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HV support services for Perinatal Mental Health may be worse than stated in press today

31st July 2018

Further to the story on the limited NHS support for Perinatal Mental Illness published by the Guardian today, which lays bare the poor quality of community services for new mothers, iHV reinforces those concerns and advises that today’s situation is likely to have deteriorated significantly since the audit was completed. The leaked report was compiled in Spring 2017 and uses data from 2016.

Dr Cheryll Adams CBE, Executive Director, iHV, said:

“The Institute of Health Visiting warns that the real state of health visiting support for mothers suffering with perinatal mental illness may be significantly worse than that found by the NHS Benchmarking  report 14 months ago, as there have been further cuts to the workforce and the development of a significant postcode lottery of service up and down the country.

“Health visitors across the country continue to strive to deliver an excellent service to children and families, and will do everything in their power to support mothers they find are affected. The challenge they face is that many no longer deliver a universal service after their 6-8 week contact, when depression and other mental illness may not yet have manifested itself.”

From the annual iHV State of Health Visiting survey 2017 (November 2017 and 1413 respondents), 51% reported cuts to HV posts, 16% reported cuts to their skill-mix team, 12% were awaiting news of the scale of expected cuts, or reported frozen posts and students not employed, only 22% said there had been no cuts where they worked.

In addition from the 2017 survey, 15% are always able to offer listening visits to mothers identified as experiencing postnatal depression, with 36% offering them mostly and 27% some of the time. This is worse than in 2015, when 27% were able to offer listening visits all of the time.

The 2017 survey results indicate that health visitors are increasingly focused on the most vulnerable children and families at the expense of the five mandated reviews, and that the Healthy Child Programme is being implemented in an increasingly ‘targeted’ manner, against its fundamental design principles of full access to it being the right of every baby born in England. The result is that HVs cannot be confident that they are identifying needs or providing early primary prevention. 60% state their ability to make a difference is hampered by ‘Focusing only on those most at risk [that] dilutes universal service’; rather, they are managing risk with children and families with known needs.