17th December 2013
Charities and professional bodies launch new Wellbeing Plan to put maternal mental health on equal footing to physical health
Depression and anxiety among pregnant women and new mums is going under-treated due to lack of disclosure and poor continuity of care, according to new research with 2000 health professionals and 1500 women by organisations including the Royal College of Midwives and the Institute of Health Visiting (1).
In a shocking indication of the scale of unmet need, the report found that only 18% of patients fully disclosed their mental health concerns to their midwife or health visitor. The end result was that 40% of women with a perinatal mental health problem received no formal treatment or support at all (2).
The major barriers to discussion around mental health included:
- 31% of women did not disclose because they saw a different professional at every appointment
- 1 in 5 women did not disclose because they thought health professionals were too busy (21%)
- 44% of community midwives, and 18% of health visitors reported there was not enough time to discuss mental health at appointments
- 22% of health professionals felt that women wouldn’t want to discuss their mental wellbeing
- 59% reported that women themselves don’t talk about it enough in comparison to their physical health.
The report showed that while nearly all health professionals felt comfortable in raising the topic (97%), both patients and professionals felt that a lack of continuity of care, and lack of time in appointments, made it difficult to establish a trusting relationship within which women felt able to disclose mental distress.
In an added barrier to discovery and treatment, health visitors and midwives also felt that the tools for spotting mental health problems weren’t always sophisticated enough. Current NICE guidelines recommend the Whooley questions, but professionals felt that the two simple questions involved – whether a woman feels sad or has lost interest in things – were not sufficient to pick up on many symptoms of mental health problems. Furthermore, just 1 in 5 (22%) felt that they had good perinatal mental health services available in their area.
Midwives and health visitors also wanted more resources to facilitate discussion and treatment. Over half (55%) wanted better information on available support services, while 55% wanted resources to support discussion and 45% wanted access to a colleague who was a specialist in perinatal mental health.
Responding to the concerns and needs of health professionals, the report authors are today launching a new Wellbeing Plan (3) to help open discussions between patients and professionals, and plan support so that women’s perinatal mental health can be given the same attention as their physical health.
