2024-12-31-accounts

REGISTERED COMPANY NUMBER: 07466643 (England and Wales)

REGISTERED CHARITY NUMBER: 1139925

Action on Postpartum Psychosis (a Company Limited by Guarantee)

Trustees’ Report & Unaudited Financial Statements for the Year ended 31 December 2024

Action on Postpartum Psychosis Trustees’ Report and Unaudited Financial Statements for the year ended 31 December 2024

Contents

Reference & Administrative Details ................................................................................................................... 1 Trustees’ Report ................................................................................................................................................ 3 Objectives and Activities ................................................................................................................................ 3 Achievements and performance ..................................................................................................................... 7 Financial Review .......................................................................................................................................... 22 Structure, Governance and Management..................................................................................................... 22 Risk management ........................................................................................................................................ 23 Plans for Next Year ...................................................................................................................................... 24 Public Benefit Statement .............................................................................................................................. 27 Trustees’ Responsibility Statement .................................................................................................................. 28 Independent Examiner’s Report to the Trustees of Action on Postpartum Psychosis ...................................... 29 Statement of Financial Activities (incorporating and income and expenditure account) for the year ended 31 December 2024 ............................................................................................................................................... 30 Statement of Financial Position 31 December 2024 ........................................................................................ 31 Statement of Cash Flows for the year ended 31 December 2024 .................................................................... 32 Notes to the Financial Statements for the year ended 31 December 2024 ...................................................... 34

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Action on Postpartum Psychosis Reference & Administrative Details for the year ended 31 December 2024

TRUSTEES A Bauer G S Berrisford C K Cho C Dolman S A Hind (resigned 2 December 2024) I R Jones A R Jones T C Robinson CHIEF EXECUTIVE J Heron DIRECTOR OF FINANCE AND K Mullard OPERATIONS REGISTERED OFFICE International House 12 Constance Street London E16 2DQ REGISTERED COMPANY NUMBER 07466643 (England and Wales) REGISTERED CHARITY NUMBER 1139925 INDEPENDENT EXAMINER TCA (Shrewsbury) LLP Third Floor 21 St Mary's Street Shrewsbury Shropshire SY1 1ED SOLICITORS (PRO BONO) Howard Kennedy LLP No 1 London Bridge London SE1 9BG

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Action on Postpartum Psychosis Reference & Administrative Details for the year ended 31 December 2024

BANKERS

HSBC Bank PLC 18 High Street Burton on Trent Staffordshire DE14 1HU

The Cooperative Bank PLC 1 Balloon Street Manchester M60 4EP Bath Building Society 15 Queen Square Bath BA1 2HN Saffron Building Society Saffron House 1A Market Street Saffron Walden Essex, CB10 1HX

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

The trustees who are also directors of the charity for the purposes of the Companies Act 2006, present their report with the financial statements of the charity for the year ended 31 December 2024. The trustees have adopted the provisions of Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019).

Objectives and Activities

Postpartum Psychosis

Each year, one to two in every thousand new mums will develop hallucinations, delusions, mania, depression and unusual behaviour within days of childbirth, often out of the blue. When a mother experiences mania or psychosis following the birth of their baby it is known as postpartum psychosis (PP). The condition is frightening and can have a devastating impact, not only on the woman affected, but also on their partner and wider family. Ignorance about the illness is widespread and many women experience stigma, isolation, and a lifetime burden of guilt.

Suicide is the leading cause of death among new mothers. Prior to 2011 when our charity began, postpartum psychosis was responsible for almost half of (non-substance abuse) psychiatric deaths. During the last decade, PP-related maternal deaths have become rare, although maternal suicides as a whole have continued to increase. However, early evidence suggests that deaths due to PP could be on the increase in the postpandemic period. For each of these statistics, a baby loses a mother, and a family sustains an unimaginable loss, when the fact is, postpartum psychosis is a treatable illness and full recovery is possible. A shortage of Mother and Baby Units (MBUs) means that mothers can be separated from their newborns when placed in General Adult Psychiatric Wards with the burden of care falling to other members of the family or social services - the separation compounding an already devastating situation.

Charitable Objects, Vision and Long-term Objectives

Under its Articles of Association, the charitable objects for which Action on Postpartum Psychosis (APP) is established are:

• to promote and protect the physical and mental health of women who have experienced postpartum psychosis and their families through the provision of support, education and practical advice;

• to advance the education of the public in general (and particularly amongst health professionals) on the subject of postpartum psychosis and to promote research for the public benefit in all aspects of that subject and to publish the useful results; and

• to advocate for perinatal mental health services for women and their families.

Our vision is for all women and families affected by postpartum psychosis to benefit from best-practice treatment and appropriate support through to full recovery. Our long-term objectives are:

• Improving recovery outcomes by: supporting women and families affected by postpartum psychosis to engage with others who’ve ‘been there’; improving access to evidence-based information; signposting to appropriate support; training and informing health professionals; facilitating research into all aspects of PP; and increasing knowledge of postpartum psychosis in the general public.

• Reducing isolation by building a supportive, peer-led, lived experience community of women and families affected by postpartum psychosis online and in person across the UK.

• Combating stigma and silence by promoting greater awareness of postpartum psychosis in the general public, the media and at conferences and events.

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

• Improving services and care for women and families by offering specialist information, training on postpartum psychosis and campaigning to increase the number of Mother and Baby Unit beds available across the UK. Facilitating research into all aspects of postpartum psychosis and promoting the useful results of research.

• Reducing the maternal suicide rate by improving understanding of postpartum psychosis among the general public and health professionals; and improving access to specialist care, peer support and information.

APP works nationally in England, Wales, Scotland and Northern Ireland, although we also look for opportunities to influence care and understanding of PP globally.

Volunteers

APP works with and is supported by several types of volunteers: peer support volunteers, media and storytelling volunteers, regional reps and fundraising volunteers. Our volunteers are women with lived experience of postpartum psychosis or their partners and family members and are passionate about making a difference for women and families affected by PP. Our volunteers enable us to draw from a wider range of postpartum psychosis experiences in our work, rather than only those of our lived experience staff team. Our peer support volunteers provide one to one and group support for women and their families who have experienced and been affected by PP. Media and storytelling volunteers raise awareness by telling their stories in the regional and national press, on social media, websites, television and radio. Regional Reps give lived experience talks at events and training sessions, often alongside APP staff, helping APP to connect with health professionals as well as disseminating information and supporting patient involvement in developing NHS services in their area. Fundraising volunteers plan events and identify fundraising ideas and opportunities to help generate income to support APP’s work. We are very grateful for the work of all our volunteers, who enable us to reach more people and achieve a greater impact in all areas of our work.

Objectives and Activities in 2024

APP is an innovative collaboration between women and families who have experienced postpartum psychosis, leading academic researchers and expert health professionals. Our main objectives and activities in 2024 are described below. Our charitable activities consisted of: providing specialist support and information to affected women and families; raising awareness of postpartum psychosis amongst the public and health professionals; campaigning for improved services; and conducting research to better understand the illness. These activities are undertaken to further our charitable purposes for the public benefit. We measure the success of our work through: surveying service users, volunteers and training participants (using an online survey and feedback forms); monitoring service user data; and asking individuals to write about their experience.

Supporting affected women and families

APP’s Peer Support Service aims to create an active and engaged postpartum psychosis community, improve recovery outcomes for women and families, reduce social isolation, reduce the maternal suicide rate and decrease the long-term impact of the illness on family life.

Our Peer Support Service offers one-to-one support (via email, telephone, video call and face-to-face), café groups (face-to-face and online) and a community forum where those affected can go to ask questions, gain support and signposting. We employ Peer Support Coordinators with personal experience of postpartum psychosis to manage the service and carefully moderate to ensure that the service and forum are safe; the Coordinators are supported in turn by specialist health professionals and academic experts.

The Coordinators recruit, train and support Peer Support Volunteers and staff with experience of postpartum psychosis to provide empathy, practical information and hope for recovery. In 2024, we aimed to maintain and grow our national and regional peer support service by:

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

• Offering online, in person, video call and café group support to all who need it nationally and via our NHS projects, and maintaining long term contact with those we support.

• Training new peer supporters at two training days, prioritising volunteers from diverse communities Northern Ireland, Scotland, Wales & NHS project regions; and continuing to develop ongoing training and creative and wellbeing activities for volunteers, building a strong, engaged, well supported volunteer community.

• Developing a bereavement support online group and one-to-one calls, training our first bereaved partner peer supporter and grandparent volunteer. Working with our volunteers and a consultant to better understand the support and information needs of bereaved partners and family members.

• Growing our diverse communities peer support, supporting staff to outreach into communities to educate about PP, using pieces on social media, and networking to identify more volunteers from Black, Asian, and other ethnic communities and LGBTQ+ backgrounds. To continue our Muslim women’s group and to set up a Black women’s café group once staff/volunteers have been identified. Funding for a diverse communities’ Coordinator and project will be sought to further develop this work.

• Increasing attendance at café groups, building community and café group activities, developing protocols and resources for café group leaders.

• Developing initiatives to identify more partner volunteers, increasing staff capacity and awareness of the dads and co-parents project as funding allows.

We measure the success of our peer support work through the number of women and family members reached, through surveying service users and volunteers about the benefits and downsides of receiving or delivering support in this way, and by asking individuals to write about their experiences. Survey questions include whether service users feel more supported, less isolated, more informed, less negative about postpartum psychosis, more hopeful, and whether the peer support has aided users’ recovery. We also survey peer support volunteers about the experience of training and volunteering.

Raising awareness amongst health professionals

In 2024, we aimed to reach more health professionals with training by:

• Continuing to offer online bookable one-day training and NHS commissioned in-person training days.

• Arranging a second annual free Alex Baish Memorial Webinar, building our database of health professionals.

• Continuing collaborations with the Institute of Health Visiting (iHV) and the Royal College of Psychiatrists (RCPscyh) and strengthening new collaborations with GP bodies and antenatal educators, delivering tailored training & lived experience talks.

• Continuing to run specialist training on supporting partners and working with women from diverse backgrounds, using recorded content to develop our first two paid online modules.

Our workforce training courses are delivered by our world leading experts in Perinatal Psychiatry, APP staff members, and APP Experts by Experience. By utilising clinical experience, cutting-edge research, and the real experiences of affected women and families, the courses aim to up-skill the workforce, developing expertise and empathetic understanding. APP’s Experts by Experience – trained volunteers and staff members with experience of postpartum psychosis - raise awareness in their local regions, by giving talks to health professionals at conferences and events, disseminating information, and sharing their personal experiences: describing their symptoms, experience of treatment and recovery, what worked well for them and what did not, and the impact on their relationship with their baby, family and friends.

We assess the success of this awareness-raising work through the number and range of professionals reached, session feedback and through questionnaire feedback on the one-day training. We ask whether the training: will change their practice; has increased their knowledge of postpartum psychosis and the risks; has

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

increased their confidence and empathy in working with affected women and families; and whether it has made them feel better equipped to help women recover.

Raising awareness amongst the general public

In 2024, we aimed to continue to raise awareness in the general public to reduce stigma and misinformation and help newly affected women and families access our lifesaving information and support by:

• Developing media and communications for the main ‘moments’ across the year (for example Maternal Mental Health Awareness Week, Black Maternal Mental Health Week, World Mental Health Day, and Suicide Awareness Week); placing case studies in the media and social media to support APP campaigns, new projects, and to raise awareness of APP peer support, training and information resources.

• Supporting APP’s relationship with: Ambassadors; Maternal Mental Health Alliance; National Suicide Prevention Alliance; Pregnancy & Baby Charities Network; NHS (influencers in perinatal mental health professionals, midwifery, health visiting, psychiatry); universities (key postpartum psychosis and PMH academics). Using the BBC Radio 4 appeal media campaign and other opportunities to engage our community and raise awareness of PP.

• Supporting engagement with & reporting on creative projects as staff capacity allows.

We measure the success of this awareness raising work through the range and reach of media pieces about PP that we are involved in, and the number of followers and level of engagement on our social media channels and website.

Campaigning for improved services

Our goal is that all women and families in the UK have access to the services they need to get help and recover from PP. In 2024, we aimed to use our specialist expertise and lived experience voice to create change in systems, by:

• Continuing APP’s MBU campaign, with a particular focus on: maintaining pressure for an MBU for Northern Ireland; supporting calls for MBU beds in Northern Scotland; building good relationships with all MBUs, connecting and helping to amplify their social media content; sharing positive MBU stories to demonstrate their value; engaging with the North Wales/Chester MBU build, supporting Lived Experience engagement; and monitoring NHS England bed number commitments and responding to any risk of bed closures.

• Continuing APP’s antenatal education class campaign: developing social media assets to convey PP information to pregnant women and partners and to raise awareness of the antenatal education toolkit to midwives, health visitors, antenatal educators and GPs; and repeat APP’s YouGov survey at the end of 2024 and social media midwife survey to determine the impact of the campaign.

Research

In 2024, we aimed to continue to facilitate research studies of importance to women and families affected by postpartum psychosis, as capacity and funding allowed, by:

• Introducing an annual research gaps survey and promoting findings to universities/funders.

• Seeking funding for our research support infrastructure

• Finalising APP’s MBU survey reports.

Fundraising and strengthening our capacity

In 2024, we aimed to strengthen our capacity to fulfil our charitable objectives through improving our internal systems to support sustainable growth. We planned to:

• Develop a more diverse fundraising base, stronger fundraising processes and increased grassroots income, in particular: delivering an effective Radio 4 appeal; building relationships with grassroots

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

fundraisers, offering new events and activities; increasing our capacity for trust and foundation application writing; and identifying potential funding opportunities to develop APP as a research support facility.

• Further develop the data manager role - implementing more efficient processes to manage organisational data simply and effectively.

• Continue work on our First Point of Contact project, reviewing our beneficiary journey and information, supporting recruitment to research and long-term engagement with APP.

• Further develop our impact reporting

• Continue development as gold standard lived experience, family friendly employer.

Achievements and performance

Peer Support to affected women and families

In 2024, APP continued its national peer support service, expanding our work with dads and co-parents, families from diverse communities and bereaved families. We launched our fourth Insider Guide - ‘Being a parent after Postpartum Psychosis’ – providing valuable information for women and families affected by PP, produced a new webpage on becoming a grandparent after PP and continued working to develop information on legal and rights-based issues faced by women after PP. The new guide shares information and ideas from APP parents at children’s various ages and stages of development. Face to face workshops and an online working group were used to inform the guide, alongside input from APP’s staff and experts in child development and perinatal mental health. Feedback on the new guide from our social media followers included:

“Well done to…everyone who put this together - it’s really useful and well written.”

“I couldn’t love a resource anymore. I would have given my eye teeth for this in 2010. Awesome doesn’t even come close.”

Overall, in 2024 APP supported 1,045 people, including women, partners, grandparents, and families (2023: 1062). An average of 218 people used our online peer support forum every month (2023:226), with the number of registered forum users increasing from 3,518 to 3,776. Coordinators and volunteers supported 381 people via email, telephone, video call, in person meet-up and café groups (2023: 338), which included 301 women (2023: 275), 46 partners (2023: 31), 23 grandparents (2023: 32), and 11 other family members/friends. Our NHS embedded partnership projects supported 393 individuals (2023: 335). We continued to use social media to provide peer support ensuring that there was always a trained peer supporter monitoring our social media to offer support and signposting to anyone needing help who commented or messaged us.

We conducted our annual peer support user survey between late July and early October 2024, promoting it widely and repeating the new questions asked in 2023 about whether peer support had helped with specific elements of people’s PP experience. Almost all respondents (99%) felt more supported since finding APP (2023: 99%); 95 percent felt less isolated (2023: 96%); 96 percent felt more informed about PP (2023: 97%), and 91 percent felt less negative about PP (2023: 87%). Meanwhile, 93 percent felt more hopeful about the future (2023: 94%), and 96 percent felt that APP had helped, or was helping, them to recover (2023: 97%). Nearly half of respondents (48%) said they might not be alive if they had not found APP's peer support services this year, a similar proportion to 2023 (46%) and continuing the marked increase on previous years (normally around 31-33%), demonstrating that APP’s peer support continues to change and save lives. These examples of responses from the survey show the impact of peer support:

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

“Under no uncertain terms, APP was a pivotal part of my recovery. It provided a safe environment where I felt a sense of belonging during my recovery.” (survey respondent)

“It is so nice to feel a part of a community, to know others have been through a version of what you have, it validates the whole thing. I feel less alone knowing that I'm not the only one to have had this extremely scary experience.” (survey respondent)

“The fact that APP are very welcoming and open about everything PP-related made me realise that there is nothing to be ashamed about having experienced PP. If others are out there talking about it and sharing their story, then so can I.” (survey respondent)

The 2024 peer support survey again asked more detail about people’s experiences and whether APP’s peer support had helped them with these. The questions were:

• Did you experience, or do you currently experience, any of the following in relation to your episode(s) of PP? (anxiety, depression, further psychosis, ongoing bipolar, intrusive or suicidal thoughts)

• Has APP peer support helped with this?

We discovered that APP’s peer support had been overwhelmingly helpful across a range of experiences during and/or following episodes of PP. The responses are in the table below:

Proportion of survey respondents who had experienced this symptom in relation to their PP episode. (2023 in brackets)	Proportion of survey respondents who had experienced this symptom in relation to their PP episode. (2023 in brackets)	Proportion of respondents with the symptom who found APP peer support had helped with this symptom(2023inbrackets)
Anxiety	85% (98%)	100% (96%)
**Depression **	73% (90%)	98% (98%)
Further episode(s) of psychosis	35% (36%)	88% (94%)
Ongoing bipolar illness	44% (37%)	85% (94%)
Intrusive thoughts	63% (71%)	86% (84%)
Suicidal thoughts	53% (51%)	94% (83%)

Our 2023 peer support survey had asked questions to explore whether our beneficiaries need more support and information on legal, rights-based and financial issues as a result of PP. Our peer supporters often discuss and signpost users to further support in this area, so we wanted to understand more about the prevalence of these issues. In 2024, we engaged a consultant who spoke to survey respondents in more depth about the issues they had reported facing and we began raising funds to take this work forward (see fundraising and internal capacity below).

Café groups and wellbeing activities.

Our ten monthly regional café groups continued to operate in Wales, Sussex & Hampshire, Yorkshire, Lancashire & Cumbria, the North-East, Birmingham, Manchester, London, Scotland and Northern Ireland. Our UK-wide café group meeting continued to take place online and a group for LGBTQ+ families met for the first time. We also ran a monthly dads and co-parents group, a quarterly grandparents’ group, a quarterly Muslim women’s group, a quarterly group for volunteers who manage an ongoing bipolar disorder or other mental health diagnosis, and a peer supporters’ group. In total, 201 people attended an APP café group in 2024, including those groups run as part of our NHS projects and our dads and co-parents group (2023: 172). Our annual peer support survey showed how women, their partners and family members value café group peer

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

support, with 87% saying they would recommend APP’s group peer support to others in a similar situation. Feedback on café groups in 2024 included:

“The cafe group has totally normalised my experience. I am not alone and never will be again.” (survey respondent).

“Cafe groups have [given] me the opportunity to talk over what it is like to have PP… I just feel like it's a place where I belong.” (Northern Ireland café group attendee)

We used social media to promote our online café groups, online volunteer meetups and community activities, for example our regular book club. In 2024, community wellbeing activities included two writing workshops. Writer and actress Lauren-Nicole Mayes (Coronation Street, BBC Writers Room Northern Voices) ran a session ‘finding your own voice’ in November, whilst APP Ambassador and author Laura Dockrill led a creative writing workshop during Maternal Mental Health Week.

Dad and co-parent peer support

Through training new volunteers (see p. 10 below) we were able to expand our work supporting the partners of women experiencing PP. A total of 46 partners were supported, 17 of whom attended our monthly virtual café group meetings (2023: 9). Feedback from dads and co-parents supported in 2024 included:

“My wife and I have both accessed APP's peer support service. It has been one of the most welcoming support services I have accessed and despite PP being a horrific illness the peer support has been nothing short of amazing.” (peer support survey respondent)

“I just wish I’d attended the partner cafes sooner; I kept putting it off but then attended my first one and realised how I could’ve been getting this help sooner.” (café group attendee)

“Peer support massively helps. I also find it healing listening to other dads and find myself wanting to help them.” (peer support survey respondent)

Diverse communities peer support

In addition to running our quarterly Muslim women’s cafe group, we began considering the information needs of Muslim women and their families. We began working with the British Board of Scholars and Imams on a postpartum psychosis guide for Imams, community leaders and families. We also continued our work in raising awareness of PP in Black and Asian communities (see raising awareness amongst the general public below).

Bereavement peer support

In June 2024, we held our first training day for bereavement peer support volunteers. We were joined by five new volunteers who want to use their experiences to help provide support for others who have lost family members to PP. The volunteers are also helping us to produce web content for bereaved family members and will be developing a peer support group for families bereaved by PP. Feedback from the day included:

“Really excited by what this group will be able to bring to those who really need the support.” (attendee)

“It was great to meet other people who’d experienced similar to me, but also to learn how to help others.” (attendee)

“It was the first time I'd ever met someone with a similar experience to my own, something I won't forget. It's given me greater confidence in the experience and what good I can use it for.” (attendee)

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

APP has seen an increase in bereaved families contacting us since the pandemic. This might reflect an increase in poorer outcomes in the context of stretched NHS maternity and mental health services, but we are awaiting further national statistics. In 2024, APP supported 16 individuals from families bereaved due to PP. For three of these families, this support was ongoing from contact started in late 2022. We provided support to individuals from two new families who contacted us during the year, including one mother who we are working with to develop resources to support individuals affected by child loss caused by PP. In 2024, APP staff also received training in supporting with grief and loss, bereavement by suicide, and suicide prevention funded by our Department for Health and Social Care grant suicide prevention grant.

Training and supporting volunteers

We recruited and trained 25 new peer support volunteers in 2024 (2023:13), one of whom is now working as staff on our Birmingham NHS partnership project. Four of these new peer supporters are people whose partners experienced PP and will provide support to dads and co-parents, whilst five were bereavement peer support volunteers (see above). We had 134 active peer support volunteers (2023: 112) who provide support to women and families via our online forum, café group meet-ups, video call, one to one emails and telephone calls. In 2024, we continued to receive good feedback from new volunteers about the peer support training we provided – 100 percent would recommend the training to others (2023: 100%). Many also found it supported their own wellbeing and recovery: 100 percent felt more supported (2023: 100%), and 100 percent felt less isolated and better connected with others with similar experiences (2023: 100%). We received positive feedback in training evaluation forms:

“It was incredibly inspiring and informative. I came away feeling ready to be part of the APP family.” (attendee)

“I left the training feeling so empowered, and strong. And even though I was being trained to support others it was incredibly healing for myself too.” (attendee)

Our ongoing volunteer support programme included: six peer supporter online sessions, including: a focus on self-care and maintaining boundaries; an expert-led session about supporting new mums with anxiety and informal supportive social meet ups. Feedback on the session on supporting with anxiety included:

“Thank you for providing high quality training and for allowing me to learn about other peer supporters’ experiences ” (peer support volunteer)

“It allowed me to learn about anxiety symptoms associated with PP (most of which I had myself in the early days) and how to manage them/support someone with them ” (peer support volunteer)

Our training and support programme for volunteers also included creative and wellbeing activities, including two creative writing workshops, the APP book club meetings and a festive meet up and quiz. Some of the sessions were open to our wider network, not just volunteers, giving participants the opportunity to further broaden their connections with others who have experienced PP. We continued with our two regular volunteer newsletters: one for peer support volunteers, and one for all volunteers, including peer supporters, storytellers and regional reps. We shared updates about the APP team, peer support project and wider work of the charity. Links to fundraising news and volunteering opportunities and information are shared, as well as upcoming events for volunteers and the wider network.

Peer support embedded in NHS perinatal mental health services

In 2024, we had four Peer Support Facilitators embedded in NHS perinatal mental health services: in the MBU in Chorley and Lancashire & South Cumbria community; in the Birmingham MBU and in the Birmingham & Solihull Community Perinatal Mental Health Teams; and in the Community Perinatal Mental Health Teams in

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

the Black Country (until October 2024). We renewed our partnership with the MBU in Manchester for a second year, working in the MBU in Manchester with a team of three sessional peer support workers. In addition, we had sessional peer support workers in the Birmingham & Solihull and Lancashire & South Cumbria partnership projects able to provide additional support to women and families.

Our NHS embedded peer supporters helped 393 women (2023: 333) in 2024, in the Chorley, Birmingham and Manchester MBUs and in the community in Birmingham, Solihull, Lancashire and South Cumbria and the Black Country. Café groups remain an integral part of our NHS partnership projects to enable recovering women to meet; 53 women and partners attended our NHS café groups in 2024 (2023: 41). We have continued to offer a choice of online or in person groups on our Lancashire and South Cumbria project, which covers a large geographical area. All other NHS partnership projects café groups are held in person. We continued to support dads, co-parents and other family members of women experiencing PP. We referred women’s partners for further support from our national dads and co-parents peer support team and women’s (or their partner’s) parents to our grandparent peer support group. Our 2024 peer support survey found that 91 percent of respondents who received peer support through our NHS partnership projects would recommend it.

In 2023, we had begun providing peer support on Andersen Ward, the MBU in Manchester, as part of a new partnership project with Greater Manchester Mental Health NHS Foundation Trust. The project also involves supporting the transition home and running a monthly café group. Our work on Andersen Ward is closely linked to our work at Ribblemere, the MBU in Chorley, Lancashire, providing joined-up peer support for women and families across the northwest of England. Some APP staff work across both the Lancashire & South Cumbria and Manchester partnership projects, and we find that women from the Greater Manchester area may be admitted in Chorley and vice versa, before returning home and receiving support from the café group in their home area. In 2024, both the Lancashire & South Cumbria and Greater Manchester partnerships were renewed for further funding periods. Our contract with Black Country Healthcare NHS Foundation Trust to provide peer support in the community ended in October 2024. However, we were able to provide ongoing support for women and families recovering from PP as part of our national peer support service. In the West Midlands, we continued to provide peer support in the community in Birmingham and Solihull, as well as Chamomile Suite MBU in Birmingham.

We received excellent feedback on our peer support in NHS perinatal mental health services, both from NHS staff and people who had used our support, including:

“As a staff member it has been amazing to watch how supportive the APP workers have been to the mums on the ward. Having someone who can say, 'I have been there' provides a completely different level of understanding and perspective than what we can give as medical professionals and is invaluable.” (Greater Manchester peer support survey respondent)

[APP’s peer support made] “...a massive difference. Being able to speak to someone who has experienced mental health issues themselves was very useful and comforting.” (Birmingham & Solihull peer support survey respondent)

“It was my recovery support tool. I leaned on it and used it quite regularly and I cannot thank my peer support colleague for everything - she helped me to get to where I am now. I honestly think that without her I wouldn't be where I am today.” (Black Country peer support survey respondent)

“Jocelyn was very warm and kind. She felt very approachable and was able to share experiences which helped me to be more hopeful of a positive future.” (Lancashire & South Cumbria peer support survey respondent)

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

Case study

APP supports women and their families through their acute illness and beyond, as they: seek help, recover, rebuild relationships, come to terms with the illness, have concerns about parenting toddlers and teenagers, wish to campaign for change and improve the future for others, plan further pregnancies, navigate menopause, and become grandparents. Many women and family members who initially receive peer support go on to support others on our online forum and may choose to become volunteers themselves. Postpartum psychosis affects women’s extended families and often the baby’s grandparents provide considerable emotional and practical support when their child or their child’s partner is diagnosed with PP. This case study demonstrates the impact of APP’s peer support on one family many years after their PP experience:

“It took me 24 years to access peer support through APP after my experience of postpartum psychosis (PP) in 1998, but it has completely changed my life. I went from being a survivor to actually living my life, and the self-stigma I used to feel has diminished dramatically. I had never heard of PP when I was diagnosed with it after giving birth to my first child. I was thankfully given a bed on the MBU in West London. I was very delusional by this point and I ended up staying there, with my baby daughter Eva, for three months. It was a really traumatic time. I wasn’t really aware of how unwell I was...

I gave birth to a second child, a boy, and it all went really well. I had been told that I was at risk of another episode of PP after giving birth again, but nobody said there was a risk of a psychotic episode later. And this is precisely what happened when my little boy was three years old. I was eventually diagnosed with bipolar and experienced a few more episodes and hospital admissions over the years which deeply affected me. I felt as though I had this awful illness that I was stuck with forever, and I was overwhelmed with feelings of hopelessness.

Thankfully, I haven’t experienced another episode since 2015, but it’s not just the time that has elapsed that has helped me come to terms with my illness. It’s the peer support that I found through APP that has really helped me to feel more hopeful and less alone.

It was 2022 when I found out about APP’s peer support. I reached out to APP and the first person I spoke to who had experienced PP was Ellie, and it was such a moving moment. After all these years, I’d finally found someone else who had been through what I had. It was like after all these years, and this long ordeal that felt so hard and endless, I was able to see that there was light at the end of the tunnel. My husband and I also went along to an APP café group and we met all these beautiful people. They were much younger than me and my husband, but we both sat listening to them with tears in our eyes. We had never cried about the experience before. It was like relief. Finally, we could face what had happened and address it in a more open way.

I think in all the years previous to this I had been so determined to get through life that I forgot to address it, to face it head on. Now I am doing it all with my eyes open, with less shame and with so much more support. I always had my husband, my family and the brilliant staff at the MBU. But being with others who have been where you are is so powerful.

My daughter Eva is now 25 and she came along to one of the meetings too. They can help all family members – whether you have experienced PP yourself, your partner has or your daughter or parent has.

Now I feel like I can give something back, I can share my story so that other women going through this won’t feel as alone as I did.

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…it’s never too late to benefit from peer support. Whether you’ve just experienced PP in the last year, or whether it’s something that affected you many years or even decades ago, reaching out and hearing from others is a comforting and life changing experience. Don’t hesitate to find your community. It really has helped to change my life.” (peer support beneficiary).

Raising awareness amongst health professionals

In 2024, we continued to provide training and Expert by Experience talks to health professionals across the UK. A total of 3,375 health professionals heard one of APP’s lived experience speakers in 2024 (2023: 2,671), including one-day training courses. These were across 13 different online training events (2023: 21) and 26 onsite events (2023: 20). The professionals attending these events included midwives, health visitors, psychiatrists, mental health staff, perinatal mental health and MBU teams, psychologists, nursery nurse staff, obstetrics and gynaecology doctors, pharmacists, social workers, occupational therapists, psychology, nursing and midwifery students, ambulance workers, police force and mental health link workers. These events consisted of NHS training days, perinatal mental health study days, study days for GPs, Psychiatrists’ study days, lectures to student midwives and mental health nurses, and conferences.

We continued our partnership with the Institute of Health Visiting (iHV) inputting into their two-day perinatal mental health champions training. In 2024, we reached 100 health visitors (2023: 172) and will continue to deliver on these courses in 2025. We delivered specialist training to GPs in collaboration with the Coventry and Warwickshire Training hub for GPs and with the Yorkshire and Humber NHS Trust (funded by NHS Health Education England). In 2024, we reached more than 350 GPs with this training (this does not include GPs who attended the Alex Baish memorial webinar– see below). In May 2024, we spoke at the Maternity and Midwifery hour: a live webinar aimed at maternity professionals, detailing what postpartum psychosis is, how it should be treated and managed, and what the role of a midwife is. This reached more than 250 maternity and midwifery professionals.

“You both had such a lovely warm and engaging approach, and the whole presentation was excellent, very clear, packed full of information about postnatal psychosis, recognition, care and support for women and families who might experience this, and I think will be incredibly helpful for student midwives and midwives. I really appreciate your courage and passion for sharing this information” (Attendee)

In 2024, we inputted into course design for midwifery and mental health degrees (Undergraduate and Postgraduate level) at four universities - Universities of York, Hull, King’s College London and Central London (2023: 3 universities). These courses now include three to four hours on PP, including a lived experience talk, up to date research and case study discussions to allow the students to think about their roles as professionals in the future. APP Volunteer Chris Wasley spoke at the University of Surrey Midwifery Society conference and was then invited to write an article in the Royal College of Midwives' evidence-based quarterly journal, raising awareness of PP and of how maternity workers can support the partners of women experiencing PP[1]

Feedback on APP lived experience talks in 2024 included:

“The lived experiences were so powerful. To hear the impact on families will stay with me and will no doubt ensure my practice remains compassionate and beneficial in people’s journey to recovery” (attendee)

1 Wasley C. (2024) Heaven then hell: a partner’s experience of postpartum psychosis , MIDIRS Midwifery Digest, vol 34, no 4, December 2024, pp 278-281.

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“The lived experience was extremely powerful, and I will remember this forever.” (attendee)

“This was the most powerful part of the whole training. Amazing to be given such a window into someone’s lived experience. It felt like a privilege, will make me think about every interaction and its impact and the importance of being alongside clients, advocating.” (attendee)

In 2024, we delivered six sessions (2023: 4) of APP’s full day workforce training to 142 health professionals from NHS Trusts including Derby, Manchester, Lincolnshire and Bradford (2023:80). 90% of the delegates thought the training was “excellent” (2023: 99%) and 10% rated it as “good” and 100% would recommend it to other health professionals working in the perinatal period (2023: 100%). Onsite training is consistently rated slightly higher than that delivered online (94 % vs 86 % rated it as ‘excellent’). Individual feedback included:

“It was excellent; it could have carried on for many more hours; it was so insightful and informative” (attendee)

“The best training I have attended in a long time, thank you” (attendee)

On Wednesday 16th October, we hosted our second annual Alex Baish Memorial Lecture - Essential knowledge in preventing maternal suicide. The free 60-minute event was run in partnership with the National Centre for Mental Health (NCMH) and General Practitioners Championing Perinatal Care (GPCPC). The webinar highlighted the early symptoms of postpartum psychosis, red flags, and the actions health professionals need to take to support and protect those who develop the condition. We promoted the webinar widely, 3,891 health professionals, including GPs and other frontline professionals, registered to attend (2023: 2,547) and there have been more than 1,200 views of the recording on YouTube since. Of the attendees, 94 percent rated the training as ‘excellent’ (2023: 92%); 6 percent rated it ‘good’ (2023: 8%) whilst 100 percent agreed they would change their practice because of the webinar (2023:100%). Feedback was excellent and will be used to plan the 2025 webinar:

“This has contributed to my learning and will help save lives.” (attendee)

“I appreciate you all sharing your personal stories and the knowledge you have in this area. It is such an important area that I have very little knowledge of, so thank you.” (attendee)

“A truly inspiring, emotional, educational and thought-provoking webinar with @ActionOnPP - it has been a privilege to attend, thank you to all involved." (attendee)

“Most powerful session I have ever attended.” (attendee)

“So much valuable information delivered today, so well put together. Very touching real-life stories bravely told from those who have lived experiences”. (attendee)

“Really well put together- the content, the speakers, the information sharing and all the research and evidence presented. From my experience of working within perinatal teams, this is exactly the type of training needed. The issue is too urgent to ignore and too desperate to not be passionate about. Huge well done to the people that put this together.” (attendee)

We had planned to develop two online modules in 2024. We began collating content and researching the best platform to host these. Selection of a platform and development of a costed work plan for the first two modules (supporting partners and supporting families from diverse communities) have been prioritised for early 2025.

Raising awareness amongst the general public

In 2024, our lived experience storytellers continued to help us drive engagement with thousands of people, to activate interest in APP’s work, support services, and ensure women and families with PP are heard regionally

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and nationally. As in 2022 and 2023, many of our media case studies and related social media during the year were in support of our campaigning work (see campaigning for improved services below, p. 17). We continued to raise awareness of PP and the vital need for an MBU in Northern Ireland with the support of a media consultant from Northern Ireland. We also continued our work to raise awareness of PP in Black and Asian communities through media, social media and events. APP was invited to speak at the conference of the Motivational Mums Club, which supports Black mums in London. Our volunteer Rushina shared her personal experience of PP as a Black mum, whilst APP staff, Jessie Hunt and Shaheda Akhtar, spoke about the signs and symptoms of postpartum psychosis, our peer support services and Diverse Communities Outreach Project.

In the spring, we conducted our first ever billboard campaign reaching 16 million people in the UK. The campaign was spread over four weeks with a total of 74 large format roadside screens. Billboard space was donated by JC Decaux’s Community Channel scheme and design expertise by award-winning creative agency MotherLondon. APP’s signs and symptoms graphic was adapted for the digital billboard format, whilst we also promoted our BBC Radio 4 appeal (see fundraising and internal capacity below, p.19). The campaign raised awareness of PP and of APP as a charity amongst the general public. As part of the accounts preparations, the Board, along with the Director of Finance & Operations considered, but ultimately have been unable to determine a monetary value of these donated services. In the absence of a reliable measurement basis, the donation of billboard space from JC Decaux has not been recognised as income within these accounts.

In 2024, we continued to plan social media and media work around awareness days and in support of our campaigns and regional projects, as well as reacting to events and media requests. We supported pieces in national, regional and health sector media. In May, we ran a social media campaign for Maternal Mental Health Awareness Week (MMHAW), reaching 74,000 people (2023:111,000) with our content being shared by celebrities such as Davina McCall and Denise Welch. During the week we launched our new APP Insider Guide “Being a Parent after Postpartum Psychosis” (see peer support above)[2] . We also collaborated with the National Childbirth Trust (NCT), who shared information about spotting the signs and symptoms of PP, as part of our Antenatal Education campaign (see campaigning for better services, p. 17 below). Media highlights in 2024 included:

• An episode of BBC Radio 4’s Is Psychiatry Working ? programme focused on postpartum psychosis and how the Mother and Baby Unit model looks after mother, baby and the family unit. APP staff met with the programme makers as they developed the programme and APP volunteer storytellers Jade and Lee told their stories.[3]

• APP Ambassador Laura Dockrill shared her postpartum psychosis experience in Psychology Today[4] , on the BBC World Service[5] , in the Sunday Times magazine[6] and on BBC Radio 4 for APP’s charity appeal[7] (see fundraising below, p. 19).

• APP Storytellers Ruth and Alexandra spoke to the New York Times about the power of Mother and Baby Units in the UK[8] .

2 https://www.app-network.org/postpartum-psychosis/insider-guides/

• 3 Is Psychiatry Working? Jade and postpartum psychosis , https://www.bbc.co.uk/sounds/play/m00213gm

4 https://www.psychologytoday.com/us/blog/well-read/202407/overcoming-postpartum-psychosis

5 https://www.bbc.co.uk/sounds/play/w3ct5nxy

6 https://www.thetimes.com/life-style/health-fitness/article/how-i-recovered-from-postpartum-psychosis-andreconnected-with-my-son-g5dsjt5ch (paywall)

• 7 https://www.bbc.co.uk/sounds/play/m001xm04

• 8 https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-health-pregnancy-

women.html?unlocked_article_code=1.Q04.SzE6.yH6rVNRBGauU&smid=url-share (paywall)

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• APP Chief Executive Dr Jess Heron spoke to Mail Online about why we need more awareness and health professional training on PP to reduce rates of maternal suicide.[9]

• APP’s National Coordinator Jessie Hunt was interviewed for the Yale Journal of Biology and Medicine.[10]

• APP volunteer storyteller, Tara, and Chief Executive, Dr Jess Heron, spoke to the Guardian[11] about the need to improve access to Mother and Baby Units. Tara also shared her story with Belfast Live[12] , whilst APP storyteller Teresa supported our campaign for a Northern Ireland unit by sharing her story with ITV News[13] .

We supported 39 national and regional media stories in 2024 (2022: 32) and shared these across our main social media channels. Our number of social media followers grew to 28,761 (2023: 27,035). Following wider trends and an effort to increase our presence on LinkedIn, we saw our X (formerly Twitter) followers fall whilst LinkedIn followers increased by more than 60 percent. Overall social media reach was slightly lower than the previous year at 844,704 (2023: 1,211,858), although the 2024 figure doesn't include numbers reached on X (formerly Twitter) during June-December inclusive as we were unable to access data on the platform. Reach across the other platforms – Facebook, Instagram and LinkedIn – increased nearly 40 per cent compared with 2023. We focused on creating more short-form social media video content throughout the year, launching our TikTok channel in April and began exploring Threads in November and BlueSky in December. One of the social media highlights of the year was a video highlighting APP’s free training toolkit for antenatal educators. ‘How To Talk To Expectant Parents About Postpartum Psychosis’ presented by Midwife Marley[14] which had more than 9,000 views across APP’s and Midwife Marley’s own social media channels. Newsletter engagement remained adequate with an average open rate of 38 percent (2023: 40%), whilst the number of subscribers increased by 87%.

APP seeks to increase the public understanding of PP in a variety of ways, from writing scientific reports to sharing supporting personal stories, and working with artists, writers and performers. In 2024, we continued to work with Company Four on the development of their theatre production sharing experiences of PP. Members of our network were invited to two creative workshops with Company Four, in which artists, writers and APP peer supporters focused on embroidery and creative writing. Company Four’s theatre production - Who Is Your Mummy and Where Did She Go? – opened at the end of January 2025 alongside a curated exhibition featuring poetry and artwork by women who have experienced postpartum psychosis (including pieces from the workshops). APP also supported the development of Bijan Sheibani’s play – The Cord – which premiered in May 2024 at the Bush Theatre, London. The play explores the intergenerational impact of postpartum psychosis - of becoming a father with knowledge of your own mother’s PP many years before. APP’s Chief Executive, Dr Jess Heron and APP’s National Training Coordinator, Dr Sally Wilson participated in a postperformance Q&A session with the writer/director Bijan. Also in Maternal Mental Health Awareness Week, APP National Coordinator Ellie Ware interviewed Aaisha Alvi, author of 'A Mom Like That: A Memoir of Postpartum

9 https://www.dailymail.co.uk/health/article-14006745/NHS-failed-mother-tragedy-reading-maidenheadpostpartum-psychosis.html

10 Iyengar, U and Hunt, J (2024) An Open Conversation About Postpartum Psychosis, Yale J Biol Med. 2024 Mar 29;97(1):107–112. https://pmc.ncbi.nlm.nih.gov/articles/PMC10964824/

11 https://www.theguardian.com/society/2024/jan/20/maternal-mental-health-care-nhs-postpartum-psychosisdepression-mother-baby-unit?CMP=Share_AndroidApp_Post

12 https://www.belfastlive.co.uk/news/health/how-belfast-mum-road-recovery-28532265

13 https://www.itv.com/news/utv/2024-06-07/woman-with-postpartum-psychosis-considered-taking-own-life 14 https://www.instagram.com/p/C6ebr4WNJpX/?hl=en

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Psychosis.'. In addition, we supported APP volunteer Ruth Stacey's publication of her book 'Everyone is Here to Help: A healing account of postpartum psychosis and recovery'[15] :

Campaigning for improved services

In 2024, we continued using our specialist expertise and lived experience voice to influence change in systems that are important to women and families affected by postpartum psychosis, with a particular focus on campaigning for women throughout the UK to have access to a Mother and Baby Unit (MBU); campaigning for PP to be an essential part of all antenatal class training; and raising awareness that PP must be managed as a medical emergency for the safety of both mother and baby. We continued to be an active member of the National Suicide Prevention Alliance, the Pregnancy and Baby Charities Network and the Maternal Mental Health Alliance.

Mother & Baby Unit campaign

In Northern Ireland, we continued our partnership with the MAS project (maternal advocacy and support) to campaign for funding and a timeline for the development of a first Mother and Baby Unit in the region. We attended the All-Party Group on Women’s Health, a cross-party group of Members of the Legislative Assembly (MLAs) and their advisors with the Maternal Mental Health Alliance (MMHA) and MAS. Laura, who experienced being on an acute ward when she should have been in an MBU, spoke powerfully about the reasons an MBU is needed. The group chair subsequently wrote to the Health Minister urging him to find funding for an MBU and put questions to him in the Assembly. In December, APP, MAS and MMHA met with the Health Minister, Mike Nesbitt. APP’s consultant also met with Alliance Party MLAs Siân Mulholland and Danny Donnelly, whilst APP’s National Peer Support Coordinator continued attending monthly meetings with the MMHA to co-ordinate campaigning for specialist perinatal mental health services.

We continued to work with our volunteers from bereaved families and from our Northern Ireland café group to keep the Mother and Baby Unit on the agenda. APP volunteer, Teresa, met with her MLA Nicola Brogan to talk about the need for an MBU, and Nicola also wrote to the health minister. Media pieces included: The Guardian[16] ; Belfast Live[17] ; Belfast Telegraph[18] and ITV news[19] . Volunteers and families in NI have valued being able to support APP’s campaign:

“Campaigning for a Mother and Baby Unit for me is about dispelling the stigma, we cannot control why we get unwell, but we can control how we are treated; it’s about reclaiming control, fostering resilience, and ensuring every mother finds solace in the strength she possesses.” (APP volunteer)

In January 2024, after years of campaigning, APP staff and volunteers were delighted to attend the official groundbreaking ceremony for Chester’s new Mother and Baby Unit, Seren Lodge. The eight-bed unit will support new and expectant parents across Cheshire, Merseyside and North Wales. The APP team continues to work with NHS teams in England and Wales to ensure the voices of lived experience are heard during the development process, as well as ensuring the unit meets the specific needs of families from North Wales. Our volunteers have input into the design, landscaping, and functionality of the MBU. The Cheshire and Merseyside, Perinatal Mental Health, Lead Provider Collaborative ‘Helix’ was launched in April 2024; APP staff

15 https://www.instagram.com/p/C6g4S5LrWQ-/?img_index=1

16 https://www.theguardian.com/society/2024/jan/20/maternal-mental-health-care-nhs-postpartum-psychosisdepression-mother-baby-unit?CMP=Share_AndroidApp_Post

17 https://www.belfastlive.co.uk/news/health/how-belfast-mum-road-recovery-28532265

18 https://www.belfasttelegraph.co.uk/life/health/mum-of-two-running-belfast-marathon-to-raise-awareness-ofmental-health-services-for-mothers-after-suffering-postpartum-psychosis/a1817875207.html

19 https://www.itv.com/news/utv/2024-06-07/woman-with-postpartum-psychosis-considered-taking-own-life

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and volunteers have joined its experts by experience forum to ensure the voices of those with PP are heard in the development of the perinatal services, including the new MBU.

We have continued to campaign for MBUs in Wales, Scotland and underserved areas of England with media pieces in BBC NE and Cumbria[20] and the New York Times[21] . As detailed above under raising public awareness, APP staff and volunteers collaborated with the BBC’s ‘Is Psychiatry Working?’ programme which focused on postpartum psychosis and how the Mother and Baby Unit model looks after mother, baby and the family unit and shared the campaign in many of our other national press pieces. APP volunteer Chris has been raising awareness of PP and MBUs since 2023 by attending football matches at grounds closest to the 22 UK MBUs and visiting the MBU where possible. He has a specially made purple APP football shirt that he wears for every match and does his best to get a mention in the matchday programme each time. He continued his awareness raising tour in 2024 with matches at Stoke City FC, Newcastle United, West Ham, Crystal Palace, Bolton, and Derby[22] . We are very grateful for all Chris’s hard work in raising awareness of PP and MBUs with football clubs and their supporters. Many of our Miles for Mums fundraisers used their challenges to raise awareness of the need for women across the UK to be able to access MBU care covering distances to Belfast or the new MBU in Chester (see fundraising and strengthening our capacity, p. 19 below).

Antenatal Campaign

We continued our campaign for information about postpartum psychosis to be shared at every antenatal class in the UK, sharing information about the campaign widely. In 2023, we launched our antenatal education toolkit, which was developed in conjunction with families affected by PP, our volunteers and antenatal class providers. In 2024 we sent this toolkit to all 192 maternity hospitals in England, enclosing hard copies of the toolkit and posters for expectant parents[23] , for antenatal educators[24] , and our signs and symptoms posters[25] . Midwife Marley’s video highlighting the toolkit: ‘How to Talk To Expectant Parents About Postpartum Psychosis’[26] launched in Maternal Mental Health Awareness week (29th April to 5th May 2024) has been viewed more than 9,000 times. We partnered with the National Childbirth Trust (NCT) to raise awareness of PP[27] and reach their antenatal educators. NCT included an article on the toolkit and a link to our survey[28] in a practitioner email update in May; it was sent to 699 people, with a 64% open rate.

The repeat of our 2021 YouGov survey about postpartum psychosis in antenatal classes was prepared in 2024, with questions confirmed. The survey went live in January 2025. As detailed under ‘Raising awareness amongst health professionals’ above, APP’s staff and lived experience volunteers continued to talk about the importance of antenatal education regarding PP. Volunteers distributed APP’s materials, for example getting our signs and symptoms poster displayed at their local medical centre[29] . APP’s 2024 billboard campaign also contributed to raising awareness of the signs and symptoms of PP (see raising awareness amongst the general public, p. 14 above).

20 https://www.bbc.co.uk/news/articles/c05g6jmj488o

21 https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-health-pregnancywomen.html?unlocked_article_code=1.Q04.SzE6.yH6rVNRBGauU&smid=url-share (paywall) 22 https://www.app-network.org/news/chris-kicks-off-a-new-season-of-awareness-raising/

23 https://www.app-network.org/wp-content/uploads/2023/10/Antenatal-campaign-flyers-October-2023.pdf

24 https://www.app-network.org/wp-content/uploads/2023/10/Antenatal-campaign-HP-flyers-October-2023.pdf 25 https://www.app-network.org/wp-content/uploads/2023/05/POSTER_APP_A4_PINK-1-1.pdf

26 https://www.instagram.com/p/C6ebr4WNJpX/?hl=en

27 https://www.instagram.com/p/C6gF5a0MQHJ/?img_index=1

28 https://r1.dotdigital-pages.com/p/C29-1E53

29 https://www.instagram.com/p/C6gwnjrtT8U/

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Research

APP facilitates research, supports lived experience consultancy, and helps disseminate findings, ensuring evidence-based information is accessible to women, families, and health professionals. In 2024, we used our limited research capacity to support and promote a variety of studies, and to seek funding for APP’s research support infrastructure. We continued to work closely with researchers at the National Centre for Mental Health (NCMH) at Cardiff University on recruitment and awareness-raising of the importance of research. In early 2024, APP spoke at NCMH’s Women’s Winter Webinar: understanding postpartum psychosis. The event was part of the National Centre for Mental Health’s Women’s Winter Webinar series, which were open to the general public as well as health professionals and those with an interest in mental health research. More than 50 attendees[30] joined live and it has since had hundreds of views on YouTube[31] . The National Centre for Mental Health (NCMH) and Action on Postpartum Psychosis are working together to understand more about the causes and triggers of severe mental illness during pregnancy and following childbirth. We promoted this research to members of our network with a targeted newsletter for those with an interest in research participation.

We supported the Care Policy and Evaluation Centre (CPEC) at The London School of Economics to secure funding from the Three NIHR (National Institute for Health and Care Research) Schools Mental Health Programme for a new study to start in January 2025. The RAPPORT study ( R ealist evaluation of A ction on P ostpartum P sychosis’ MBU peer supp ORT ) will assess APP-provided peer support at three Mother and Baby Units in England. Researchers will carry out in-depth conversations with mothers who have accessed support, APP peers and managers, and NHS staff to understand how the charity’s model impacts women's lives. Peer support in Mother and Baby Units is patchy and varies across the country. This research aims to understand the benefits and essential ingredients. It aims to identify the resources needed for effective implementation and assess value for money.

We worked with Jo Hodgkins on a study of psychological recovery following PP, examining the views of women, partners and establishing the care that providers currently offer. We supported Vimbai Carr’s PhD research, Experiences of care and support for mothers with postpartum psychosis; a hermeneutic phenomenology study. APP also worked on applications with Oxford University for funding for research to develop national guidelines on diverse community care for PP; and on Case Registry studies in the UK and Sweden to examine predictors and outcomes following PP and the economic costs of the illness. We worked on an application for pilot work to adapt our model of training lived experience peers to research PP experiences and support needs in Malawi. The team held meetings with researchers at Oxford University to make plans to analyse and report APP’s MBU survey and research gaps survey, but lacked sufficient staff capacity to progress this work.

Fundraising and strengthening our capacity

In 2024, we continued to develop and diversify our fundraising base and strengthen our fundraising processes. We repackaged and soft launched our Legacy Giving information and we aim to weave this into our communications throughout 2025. We successfully applied for London Marathon places – this was the first time that we had been able to access charity places – although previously we have had runners who have secured their own place and a celebrity runner. We will now have 12 guaranteed places in the marathon for the four years from 2026 - 2029. The board reviewed and updated APPs fundraising strategy towards the end of the year, providing direction and identifying resources for 2025 and beyond.

30 https://www.cardiff.ac.uk/reproductive-mental-health-programme/news/third-instalment-of-womens-winterwebinars-series-focuses-on-maternal-mental-health-with-action-on-postpartum-psychosis 31 https://www.youtube.com/watch?v=h12FQWkryLU

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We had our first BBC Radio 4 appeal in 2024, presented by our Ambassador, Laura Dockrill[32] , accompanied by a nationwide awareness-raising billboard campaign (see awareness raising amongst the general public p. 14 above). The appeal raised £19,344 from donations made during the appeal week, gift aid and match funding, plus £8,222 received later from the Radio 4 Appeal Fund. We also ran three match-funding appeals, via the Big Give, raising more than £16,000 for our work with dads, co-parents and grandparents, our national peer support service and for our legal and human rights project.

Our annual Miles for Mums and Babies campaign was well supported again, with at least six groups from Mother and Baby Units or Perinatal Mental Health Teams taking part. Each mile reflects the journey mums, babies and families travel to be together, whilst mums receive care in Mother and Baby Units (MBUs). Many fundraisers told their own stories to help raise awareness. Fundraisers and their chosen challenges included:

• The Margaret Oates MBU in Nottingham took part for the second year in a row. This year they covered 365 miles – representing the journey between Nottingham and Belfast in recognition of APP’s campaign to raise awareness of the urgent need for an MBU in Northern Ireland.

• The team at The Beeches MBU in Derbyshire decided to go for 1,240 miles, raising £1,270. They chose this number as one mile for every mum or family The Beeches has supported since opening in 1993.

• The North Wales Perinatal Team also took part for the second year. Team members each walked, ran, cycled or swam 141 miles throughout the month of May, representing the distance from South Stack on Anglesey to Ribblemere MBU in Chorley. They said: 'This is where we admit women most often for the highest level of support when they become unwell in the perinatal period. While the support they receive is undoubtedly to a high standard it is a long way for women to be away from their homes and families while they recover. '

• The Suffolk Perinatal Mental Health team walked 1,400 miles over the month, to raise awareness of the number of new mums who are diagnosed with postpartum psychosis each year in the UK, raising £2,220.

• The Andersen MBU in Manchester initially planned to go for 500 miles but ended their challenge on an amazing 951 miles.

• A group from the Humber Perinatal Mental Health Liaison Team all chose to cover 99 km each during May to raise awareness, foster empathy, and generate vital funds to ensure that individuals facing PP receive the support they need. The team raised more than £1500.

• Gwen, who raised nearly £5,000, walking the distance between their home and the MBU.

• Kate who walked 100 miles in May and June to raise awareness of PP and the symptoms to look out for, raising more than £1,300.[33]

• Sarah who walked 300 miles throughout the month of May, raising more than £1,100. She chose 300 miles as the distance of a return journey between the only MBU currently open in Wales (Swansea) and the new MBU that she is helping develop in Chester that will have beds for women North Wales, Cheshire and Merseyside.

In 2024 we had more than 200 individual fundraisers taking part in challenges including marathons, half marathons, skydives, and triathlons. We also had several supporters run Big Bake events at their homes or workplaces. We are very grateful to all our individual fundraisers who have found many inventive ways to fundraise and increase awareness. We’d particularly like to thank:

32 https://www.bbc.co.uk/programmes/m001xm04 33 https://www.justgiving.com/page/kate-wood-1713784554708

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• Two of our youngest fundraisers who took on big events for APP in October: 17-year-old Emily ran the Cardiff Half and raised nearly £800 and 17-year-old Aideen completed the Belfast Half in memory of her aunt Orlaith, and raised more than £1,200.

• Chris and Emma who ran the Hampton Court Palace Half Marathon, pushing their son in a running buggy, raising nearly £5,500.[34]

• Burford Golf Club and their Ladies’ Captain, Carole Harris, who chose APP as her charity of the year and raised more than £4,000.

• Our Brighton, London and Kielder marathon runners, Mollie, Gen, Chris, Lauren-Nicole, Rebecca, Luke and Matt who between them raised nearly £14,000.

• Kathryn, who completed the Great North Swim, raising more than £1,700.[35]

• James, who ran the Paris marathon in memory of his sister’s friend, raising more than £1,200[36] .

• Fionnuala, who raised more than £1,000, running the Nottingham 10k[37] .

• Five APP supporters, Philippa, Owen, Tim, Rob, and Mikyla completed the Great North Run, and between them raised more than £5,200, whilst Steve and Mark raised nearly £1,600 running the Hackney Half Marathon.

• Leanne and Stuart completed the Edinburgh Kiltwalk, raising more than £1,700 and sharing their story of recovery from PP[38] .

• Sarah, who completed a skydive for APP after her wife suffered with PP, raising more than £1,100.[39]

• Amy, Meg and Sophie, perinatal mental health nurses from Ribblemere MBU, who completed the Manchester Half Marathon for APP, raising more than £1,800.

• Will, who completed a triathlon after his friend was diagnosed with PP, raising more than £1,500.[40]

• Sarah, who decided to take on Tough Mudder for APP to mark three years since she became unwell with PP and to celebrate her recovery journey, raising more than £2,200[41] . Sarah said:

“Tough Mudder, with its gruelling physical and mental challenges, serves as a symbolic representation of my belief that today, there's nothing I cannot overcome. The obstacles on the course reflect the hurdles life throws at us, and as I navigate mud pits and conquer towering walls, I'll be proving to myself and others that, after facing the darkest moments of my life, resilience and inner strength can conquer all….I have chosen to dedicate my Tough Mudder challenge to the charity APP (Action on Postpartum Psychosis), an organisation committed to supporting those affected by postpartum psychosis. APP introduced me to a community of genuine and caring people who helped me navigate the loneliness and complexities of this illness, and played a huge part in my recovery.”

In 2024, we invested in our grant fundraising capacity and were successful in securing new grants, including from the Garfield Weston Foundation and the City Bridge Foundation (to start in 2025). We also continued work to manage our data more efficiently and to improve journeys for beneficiaries and others who contact us. In this we particularly focused on supporting recruitment to research and long-term engagement with APP. We

• 34 https://www.justgiving.com/page/love-wins-1709839587970

35 https://www.justgiving.com/page/kathryn-grant-app-swim

36 https://www.justgiving.com/page/jimparismarathon

37 https://www.justgiving.com/page/fionnuala-sutton-1704482204461

38 https://www.app-network.org/ourstories/stories/leannes-story-reading-other-peoples-recovery-stories-hasallowed-me-to-process-what-happened-to-me/

39 https://www.justgiving.com/page/charity-sarahhorton

40 https://www.justgiving.com/page/post-partum-psychosis

41 https://www.justgiving.com/page/sarahjuliepujol-toughmudderforapp

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

continued to improve our staff and volunteer training and development, for example training on grief and suicide awareness (see peer support above p10), and to seek opportunities for staff to participate in training and events relevant to their roles and new areas of work we are developing, for example our Marketing and Digital Communications Coordinator took part in the Media Trust’s TikTok Academy.

Financial Review

The Statement of Financial Activities on page 30 shows APP’s income and expenditure for the year. During the year ended 31 December 2024, income exceeded expenditure by £45,485. In our Unrestricted Funds, income exceeded expenditure by £25,239 bringing reserves back within our target range. Income from charitable activities increased, reflecting the suicide prevention grant awarded by the Department for Health and Social Care and a slight increase in contract income, offset by falls in research and training income. Income from donations increased slightly. Investment income increased significantly due to reserves being held on deposit with sustained higher interest rates. In our restricted funds, income exceeded expenditure by £20,246. This reflects grants from the Garfield Weston Foundation and The D'Oyly Carte Charitable Trust, and income from a Big Give match funding campaign in October 2024 which will be spent on our national peer support project across the 2024 and 2025 financial years, together with income from a Big Give match funding campaign in December 2024 which will be spent on our legal and human rights project in 2025.

The Balance Sheet on page 31 shows that at 31st December 2024, APP was holding reserves of £161,585; of which £24,025 was restricted funds. At the start of 2024, APP’s reserves policy was to hold three to five months of core charitable expenditure in reserve. In determining this range, Trustees had considered the risks to which the charity is exposed and its working capital requirements. Core charitable expenditure consists of the costs of running APP’s national peer support service, our information resources, website and social media and running the organisation effectively. It excludes the costs of operating our NHS contracts. On 1st January 2024, APP was holding £110,634 in free reserves, which was slightly below the range then recommended by our reserves policy (£113,000 to £188,000). Trustees agreed an annual plan and budget for 2024 which would bring reserves back into the recommended range. Trustees reviewed and reconfirmed the reserves policy at the end of 2024 and deemed the recommended reserves range of three to five months core charitable expenditure to then be £128,000 to £213,000. On 31st December 2024, APP was holding £136,483 in free reserves, which was within this recommended range. The Trustees are not aware of any factors likely to impact the future financials of the charity other than those discussed elsewhere in this report, including under risk management below.

Structure, Governance and Management

Action on Postpartum Psychosis was incorporated as a Company Limited by Guarantee on 10th December 2010. It is governed by its Articles of Association, amended by special resolution in 2012 and 2018. The charity arose from a research network within the University of Birmingham Medical School and was hosted by University of Birmingham until 31st December 2023. The University provided office space, expert time, infrastructure and resources to the charity. In January 2024, APP became independent of the University of Birmingham. APP is supported by the University of Cardiff National Centre for Mental Health, which provides expert time and resource support for the charity.

APP’s Board of Directors/Trustees is made up of women with personal experience of postpartum psychosis; world-leading clinical and academic experts in postpartum psychosis; and individuals with specific skills relevant to the management of a charity. Dr Jessica Heron is APP’s Chief Executive and manages the running of the charity. Her time for this was bought by the charity from the University of Birmingham until 31st December 2023. From 1st January 2024, Dr Heron has been employed directly by the charity. The Charity’s pay and conditions committee met in 2003 to consider Chief Executive pay and conditions. The committee

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

considered Charity Commission guidance and the role was benchmarked against similar roles being advertised at the time, and sector-wide reports on charity chief executive pay and benefits. The committee developed a recommendation for the trustee board which made the decision on pay and benefits.

Operational plans and all major strategic decisions are discussed and agreed by the Board of Trustees.

A senior management team, consisting of the Chief Executive, Director of Finance and Operations and UK Programme Manager, run the day-to-day operations of the charity including human resources, finance, grant management, data and systems, fundraising and governance activities. National Coordinators, all of whom have lived experience of postpartum psychosis, lead on each of APP’s main workstreams. These include a: National Health Professional Training & Research Coordinator; National Peer Support Coordinator; Peer Support Groups Coordinator; Partners Peer Support Coordinator; National NHS Contracts Coordinator; and Marketing/Digital Communications Coordinator. They line manage staff and work closely with beneficiaries and volunteers to ensure that our peer support, information, awareness raising, campaigning and research work all have lived experience at their heart.

Directors/Trustees are recruited through advertising and networking and appointed in a general meeting or by the other directors at a board meeting. New Directors/Trustees are inducted and trained through meetings with the Chair, Chief Executive, and members of staff, as appropriate to their particular area of expertise, and provided with a pack of background information about the charity. A skills audit has been undertaken and efforts are made to recruit Trustees who meet the skills requirement. In 2016, the Board agreed to aim towards a leaner Board, with all the skills necessary to the functioning of the charity. One Board member stepped down at the end of 2024.

APP is part of the Maternal Mental Health Alliance and seeks to support and collaborate with the Alliance in campaigning for better perinatal mental health services; this does not impact on the charity’s operating policies.

Risk management

The Trustees consider the principal risks to which the charity is exposed, and the systems in place to mitigate those risks. The Chief Executive reports the most substantial inherent risks, together with any significant emerging risks, and the control measures in place to Trustees at each Board meeting. During 2024, APP’s risk register and reporting process were refined. The full risk register is now presented to the board annually, whilst at intermediate meetings the Chief Executive presents a risk report containing the “red” and “amber” risks, any new or emerging risks and any new activities where the board might need to consider the risks entailed and whether current risk mitigation is adequate.

Financial risk: The Trustees have identified that financial sustainability is the major financial risk to the charity. The political climate for small charities is tough, demand for services and competition for grant funding are high, and capacity pressures impact on income generation. In 2022 we recruited a dedicated fundraiser who has overhauled fundraising systems and processes. In 2024, the board reviewed and updated APP’s funding and fundraising strategy, including agreeing resources to grow grassroots fundraising further and to focus on major donor fundraising. Internal financial management risks are reduced by the implementation of procedures for authorisation of all transactions. Budgets are set for all major areas of expenditure, and adjustments are reviewed by the Board.

Non-financial risks: The Trustees have focussed attention on mitigating non-financial risks such as safeguarding, health and safety, lone working, operational and legal risks, with different risks assigned to members of senior staff or Board of Trustees. For each new area of operation (for example peer support contracts), the financial, legal, health and safety, operational and reputational risks are reviewed by senior staff

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

and the Board of Trustees, to determine new policies and procedures needed, training and information needed by managers, Coordinators and volunteers, and additional external advice and support needed.

Key risks facing the organisation in 2024 were financial sustainability, management capacity and operational risks, in particular maintaining sufficient income from a diversity of sources, identifying funds and capacity to support research involvement work, ensuring the Board, staff, and volunteers are representative of the individuals and communities we aim to serve and that our data is managed effectively and in a compliant manner. Financial sustainability was addressed by: frequent reviews of forecast income and expenditure by the Board; updating our funding and fundraising strategy; jointly applying for research funding with several university researchers and carefully planning and budgeting for 2025. Management capacity and operational risks were addressed through: contracting support for grant fundraising, data protection toolkit work and outreach work and engagement to build community networks, strength collaborations and increase the number of women from diverse communities we support and train as volunteers

Plans for Next Year

Action on Postpartum Psychosis plans for 2025 were grouped under the following objectives:

Supporting women and families.

We plan to maintain and grow our national and regional peer support service by:

• Offering online, in person, video call and café group support to all who need it nationally and via our NHS projects.

• Developing our work in Greater London building stronger links with London MBUs, and growing our bereavement, partners, diverse community and LGBTQ+ support.

• Completing our bereavement web content and work with British Board of Scholars and Imams on a PP guide, with staff and volunteer training in these areas, and beginning development of legal and rightsbased web content.

• Continuing building projects that encourage long term contact with our community – strengthening café groups, volunteer engagement, community and wellbeing sessions.

• Maintaining high-quality service delivery and good functioning of our NHS partnership contracts.

Raising awareness amongst health professionals.

We plan reach more health professionals with training by:

• Continuing to offer online bookable one-day training and NHS commissioned in-person training days.

• Arranging a third annual free Alex Baish Memorial Webinar, building our database of health professionals.

• Continuing collaborations with the Institute of Health Visiting (iHV) and the Royal College of Psychiatrists (RCPscyh), GP bodies and antenatal educators delivering tailored training & lived experience talks.

• Continuing to train and support lived experience speakers and regional reps to give talks to services in their regions.

• Completing and marketing our first health professional training e-modules.

• Building relationships with all MBUs communicating the expectation that all UK MBUs/perinatal teams should receive APP training once every three years and that new starters can join online training sessions freely in the interim.

Raising awareness amongst the general public.

We plan to raise awareness in the general public to reduce stigma and misinformation by:

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

• Building on our national profile, increasing diverse community storytelling and outreach,

• Developing media and communications for the main ‘moments’ across the year: Mothers’ Day; Maternal Mental Health Awareness Week, Black Maternal Mental Health Week, World Mental Health Day, Suicide Awareness Week.

• Supporting APP’s MBU campaign, developing storytellers sharing stories and data to campaign for beds in places where there are insufficient beds, sharing positive MBU stories to help the public understand their value.

• Working with diverse community storytellers to raise awareness of PP and our groups in Black and Asian communities, reducing fear of services; identifying more Black and Asian volunteers.

• Raising awareness of our peer support community, outreaching to those who need peer support and showcasing APP’s café groups and London community building work.

Campaigning.

Our goal is that all women and families in the UK have access to the services they need to get help and recover from PP. We plan to use our specialist expertise and lived experience voice to create change in systems, by:

Continuing APP’s MBU campaign , with a particular focus on:

• maintaining pressure for an MBU for Northern Ireland, working with our consultant to maintain networks with other organisations, volunteers; journalists and Members of the Legislative Assembly.

• supporting calls for MBU in northern Scotland.

• engaging with the Seren Lodge MBU build, supporting lived experience engagement and peer support, ensuring the needs of women in north Wales are met.

• continuing to highlight the benefits of MBUs, sharing positive MBU stories to help commissioners understand their value; and reaching GPs & other professionals with information.

• building good relationships with all MBUs, connecting and helping to amplify their social media.

• monitoring NHS England bed number commitment and responding to any risk of bed closures or decreased in care pathway quality.

Continuing APP’s antenatal education class campaign :

• Analysing the YouGov survey to determine the impact of the campaign.

• Continuing to promote and distribute the antenatal toolkit.

• Repeating our social media midwife survey.

• Sharing the story of our campaign

Research.

We will continue to facilitate research studies of importance to women and families affected by postpartum psychosis, as capacity and funding allows, including:

• Supporting the RAPPORT study ( R ealist evaluation of A ction on P ostpartum P sychosis’ MBU peer supp ORT ) which will be assessing APP-provided peer support at three Mother and Baby Units in England.

• Identifying funding opportunities to support APP’s development as a research support facility.

Strengthening our capacity to fulfil our charitable objectives

We plan to strengthen our internal systems to support sustainable growth by:

• Growing our fundraising income via promoting challenges and lived experience group events, continuing to strengthen links with MBUs, and developing a new major donor engagement strategy.

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

• Increasing staff capacity in the fundraising team with a new post and an existing staff member spending more time on community engagement.

• Continuing to seek funds from a diversity of sources, including small and large grant applications, NHS funding to deliver peer support, research funding and developing and promoting APP’s online training offer.

• Continuing data collection and cyber security improvement work, planning integration of data and preparation for implementation of a CRM (customer relationship management database).

• Continuing our development as gold standard lived experience, family friendly employer, reviewing pastoral support, pensions, sick pay, working practices, reviewing roles and titles and benchmarking pay.

• Continuing staff development, with training in suicide prevention, grief and loss, safeguarding, GDPR, cyber security, peer support development.

• Reviewing our organisational structure and options for improving efficiency and building management capacity.

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

APP’s Board

APP is governed by its Board of Directors/Trustees, which remains a mix of women with lived experience of postpartum psychosis, academic researchers, clinicians and Trustees with specific skills (e.g. health economics). Directors/Trustees during 2024 were as follows:

Dr Giles Berrisford Chair Annette Bauer Treasurer Catherine Cho Dr Clare Dolman Sarah Hind (resigned 2[nd] December 2024) Anna Jones Vice Chair (Acting co-Chair) Professor Ian Jones Tracey Robinson

There have been no other changes to the Board of Directors/Trustees.

Public Benefit Statement

Under its Articles of Association, the objects for which Action on Postpartum Psychosis is established are: to promote and protect the physical and mental health of women who have experienced postpartum psychosis and their families through the provision of support, education and practical advice; to advance the education of the public in general (and particularly amongst health professionals) on the subject of postpartum psychosis and to promote research for the public benefit in all aspects of that subject and to publish the useful results; and to advocate for perinatal mental health services for women and their families. The Trustees confirm that they have referred to the guidance contained in the Charity Commission’s general guidance on public benefit when reviewing the organisation’s aims and objectives and in planning future activities.

The identifiable benefits of APP’s work are that women and family members affected by postpartum psychosis are able to access support and information to improve their recovery, and that healthcare professionals and the general public are better informed about, and have more understanding of, this illness. A number of examples of benefit appear earlier in the report. These benefits are achieved through peer support, patient information development, health professional training, public awareness raising, research and campaigning. The only restriction is that individuals receiving peer support have suffered from postpartum psychosis or are a partner or family member of someone who has had the illness. There are no fees for the peer support service; a fee may be charged for health professional training and lived experience speakers.

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Action on Postpartum Psychosis Trustees’ Report for the year ended 31 December 2024

Trustees’ Responsibility Statement

The trustees (who are also the directors of Action on Postpartum Psychosis for the purposes of company law) are responsible for preparing the Trustees' Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice) including Financial Reporting Standard 102 "The Financial Reporting Standard applicable in the UK and Republic of Ireland".

Company law requires the trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing those financial statements, the trustees are required to

• select suitable accounting policies and then apply them consistently;

• observe the methods and principles in the Charity SORP;

• make judgements and estimates that are reasonable and prudent;

• state whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements;

• prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in business.

The trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the charitable company and to enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

Trustees' report, incorporating a strategic report, approved by order of the board of trustees, as the company directors, on 5[th] June 2025 and signed on the board's behalf by:

.................................................................

A Bauer - Trustee

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INDEPENDENT EXAMINER'S REPORT TO THE TRUSTEES OF ACTION ON POSTPARTUM PSYCHOSIS

Independent examiner's report to the trustees of Action on Postpartum Psychosis ('the Company')

I report to the charity trustees on my examination of the accounts of the Company for the year ended 31 December 2024.

Responsibilities and basis of report

As the charity's trustees of the Company (and also its directors for the purposes of company law) you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 ('the 2006 Act').

Having satisfied myself that the accounts of the Company are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of your charity's accounts as carried out under Section 145 of the Charities Act 2011 ('the 2011 Act'). In carrying out my examination I have followed the Directions given by the Charity Commission under Section 145(5) (b) of the 2011 Act.

Independent examiner's statement

Since your charity's gross income exceeded £250,000 your examiner must be a member of a listed body. I can confirm that I am qualified to undertake the examination because I am a member of the Institute of Chartered Accountants in England and Wales, which is one of the listed bodies.

I have completed my examination. I confirm that no matters have come to my attention in connection with the examination giving me cause to believe:

1. accounting records were not kept in respect of the Company as required by Section 386 of the 2006 Act; or

2. the accounts do not accord with those records; or

3. the accounts do not comply with the accounting requirements of Section 396 of the 2006 Act other than any requirement that the accounts give a true and fair view which is not a matter considered as part of an independent examination; or

4. the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice for accounting and reporting by charities (applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)).

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

C L Moelwyn-Williams BSc FCA

TCA (Shrewsbury) LLP Third Floor 21 St Mary's Street Shrewsbury Shropshire SY1 1ED

Date: .............................................

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ACTION ON POSTPARTUM PSYCHOSIS

STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING AN INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 DECEMBER 2024

Unrestricted funds Notes £ INCOME AND ENDOWMENTS FROM Donations and legacies 2 261,349 Charitable activities 5 General 272,264 Other trading activities 3 1,060 Investment income 4 5,554 Total 540,227 EXPENDITURE ON Raising funds 6 33,703 Charitable activities 7 General 481,285 Total 514,988 NET INCOME/(EXPENDITURE) 25,239 RECONCILIATION OF FUNDS Total funds brought forward 112,321 TOTAL FUNDS CARRIED FORWARD 137,560	Restricted funds £ 10,906 112,982 - - 123,888 267 103,375 103,642 20,246 3,779 24,025	2024 Total funds £ 272,255 385,246 1,060 5,554 664,115 33,970 584,660 618,630 45,485 116,100 161,585	2023 Total funds £ 258,230 286,097 - 1,288 545,615 28,232 519,332 547,564 (1,949) 118,049 116,100

CONTINUING OPERATIONS

All income and expenditure has arisen from continuing activities.

The notes form part of these financial statements

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ACTION ON POSTPARTUM PSYCHOSIS (REGISTERED NUMBER: 07466643)

STATEMENT OF FINANCIAL POSITION 31 DECEMBER 2024

Notes FIXED ASSETS Tangible assets 13 CURRENT ASSETS Debtors 14 Cash at bank CREDITORS Amounts falling due within one year 15 NET CURRENT ASSETS TOTAL ASSETS LESS CURRENT LIABILITIES NET ASSETS FUNDS 17 Unrestricted funds: General Fund Restricted funds TOTAL FUNDS	2024 £ 1,077 63,023 168,934 231,957 (71,449) 160,508 161,585 161,585 137,560 24,025 161,585	2023 £ 1,687 63,916 129,300 193,216 (78,803) 114,413 116,100 116,100 112,321 3,779 116,100

The charitable company is entitled to exemption from audit under Section 477 of the Companies Act 2006 for the year ended 31 December 2024.

The members have not required the company to obtain an audit of its financial statements for the year ended 31 December 2024 in accordance with Section 476 of the Companies Act 2006.

The trustees acknowledge their responsibilities for

• (a) ensuring that the charitable company keeps accounting records that comply with Sections 386 and 387 of the Companies Act 2006 and

• (b) preparing financial statements which give a true and fair view of the state of affairs of the charitable company as at the end of each financial year and of its surplus or deficit for each financial year in accordance with the requirements of Sections 394 and 395 and which otherwise comply with the requirements of the Companies Act 2006 relating to financial statements, so far as applicable to the charitable company.

The financial statements were approved by the Board of Trustees and authorised for issue on ............................................. and were signed on its behalf by:

............................................. A Bauer - Trustee

The notes form part of these financial statements

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ACTION ON POSTPARTUM PSYCHOSIS

STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 DECEMBER 2024

Notes Cash flows from operating activities Cash generated from operations 1 Net cash provided by/(used in) operating activities Cash flows from investing activities Purchase of tangible fixed assets Net cash provided by/(used in) investing activities Change in cash and cash equivalents in the reporting period Cash and cash equivalents at the beginning of the reporting period Cash and cash equivalents at the end of the reporting period	2024 £ 39,634 39,634 - - 39,634 129,300 168,934	2023 £ (41,078) (41,078) (1,687) (1,687) (42,765) 172,065 129,300

The notes form part of these financial statements

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ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE STATEMENT OF CASH FLOWS

FOR THE YEAR ENDED 31 DECEMBER 2024

1. RECONCILIATION OF NET INCOME/(EXPENDITURE) TO NET CASH FLOW FROM OPERATING ACTIVITIES

Net income/(expenditure) for the reporting period (as per the Statement of Financial Activities) Adjustments for: Depreciation charges Decrease/(increase) in debtors Decrease in creditors Net cash provided by/(used in) operations	2024 £ 45,485 610 893 (7,354) 39,634	2023 £ (1,949) - (28,592) (10,537) (41,078)

2. ANALYSIS OF CHANGES IN NET FUNDS

	At 1.1.24	Cash flow	At 31.12.24
	£	£	£
Net cash
Cash at bank and in hand	129,300	39,634	168,934
	129,300	39,634	168,934
Total	129,300	39,634	168,934

The notes form part of these financial statements

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ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024

1. ACCOUNTING POLICIES

Basis of preparing the financial statements

The financial statements of the charitable company, which is a public benefit entity under FRS 102, have been prepared in accordance with the Charities SORP (FRS 102) 'Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019)', Financial Reporting Standard 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and the Companies Act 2006. The financial statements have been prepared under the historical cost convention.

The accounts have been prepared in pound sterling, which is the functional currency of the charity, rounded to the nearest pound.

The charitable company has taken advantage of the relevant disclosure exemptions in preparing the financial statements, as permitted by FRS 102.

Income

All income is recognised in the Statement of Financial Activities once the charity has entitlement to the funds, it is probable that the income will be received and the amount can be measured reliably.

Grants from the government and other agencies have been included as 'Grants' in furtherance of the charity's objects.

Expenditure

Liabilities are recognised as expenditure as soon as there is a legal or constructive obligation committing the charity to that expenditure, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all cost related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with the use of resources.

Tangible fixed assets

Depreciation is provided at the following annual rates in order to write off each asset over its estimated useful life.

Office equipment costing £1,000 or more is capitalised at cost and depreciated over it's estimated useful economic life of 3 years, on a straight line basis.

Taxation

The charity is exempt from corporation tax on its charitable activities.

Fund accounting

Unrestricted funds can be used in accordance with the charitable objectives at the discretion of the trustees.

Restricted funds can only be used for particular restricted purposes within the objects of the charity. Restrictions arise when specified by the donor or when funds are raised for particular restricted purposes.

Further explanation of the nature and purpose of each fund is included in the notes to the financial statements.

Pension costs and other post-retirement benefits

The charitable company operates a defined contribution pension scheme. Contributions payable to the charitable company's pension scheme are charged to the Statement of Financial Activities in the period to which they relate.

The charitable company operates a defined contribution pension scheme. Contributions payable to the charitable company's pension scheme are charged to the Statement of Financial Activities in the period to which they relate.

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ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2024

1. ACCOUNTING POLICIES - continued

Debtors

Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

Cash and cash equivalents

Cash at bank and in hand includes cash and short-term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

Creditors and provisions

Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount.

Financial instruments

The charity only has financial assets and liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

Derecognition of financial liabilities

Financial liabilities are derecognised when the company's contractual obligations expire or are discharged or cancelled.

Going concern

At the time of approving the accounts, the directors have a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future. Thus, they continue to adopt the going concern basis of accounting in preparing the accounts.

2. DONATIONS AND LEGACIES

Unrestricted funds £ Donations 244,323 Gift aid 17,026 261,349	Restricted funds £ 9,068 1,838 10,906	2024 Total funds £ 253,391 18,864 272,255	2023 Total funds £ 236,698 21,532 258,230

In the prior year, £252,231 of the income related to unrestricted funds and £5,999 to restricted funds.

3. OTHER TRADING ACTIVITIES

Unrestricted Restricted funds funds £ £ Script advice and speaker fee 1,060 -	2024 Total funds £ 1,060	2023 Total funds £ -

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ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2024

4. INVESTMENT INCOME

INVESTMENT INCOME
			2024	2023
	Unrestricted	Restricted	Total	Total
	funds	funds	funds	funds
	£	£	£	£
Bank interest	5,554	-	5,554	1,288

In the prior year, £1,288 of the income related to unrestricted fund and £nil to restricted funds.

5. INCOME FROM CHARITABLE ACTIVITIES

5. INCOME FROM CHARITABLE ACTIVITIES
Government Grants – Department for Health & Social Care Garfield Weston Foundation Voices From The Front/Rosa Other Trusts and Foundations Contract Income - Lancashire and South Cumbria NHS Foundation Trust Contract Income - Birmingham and Solihull Mental Health NHS Foundation Trust Contract Income - Black Country Healthcare NHS Foundation Trust Contract Income - Greater Manchester Mental Health NHS Foundation Trust Workforce Training and Experts by Experience Research contracts	2024 General £ 86,278 15,000 - 11,704 72,960 102,665 39,686 40,505 13,508 2,940 385,246	2023 Total activities £ - - 7,000 19,200 68,665 100,823 50,695 16,021 17,643 6,050
		286,097

In the prior year, £261,397 of the income related to unrestricted funds and £24,700 to restricted funds.

Grants received, included in the above, are as follows:

Government Grants Other Trusts and Foundations Garfield Weston Foundation	2024 £ 86,278 11,704 15,000 112,982	2023 £ - 19,200 - 19,200

Included within Government Grants noted above is a grant of £86,278 from the Department of Health and Social Care, restricted for use only towards a project called 'Reducing suicide in mothers with postpartum psychosis'

Apart from the annual Employment Allowance credit against Employers National Insurance, the charity has received no other financial assistance from the Government in this financial period.

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6. RAISING FUNDS

Raising donations and legacies

Raising donations and legacies
Unrestricted Restricted funds funds £ £ Staff costs 20,226 - Other fundraising costs 13,477 267 33,703 267	2024 Total funds £ 20,226 13,744 33,970	2023 Total funds £ 18,737 9,495
		28,232

In the prior year, £27,998 of the expenditure related to unrestricted funds and £234 to restricted funds.

7. CHARITABLE ACTIVITIES COSTS

General	Direct Costs (see note 8) £ 575,890	Support costs (see note 9) £ 8,770	Totals £ 584,660

In the prior year, £488,646 of the expenses related to unrestricted funds and £30,686 to restricted funds.

8. DIRECT COSTS OF CHARITABLE ACTIVITIES

Staff costs Recruitment and Health & Safety Consultancy Project costs Travel Information materials and awareness raising Volunteer training & expenses Office and running costs Workforce training and experts by experience costs	2024 £ 481,907 218 24,683 4,956 17,451 10,779 2,649 31,789 1,458 575,890	2023 £ 404,279 621 55,922 918 14,837 5,673 2,179 24,309 2,446
		511,184

9. SUPPORT COSTS

SUPPORT COSTS
	Governance
	costs
	£
General	8,770

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9. SUPPORT COSTS - continued

Support costs, included in the above, are as follows:

Support costs, included in the above, are as follows:
	2024	2023
		Total
	General	activities
	£	£
Independent examiners fee	2,370	2,310
Accountancy fees	5,884	5,559
Other fees	516	279
	8,770	8,148
NET INCOME/(EXPENDITURE)
Net income/(expenditure) is stated after charging/(crediting):
	2024	2023
	£	£
Depreciation - owned assets	610	-
Independent Examination Fee	2,370	2,310

10. NET INCOME/(EXPENDITURE)

Net income/(expenditure) is stated after charging/(crediting):

11. TRUSTEES' REMUNERATION AND BENEFITS

There were no trustees' remuneration or other benefits for the year ended 31 December 2024 nor for the year ended 31 December 2023.

Trustees' expenses

There were no trustees' expenses paid for the year ended 31 December 2024 nor for the year ended 31 December 2023.

12. STAFF COSTS

Wages and salaries Social security costs Other pension costs	2024 £ 437,723 30,913 33,497 502,133	2023 £ 384,988 24,612 13,416
		423,016

The average number of full-time equivalent employees during the year was 10.3. (2023: 9.8).

The average monthly number of employees during the year was as follows:

Core charitable activity	2024 16	2023 15

No employees received emoluments in excess of £60,000.

The total remuneration and benefits paid to the key management personnel, to whom the Trustees delegate the day-to-day running of the charity was £98,536 (2023: £55,767).

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13. TANGIBLE FIXED ASSETS

COST At 1 January 2024 and 31 December 2024 DEPRECIATION At 1 January 2024 Charge for year At 31 December 2024 NET BOOK VALUE At 31 December 2024 At 31 December 2023 14. DEBTORS: AMOUNTS FALLING DUE WITHIN ONE YEAR Trade debtors Other debtors Prepayments and accrued income 15. CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR Trade creditors Other creditors Accruals and deferred income	Office equipment £ 2,887 1,200 610 1,810 1,077 1,687 2024 2023 £ £ 19,232 52,191 125 - 43,666 11,725 63,023 63,916 2024 2023 £ £ 9,944 516 702 299 60,803 77,988 71,449 78,803

Deferred income includes income received during the period of £53,580 (2023: £38,186) which relates to services to be provided during the financial year ended 31 December 2025.

16. ANALYSIS OF NET ASSETS BETWEEN FUNDS

Unrestricted funds £ Fixed assets 1,077 Current assets 207,932 Current liabilities (71,449) 137,560	Restricted funds £ - 24,025 - 24,025	2024 Total funds £ 1,077 231,957 (71,449) 161,585	2023 Total funds £ 1,687 193,216 (78,803) 116,100

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17. MOVEMENT IN FUNDS

At 1.1.24 £ Unrestricted funds General Fund 112,321 Restricted funds National Peer Support - Diverse Communities Peer Support 3,393 Rosa Voices from the Frontline 386 Legal and Human Rights Project - DHSC Suicide Prevention - 3,779 TOTAL FUNDS 116,100 Net movement in funds, included in the above are as follows: Incoming resources £ Unrestricted funds General Fund 540,227 Restricted funds National Peer Support 26,598 Diverse Communities Peer Support - Rosa Voices from the Frontline - Legal and Human Rights Project 5,178 DHSC Suicide Prevention 86,278 Dads, Co-parents and Grandparents Peer Support in 2024 5,834 123,888 TOTAL FUNDS 664,115

Net movement At in funds 31.12.24 £ £ 25,239 137,560 18,918 18,918 (3,393) - (386) - 5,105 5,105 2 2 20,246 24,025 45,485 161,585 Resources Movement expended in funds £ £ (514,988) 25,239 (7,680) 18,918 (3,393) (3,393) (386) (386) (73) 5,105 (86,276) 2 (5,834) - (103,642) 20,246 (618,630) 45,485

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17. MOVEMENT IN FUNDS - continued

Comparatives for movement in funds

Unrestricted funds General Fund Restricted funds Dad's and Co-parents Peer Support in 2023 Diverse Communities Peer Support Rosa Voices from the Frontline TOTAL FUNDS	At 1.1.23 £ 114,049 4,000 - - 4,000 118,049	Net movement in funds £ (1,728) (4,000) 3,393 386 (221) (1,949)	At 31.12.23 £ 112,321 - 3,393 386 3,779 116,100

Comparative net movement in funds, included in the above are as follows:

Unrestricted funds General Fund Restricted funds National Peer Support Dad's and Co-parents Peer Support in 2023 Digital Capacity Building Diverse Communities Peer Support NE Cafe Group Rosa Voices from the Frontline TOTAL FUNDS	Incoming resources £ 514,916 7,500 6,959 700 5,540 3,000 7,000 30,699 545,615	Resources Movement expended in funds £ £ (516,644) (1,728) (7,500) - (10,959) (4,000) (700) - (2,147) 3,393 (3,000) - (6,614) 386 (30,920) (221) (547,564) (1,949)

Unrestricted funds

The general reserve represents the funds of the charity which are not designated for a particular purpose.

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17. MOVEMENT IN FUNDS - continued

Restricted funds

DHSC Suicide Prevention Grant

APP was awarded a grant from the Department for Health and Social Care's (DHSC's) Suicide Prevention Fund (£123,668 for expenditure from January 2024 to March 2025) for a project called Reducing suicide in mothers with postpartum psychosis and supporting bereaved families. The project aimed to help to prevent suicide nationally through a) delivering peer support services that reduce the risk of suicide in those affected by PP; b) raising awareness of postpartum psychosis, amongst health professionals, antenatal educators and expectant families; c) establishing a bereavement peer support service for partners and family members of those who die following PP; and d) providing staff and volunteers suicide awareness and bereavement training.

National Peer Support

APP received grants from two charitable foundations - The Garfield Weston Foundation (£15,000); and the D'Oyly Carte Charitable Trust (£6,000) - to support its national peer support project in 2024 and 2025. We also ran a Big Give match funding campaign to raise donations for this work. These grants and donations funded staff time on our national peer support work, training for our peer support staff and volunteers, and online and face-to-face café groups.

- Dads, Co parents and Grandparents Peer Support

In May 2024, APP ran a Big Give match funding campaign to raise donations for our work with dads, co-parents and grandparents. Our dads, co-parents and grandparents peer support project connects dads and co-parents whose partner has PP, and grandparents whose child, or child's partner has had PP, with trained volunteers who have 'been there', via telephone, video call or email support. A monthly group video call for dads and co-parents provides a supportive and informal group for partners to meet others, share what has helped them and their family through the experience and provide a friendly listening ear. A quarterly video call offers similar support for grandparents. Our peer support staff and trained dad, co-parent and grandparent volunteers also provide support on our online forum. Big Give fundraising income was spent on this project in 2024.

Diverse Communities Peer Support

APP successfully applied to the Big Give's Women and Girls Match Fund to run a match funding campaign in October 2023. The campaign raised more than £5,000, including match funding, for our work supporting and improving the mental health of women from Black and Asian backgrounds who experience PP and their family members. The diverse communities peer support project connects women with trained volunteers who use their personal experiences of PP from the perspective of a Black or Asian woman to provide telephone, video call or email support. Group calls, like our online meet-up for Muslim women who've experienced psychosis in the perinatal period, offer safe places for women to share what helped them and their family through PP. The donations were spent on the project in 2023 and 2024.

Legal and Human Rights project

In December 2024, APP ran a Big Give match funding campaign to raise donations for our work on legal and human rights issues faced by women and families after they experience PP. The donations will be spent in 2025 on work to develop web content based on the information gathered from our peer support survey and interviews in 2023 and 2024.

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17. MOVEMENT IN FUNDS - continued

Rosa Voices from the Frontline

In 2023, APP received a grant (£7,000) from Rosa's Voices from the Frontline fund to support our campaign to ensure all women in the UK who develop postpartum psychosis (PP) have access to a Mother and Baby Unit (MBU) from February 2023 to January 2024. The grant allowed us to make our case about the need for better MBU provision by highlighting the impact on women who aren't treated in an MBU and their families. We did this by showcasing families' voices across the year, galvanising public support through the media (digital, print, TV and radio) and bringing the human impact of inequality in service provision to life for both politicians and commissioners. We provided support for our Storytellers through café groups, particularly in Wales, Scotland and Northern Ireland. Women attending café groups were supported to place media stories, contact and influence local MPs and key decision makers, develop petitions and letters and work with other Third Sector organisations.

Dads & Co-parents Peer Support

In December 2022, The D'Oyly Carte Charitable Trust made a grant of £4,000 to support APP's Dads and Co-parents peer support project. In addition, APP successfully applied to the Big Give's Kind2Mind Fund to run a match funding campaign in May 2023. The campaign raised more than £5,000, including match funding, for the Dads & Co-parents peer support project. We also received an unexpected £1,500 payment from the Big Give which was to match the gift aid received on our 2023 Women & Girls match funding campaign. This earlier campaign had supported the entirety of our national peer support service, including the Dads & Co-parents work, so this extra funding was used for the Dad's & Co-parents work. The Dads & Co-parents Peer Support project connected dads and co-parents whose partner has PP with trained volunteers who have 'been there', via telephone, video call or email support. A monthly group video call for dads and co-parents provided a supportive and informal group for partners to meet others, share what has helped them and their family through the experience and provide a friendly listening ear. Our peer support staff and trained dad and co-parent volunteers also provide support on our online forum. The D'Oyly Carte Charitable Trust grant and Big Give fundraising income were spent on this project in 2023.

NE Café Group

In 2023, APP received a grant (£3,000) from the Sir James Knott Trust to continue running a peer support café group in the North East of England following the end our NHS contract in this region.

Digital Capacity Building

APP received a second grant for digital capacity building of £700 from The Big Give in 2023. We used this grant to continue exploring new ways using our social media to reach existing and potential new supporters, as well as developing our supporter newsletter systems and a new presentation template for our training.

18. EMPLOYEE BENEFIT OBLIGATIONS

The charity operates a defined contribution pension scheme. The assets of the scheme are held separately from those of the charity in an independently administered fund. The pension cost charge represents contributions payable by the charity to the fund and amounted to £33,497 (2023: £13,417) Contributions totalling £nil (2023: £nil) were payable to the fund at the balance sheet date.

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19. RELATED PARTY DISCLOSURES

Action on Postpartum Psychosis was hosted by the University of Birmingham until 31st December 2023. In the prior year, Action on Postpartum Psychosis paid a hosting fee to the University of £42,560. The charity received benefits from this relationship including meeting and office space.

In the prior year, the charity included an accrual of £28,496 representing the amount outstanding to the University of Birmingham at 31 December 2023, which has been paid in full in this financial year.

During the year, Trustees made donations to the charity totalling £3,450 (2023: £2,493).

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