The Pillars of Partnership Working in Perinatal Mental Health
On the back of a rich discussion at one of our online Conversation Spaces, we wanted to explore the reality of cross-sector working. It’s spoken about in strategic forums as the ‘Gold Standard’ of operational models, though it varies from region to region.
We spoke with Shelley McBride, Co-director of Connected Perinatal Support CIC, and Helen Martinez, a Community Peer Support Worker in the Derbyshire Perinatal Mental Health Service to look at how it works both strategically and ‘on the ground’ in Derby.
Career pathways
The journey to taking on her role as a Peer Support Worker in the Perinatal team came as a result of lived experience and a passion for perinatal mental health. Helen received statutory support following the birth of her daughter and she also knows first-hand the benefits of VCSE support, having volunteered with Connected. Reflecting on this, Helen said: “When I was being discharged from the perinatal team after having my daughter, they were recruiting volunteers at Connected and I applied and had the most amazing experience. This gave me the confidence to apply for this role at Derbyshire PMH Service when it came up.”
Mutual training opportunities
Volunteers at Connected take part in a 23 week training programme, co-hosted with health and social care professionals; the senior labour ward midwife at the hospital, representatives from social care, the specialist perinatal team and in the local Children’s Centre. As a result of this, volunteers get a good flavour of what support is out there.
The training offer is reciprocal, as is reiterated by Shelley: “New peer supporters in the Perinatal team are coming on our training which gives them a good insight into the way that we work and how things operate in the community.”
The importance of relationships
Connected has been through quite a journey with the service as it used to be within another organisation. In the early days in that service Shelley and fellow Co-director, Emma, were part of the first cohorts of volunteers. During that time they did a lot of outreach and consider themselves lucky as they have a Mother & Baby Unit (MBU),The Beeches, on the patch, so started to make connections with the service manager. She was so passionate about working with community services and they would go on to the ward once a week and provide peer support.
Shelley said: “As we became an independent organisation we had more autonomy and we built on those relationships. The MBU manager recognised that you couldn’t necessarily deliver the community aspects of support within a statutory service.”
The strength of complementary services
Helen and Shelley both maintain that VCSE and statutory services in perinatal mental health are complementary. They each offer something different and it’s in understanding the respective strengths of service delivery that the landscape functions more effectively as a whole.
This means recognising the interconnectedness of them, to create more seamless referral pathways and ways of working focused around families’ needs. Shelley added: “We’ve got pathways that enable us to refer straight into health visiting too as well as into perinatal mental health for assessments, which makes life easier for parents.
“We’re going to be working more closely with the Perinatal team as part of the Family Hubs work that will be rolled out in our area. We’ll be doing the mapping work that is funded under that work and that sits well with us.”
Equally, the passion and knowledge of how the services fit together is voiced by Helen: “I’m an advocate for both services so I can think about what a mum really needs support with and Connected Perinatal Support is very much part of my toolkit.
“A lot of mums in the PMH service aren’t going to go to the average mum and baby group as they’re too overwhelming. They need spaces where they feel safe, where there’s a Peer Support Worker. who understands them.”
A ‘brave new world’ in commissioning
Without champions in the statutory sector, it could be very challenging for VCSE services to be understood and included within decision-making processes.
In the current landscape, we hear more and more at a national level that VCSE services are instrumental and a partnership approach is the way forward. Shelley talked about the value of working with commissioners who ‘get’ the VCSE offer: “We’ve been really supported by a commissioning manager in Public Health, particularly in Covid, as things had to be done differently and they trusted us to get on with it.”
The new commissioning landscape with the emergence of Integrated Commissioning Boards (ICBs) has created some confusion across the sector, in terms of where services sit and the geographical boundaries. This is particularly prevalent when the focus is on maternity or infants / children and there’s such an overlap, as we can’t look at those two issues in isolation.
Erratic funding cycles mean that services aren’t always sustainable – there is a ‘stop – start’ approach which puts VCSE workers in precarious positions and sometimes means they work without any remuneration until the next funding comes into place. This is a risky and short-term way to operate. Shelley emphasised this in her comment: “Every time you de-commission a service that is doing good work, you make things harder for everyone.”
Plugging gaps and accelerating support
If a mum is discharged from the perinatal team they can access community-based support, which means VCSE services are well-placed to ensure parents don’t fall between the gaps.
Shelley added: “Especially if they start to dip a bit and might need signposting to additional support. We can have a conversation with the Perinatal service to look at the bigger picture and see how best a mum might be supported.”
Pillars of partnership working
We rounded off the chat by asking both Shelley and Helen their reflections on the key ‘ingredients’ to effective partnership working. They replied: “The community – our volunteers are such an important part of the community and they go out and do the work on the ground, helping to shape how we develop.
“It sounds cheesy but integrity is important. We need to keep standing up for what’s right, even if that gets hard.
“Courage is key, especially when funding gets challenging. Difficult conversations are reliant on good working relationships across sectors and this enables greater honesty.”
The closing comment sums up a fundamental aspect of partnership working, which is equity. Shelley concluded: “For us it’s not about replicating our service everywhere – it’s about getting it right in our area. There are community gems in every area. If you pay them enough, respect them and give them a seat at the table, they’ll let you know what works well.”