©
Shutterstock
The Improving Postpartum Outcomes of Severe Mental Illnesses in Ethnically Diverse Mothers (POSIE) project, funded by the National Institute for Health and Care Research (NIHR), is a collaboration between several UK universities, including the University of Oxford, NHS Trusts and charities. It aims to identify practical ways to improve care for mothers experiencing serious mental illnesses such as severe depression, anxiety, bipolar disorder, and psychosis.
Suicide remains the leading cause of death among mothers in the first year after giving birth, while the number of new mothers seeking mental health support has risen sharply, increasing by 30% between 2022 and 2023. Meanwhile, women from Black ethnic backgrounds are almost three times more likely to die in the year following childbirth compared to white mothers, and women from Asian backgrounds also face an increased risk.
A particular focus for the research is the transition from hospital to community care, a period when many women lose contact with support services and face heightened risk.
Dr Roisin Mooney, co-lead investigator of the project at the Department of Psychiatry, University of Oxford, said:
Cultural and structural barriers can prevent women from receiving timely and appropriate mental health support, leaving many without access to effective treatment or follow-up care. By exploring why gaps in aftercare exist and how these differ across ethnic and social groups, this inclusive research seeks to inform new, equitable approaches to postpartum mental health care.”
Professor Kam Bhui, co-lead investigator also from Oxford and lead of the CHiMES Collaborative research group, said: “The disparities between different groups highlight that current systems of care are not meeting the needs of all mothers. This exciting collaborative project aims to tackle this challenge and improve the prevention and management of severe mental illness following childbirth.”
The research team will use clinical data to investigate variations in care and outcomes, and will run workshops involving at least 120 women with lived experience of postpartum severe mental illness from Manchester, Sheffield, London and Oxford. From this data, they will design a new ‘culturally safe’ care pathway, which will be tested and evaluated at six sites across the country, before developing a toolkit and guidance to support its implementation.
Professor of Maternal and Infant Health at Sheffield Hallam University, Hora Soltani, is part of the POSIE project team and also leads the NIHR Inequalities Challenge: Maternity Disparities Consortium.
Professor Soltani said: “As lead for the perinatal mental health theme within the NIHR Maternity Disparities Consortium, I am delighted to be part of this very important project. Becoming a mother is often assumed to be a joyful and transformative experience, but for some women it can also be a period of significant vulnerability with poorer outcomes for underserved communities. This project aims to ensure that every mother, regardless of background, receives compassionate, effective, and culturally responsive support needed for recovery and long-term wellbeing. Perinatal mental health matters as its impact spans generations, making equity and inclusion a societal imperative.”
Shaheda Akhtar, a peer support facilitator from Action on Postpartum Psychosis (APP) and patient and public involvement (PPI) lead on the POSIE project, said:
We regularly hear from Black and Asian women who've had postpartum psychosis about delays in treatment and admission, that care and information did not feel appropriate to them, and they had difficulties finding information about this treatable medical emergency. Going to a Mother and Baby Unit can be quite frightening when you don't know anything about them. Our peer supporters help women to understand what they are experiencing and combat isolation and fear. At APP, we educate health professionals by sharing women’s powerful stories, but we know that they are crying out for evidence-based practical ways to improve care.”
Laura Kyrke-Smith MP is currently leading a private members bill though Parliament, which is calling for high-quality perinatal mental health assessments to be a routine part of antenatal care for all women in England. It has been named ‘Sophie’s Law’ in memory of Ms Kyrke-Smith’s friend who died by suicide following the death of her third child.
She said: “Research like the POSIE project is vital to addressing the unacceptable inequalities that continue to cost mothers their lives. We know that women from Black and Asian backgrounds face significantly higher risks of death following childbirth, and that the transition from hospital to community care is a particularly vulnerable period when too many women fall through the cracks.
"This research will help us understand why these disparities exist and, crucially, how we can design care pathways that work for all mothers, regardless of their background or postcode. Every mother deserves access to compassionate, culturally responsive mental health support when she needs it most.
"I welcome this collaboration and look forward to seeing how its findings can inform better practice across the NHS and help ensure no more families have to experience preventable tragedy."
This study is funded by the NIHR and in collaboration with the University of Oxford, King’s College London, University of Greenwich, University of Manchester, Sheffield Hallam University, University of Sheffield, University College London, Royal College of Psychiatrists, Action on Postpartum Psychosis, The Light in Sheffield, 5XMORE, Policy Connect and The Mental Elf.