Specialist care helps develop relationship between mothers with severe mental illness and their newborn children

For mothers who are suffering from severe mental illness, interactions with babies significantly improve following specialist video-feedback and treatment on an inpatient Mother and Baby Unit (MBU), according to a new study led by King's College London's Institute of Psychiatry (IoP).

The formation of the first relationship between a mother and baby is key in the development of the child's attachment relationships. This study shows the importance of providing specialist support for new mothers when they are suffering from severe mental illness (schizophrenia, major depressive disorders with or without psychosis, bipolar illness), necessitating in-patient admission.

The study followed a group of 49 mothers with severe mental illness during admission to the South London and Maudsley NHS Foundation Trust MBU and compared mother-infant interactions with a community-based group of 67 mothers with a mental health diagnosis of similar severity but who were not given specialist treatment, and a group of 22 healthy mothers.

By observing a 3 minute videotaped play session, the researchers measured maternal sensitivity and unresponsiveness, and infant cooperativeness and passiveness. Mothers were invited to take part in a video-feedback session approximately every 3 weeks. The therapeutic work, with a professional trained in infant observation, centres on watching and learning about the baby's cues so that the mother becomes more sensitive to seeing her baby as a person and learning what works and what does not work in creating a smooth dialogue between them.. The average stay in the MBU was 13 weeks.

Following admission to the MBU and video-feedback, mothers and their infants showed improvements in their interaction. On discharge from the MBU, mothers and their infants were significantly more sensitive, cooperative and responsive. Comparisons with a 'community–ill' group of mothers and their babies showed that on discharge the MBU mothers and babies were significantly more sensitive, cooperative and responsive, and that they were as attuned as a healthy group of mothers and their babies.

Dr Susan Pawlby, lead author of the study from the IoP at King's and clinical developmental psychologist at the SLaM MBU, says: "Following admission to the MBU, not only do we see improvements in the mothers' interaction with their babies, but also in the babies' interactions with their mothers. Maternal severe mental illness can severely disrupt a mother's ability to interact with her new-born child. Our study points to the importance of specialist support for new mothers with severe mental illness, to help improve interactions with their babies, and as a result, promote better development for the child."