Idea #9 Family-focused environments

What’s the idea?

Specialist perinatal mental health services are delivered in a range of inpatient and community settings. Small changes to the environment of the setting can make a big difference to whether partners and other family members feel welcomed, included and involved.

Why implement it?

  • Partners and other family members may believe that the service is ‘not for them’ if there is nowhere for them to sit during an appointment, if staff do not greet them directly, and if the images displayed around the setting are only of mothers and babies. Mothers may also believe that partners and other family members are not expected or welcome.
  • Partners and other family members may have to travel long distances to visit an MBU, often fitting these visits around their other work and caring commitments. This can come with high financial costs as well as emotional and physical fatigue. This may affect their wellbeing and self-care.
  • Older children within the family may be feeling distressed or left-out; small changes to the environment could make a big difference to their experience of this difficult time for their family.

Actions to consider

  • Carry out a ‘family check’ of the setting to identify where changes could be made to make partners and other family members feel welcomed, included and involved.
  • Aim to reduce practical barriers to partners and other family members accompanying or visiting the mother.
  • In MBUs, balance the creation of a family-focused environment with the need to ensure that it remains a safe therapeutic space for mothers with severe mental illness.

Practice tips: box 12

Family checks

This builds on the suggestion that services working with parents in the perinatal period use ‘dad checks’ [ref. 46]

Physical facilities

Check all aspects of the setting: reception area, waiting area, toilets and appointment rooms.

  • Are families given details about how to get to the building?
  • Can the building, waiting area, and rooms be easily accessed with a buggy or by those with impaired mobility?
  • If buggies can’t be brought inside, is there a safe, covered area outside where they can be left?
  • Are there changing tables, nappy bins, toys and books for different ages (including for older children)?
  • Are there inclusive toilet facilities?
  • Are there enough comfortable chairs in the waiting area and clinic rooms for multiple family members?
  • Are there places to charge a phone and information about possible wifi access?

Information and notice boards

  • Do posters and leaflets have positive images of partners with their families?
  • Do they include different types of families and people from different cultural backgrounds?
  • Are siblings and grandparents included?
  • Do notice boards have information about local and national services and support for partners and other family members? Is this up to date? Does this information include details about support available to carers?
  • If the family live out of the area, is there information on where they can find out about their local services and support available?

Practice tips: box 13

Family checks – special considerations for MBUs

  • Are there protected women-only spaces?
  • Is there space where families can spend time together away from other service users?
  • Is there a space where older children can play or sit when they come to visit? Can mothers also access this space and join in any activities?
  • Is there a private space for professionals to meet with partners and other family members?
  • Is there anywhere for partners and other family members to stay close by? (e.g. provide a list of local accommodation and acknowledge that it is difficult being away from home)
  • Is there information for partners and other family members about where they can get food and drinks on site or close by?
  • Is there any information about other services (e.g. local authority/charities for carers) who may be able to support travel costs?
  • If family members are frequently travelling long distances can they be supported to look at public transport options, to reduce fatigue and possible financial costs?

Practice example: Co-design to create a family-focused environment

Jasmine Lodge Mother and Baby Unit, Devon Partnership NHS Trust

Mothers and families with lived experience of perinatal mental health disorders were closely involved in the design of the new purpose built MBU. Co-production has helped to create respectful spaces and an environment that feels truly family- focused, down to the colours, fabrics and textures used.

The MBU includes family-friendly spaces where partners and other family members can spend time with the baby as well as allowing the whole family unit to spend time together: a family room, a large kitchen-diner, and an enclosed garden that has “organic play equipment” as well as playground equipment. There are also two apartments for families to stay overnight that are due to open.

Practice example: Becoming more inclusive

Mother and Baby Unit, Melbury Lodge, Southern Health NHS Foundation Trust

In response to feedback from a same-sex couple, the MBU changed the wording of their information board and information packs so that it did not refer exclusively to fathers.