24 March 2022

Ahead of Mothering Sunday, two colleagues from CNWL’s Perinatal mental health services discuss recent progress in their field and the team’s aspirations for the future. The following interview is with Dr Sucharita Sriranjan, Specialty Doctor in Perinatal Psychiatry, and Bana Kesete, Ward Manager at Coombe Ward Mother and Baby Unit (MBU).

CNWL’s perinatal services have been subject to significant transformational development recently. How have your services changed over the past couple of years from a frontline perspective?

In the past few years, I’ve recognised an increase in community perinatal mental health teams so it’s now easier to liaise with the community professionals once our patients have left the unit. When mothers and their babies are with us, we’re able to offer them treatment, help manage the challenges they face, support and engage with their partners and carers – we also do what’s called ‘tree of support’ which involves the whole family in their treatment. There is a risk of patients suddenly lacking support once they’re discharged but community teams are now able to fill that gap as patients transition back to their day-to-day life. The community teams are also expanding so they’re getting more psychologists and therapists to continue helping mothers within their communities – Sucharita

We’re also planning to recruit a peer support worker who can run sessions and potentially chair our community meetings. This will give mums a great opportunity to talk about their experiences with someone who has been in a very similar boat – Bana

What are some of the most important developments happening in your services currently?

Whilst our focus is on mothers and their babies, we’re also trying to involve dads and LGBT+ partners into the treatment through the tree of support. We’re also working on materials that we can share with partners who might be struggling with their own mental health during the perinatal period so that’s something for people to look out for – Sucharita

We’ve also been training more nurses in Dialectical Behavioural Therapy (DBT) which has been a great benefit to the mums as it enables them to learn coping mechanisms for particularly challenging situations – Bana

What are the most pressing challenges mothers and their partners have faced over the past few years?

Understandably, the visiting guidance during Covid has been a huge issue as mothers have only been allowed one allocated visitor. This has inevitably limited the time families can spend together during a period where they can feel very vulnerable – Bana

In many families, there’ll be older siblings who want to come in and see the baby so we’ve made efforts to enable that. We’ll carry out assessments and manage the risks so mothers can spend time out in the community with their families. As staff, we’ve been fairly lucky in that we’ve had to work through all three lockdowns and we’ve continually had admissions and successful discharges – Sucharita

How have your team coped with the Covid restrictions over the past two years?

This is one of the best teams I’ve ever worked in so I’ve always felt grateful coming into work, even during those lockdowns! There would inevitably be staff shortages some days but someone was always willing to volunteer, jump in and get the job done. We just support eachother – it’s the little chats and the little cups of tea we had which really got us through that period – Sucharita

I agree with Sucharita – it's also the best team I've ever worked in. We have such a friendly and supportive team who have been able to help one another during this difficult time. The nursing team and bank staff have continuously stepped in to support us during the pandemic. Having regular conversations with staff has been helpful with understanding how everyone is coping with the covid changes and what support is available – Bana

What part of your job brings you the most joy?

It has to be the recovery process. When mothers first come to us, they’ll often be extremely distressed and unwell but they’ll eventually get to a place where they’re able to take care of themselves and their baby, and feel far more stable with their mental health. When I speak to mothers before they experience an MBU, there isn’t usually much awareness of how much care there is available but we’re very well resourced – we have therapists, nursery nurses, clinicians, a variety of group sessions such as baby massage and sensory play. We’ll often link up with our pharmacy colleagues also so there’s a lot of teamwork – Bana

Cute babies! (laughs) No, I agree with Bana. It gives me goose bumps seeing the progress mothers make from when we first see them to when they’re discharged. There is one thing I really miss from pre-Covid times – we used to have a Christmas party where we’d invite all the mothers who had been on the unit that year and they’d come back with their babies, some of which would then be toddlers and we’d have someone dressed as Santa to give the babies presents. Talking to the mothers in that setting and reflecting on their time as a patient was particularly wonderful so I hope we can bring that back soon – Sucharita

We still manage to keep in touch a bit. Families will still send us emails and pictures of their babies after discharge to let us know how they’ve been getting on – Bana

What are your plans for celebrating Mother’s Day in Coombe Wood MBU this year?

Our Occupational Therapist has developed a pampering pack for the mums to enjoy on Sunday. One of our nurses will be leading on some of the self-care items within the pack such as facials and manicures. They’re also working on making salt dough with their baby’s hand and footprints which can be painted afterwards – Bana

In the past, we’ve done a similar thing with pillow cases and tea towels as it’s lovely for the mothers to have something with their baby’s handprints/ footprints that they can take with them beyond their stay in the unit – Sucharita