy and up to a year post delivery. This programme was launched in 2017 and implementation started in 2018. Dr. Wrigley will brief the committee on the services now available for women. We have prepared a few slides that give an overview of the service. We are happy to take any questions at the end to help members understand our programme.