What guidelines should I follow for referring a patient to specialist services after a stillbirth for further psychological support?

For a patient requiring further psychological support after a stillbirth, the guidelines recommend offering a high-intensity psychological intervention if post-traumatic stress disorder (PTSD) has resulted from the stillbirth ¹. This intervention should be trauma-focused Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitisation and Reprocessing (EMDR), in line with the NICE guideline on PTSD ¹.

Following a stillbirth, it is important to discuss options such as seeing a photograph of the baby, having mementos, seeing the baby, or holding the baby with the woman, her partner, and family ¹. This discussion should be facilitated by an experienced practitioner, and a follow-up appointment in primary or secondary care should be offered ¹.

Referral to specialist services should follow clearly specified care pathways ¹. Managers and senior healthcare professionals in perinatal mental health services, including those in maternity and primary care, must ensure these pathways are in place so that all involved professionals know how to access assessment and treatment ¹. Staff should receive supervision and training covering mental health problems, assessment methods, and referral routes to enable them to follow these pathways ¹.

Clinical networks for perinatal mental health services should be established, providing a specialist multidisciplinary perinatal service in each locality ¹. These networks should offer direct services, consultation, and advice to maternity, other mental health, and community services ¹. They should also provide clear referral and management protocols across all levels of stepped-care frameworks for mental health problems, ensuring effective information transfer and continuity of care ¹. Additionally, women should be provided with information on where to access support and counselling services, including leaflets, web addresses, and helpline numbers for support organisations ².